Blue Cross Blue Shield of Massachusetts has been providing healthcare to customers in Massachusetts for more than eight decades. The company was founded in 1936 when a group of community leaders, healthcare professionals and businesses came together to create this organization, which was initially called “Blue Cross of Massachusetts.”
Blue Cross of Massachusetts offered healthcare insurance from the very beginning. In fact, it was the first organization to offer insurance coverage for hospital stays statewide. In 1941, Blue Shield of Massachusetts was established as a separate entity to offer coverage for doctor appointments. The two organizations merged into one entity in 1988.
Blue Cross Blue Shield of Massachusetts is a non-for-profit company. As of 2019, this organization had 2.9 million members in the state of Massachusetts.
Where is Blue Cross Blue Shield of Massachusetts Accepted?
Blue Cross Blue Shield of Massachusetts is available to residents of the state of Massachusetts. This insurance company is expansive and includes a significant number of in-network hospitals, clinics and individual providers for customers to choose from. For patients in search of addiction treatment, this means that Blue Cross Blue Shield of Massachusetts will cover treatment in a wide variety of places. In fact, the Blue Cross Blue Shield network includes more than 1 million physicians and 6,100 hospitals nationwide.
Exploring Blue Cross Blue Shield of Massachusetts Plans
Blue Cross Blue Shield of Massachusetts offers multiple plans with different price points and coverage structures. The specific plan you have will determine your coverage for addiction treatment programs. Some of the plans available from Blue Cross Blue Shield of Massachusetts are listed below.
Blue Cross Blue Shield of Massachusetts HMO Plans
Blue Cross Blue Shield of Massachusetts offers several different Health Management Organization (HMO) plans. These plans require subscribers to choose a primary care provider who will coordinate all care. For individuals in need of addiction treatment services, this means a referral from the primary care provider will be necessary.
At this time, Blue Cross Blue Shield of Massachusetts offers three different HMO plans: HMO, HMO Blue Select and HMO Options. Each of these plans has a slightly different structure.
Blue Cross Blue Shield of Massachusetts PPO Plans
Blue Cross Blue Shield of Massachusetts Preferred Provider Organization (PPO) plans allow subscribers to receive services from a large network of providers, including doctors, hospitals, clinics and other facilities. These plans provide the best coverage when in-network providers are selected, with more limited coverage available for providers outside of the network.
Blue Cross Blue Shield of Massachusetts POS Plans
Blue Cross Blue Shield Point of Service of Massachusetts (POS) plans are similar to HMO plans, but they allow subscribers to direct their own care. Two different options are available: Blue Choice and Blue Choice New England. While Blue Choice gives subscribers access to providers in Massachusetts only, Blue Choice New England covers several other nearby states as well. If you are in need of addiction treatment, this type of plan will give you more freedom in the choice of your program. However, you must still remain in your network.
Blue Cross Blue Shield of Massachusetts Indemnity Plans
Blue Cross Blue Shield of Massachusetts also offers indemnity plans. These plans are fee-for-service arrangements that allow you to choose any doctor or hospital of your choice. The plan will cover a specific portion of the costs of your medically necessary diagnostic or treatment services.
Blue Cross Blue Shield of Massachusetts Open Access Plans
Blue Cross Blue Shield of Massachusetts’ Open Access Plans are managed care plans that allow subscribers more freedom to choose their providers. However, when choosing providers, you must still remain within Blue Cross Blue Shield’s HMO network. When seeking addiction treatment, you won’t need a referral, but you will need to choose an in-network program to maximize your benefits.
Will Blue Cross Blue Shield of Massachusetts Cover Addiction Treatment?
If you are a Blue Cross Blue Shield of Massachusetts customer who needs addiction treatment, your plan will most likely cover this type of service. However, many different factors will impact the exact coverage you will receive, as well as the options you have when it comes to choosing a provider. Some of these factors include:
- The structure of your plan
- The length of time you will spend in treatment
- Whether your plan includes a network of preferred or exclusive providers
- Your deductible and/or copayment requirements
When trying to estimate the cost of your addiction treatment services, you will need to consider all of these factors. For the best results, speak directly with Blue Cross Blue Shield of Massachusetts about your coverage and requirements before you begin treatment.
Will I Need to Get Preauthorization or Precertification for Addiction Treatment?
Preauthorization and pre certification are procedures used by your insurer to verify that your addiction treatment is medically necessary and that the treatment will be covered by your insurance benefits. The need for preauthorization and precertification will depend on the specific requirements of your insurance policy.
Failing to get preauthorization or precertification when required can result in unexpected treatment expenses. For this reason, it is important to make sure you find out whether preauthorization or precertification is necessary for your addiction treatment program.
Find Out How Much Your Addiction Treatment Will Cost
If you have insurance coverage from Blue Cross Blue Shield of Massachusetts, the exact amount you can expect to pay for your addiction treatment program will depend on the type of plan you have, the specifics of your coverage and other factors. The program you choose will also play a role in determining your expenses.
Because so many different factors come into play, estimating the cost of treatment on your own can be a challenge. However, with our addiction treatment coverage tool, you can get a more accurate estimate of how much you can expect to pay.