Blue Cross Blue Shield Overview
Blue Cross Blue Shield is one of the oldest, largest health insurance organizations in America and has been offering its services to citizens since the year 1929. The organization consists of 36 independent health insurance companies across America and covers more than one hundred and six million Americans. The companies operate in all American states and can be sometimes referred to as “The Blues”. The organization has more than 17 million retirees, employees, and families enrolled in their network. Blue Cross Blue Shield Association (BCBSA) contracts with almost all hospitals nationwide and works closely with doctors and other medical staff in their communities to ensure quality healthcare is being provided. The company prides itself on its individualized approach to healthcare based on the needs of their members. Blue Cross Blue Shield also covers behavioral and mental health services and also covers substance abuse problems which include inpatient and outpatient treatment. The organization’s network is large and it may prove difficult to find a center for treatment. The company’s webpage can be used to search for providers in one’s vicinity.
Blue Cross Blue Shield Recovery Programs
The organization covers some substance abuse recovery programs. These include:
Many of the organization’s plans offer health coverage for medical detoxification if necessary as detox can be often times dangerous. This might include individuals suffering from alcohol, opiate, and benzodiazepine addiction. Patients are assisted with managing withdrawal symptoms while they are being monitored by experienced medical professionals. Sometimes, only a portion of the detoxification process is covered by Blue Cross Blue Shield.
Patients are usually given medication during this form of treatment for the improvement of recovery outcomes. In addition to behavioral models of therapy, drugs like Methadone and buprenorphine are often used to help patients as they quit opioid intake. If and when these drugs have been deemed necessary for treatment by the patient’s doctor, authorization is usually required for it to be covered. The doctor may also need to provide documents and information as proof of the necessity of the medication for recovery.
The organization usually only covers inpatient treatment when there is ample medical proof to show the necessity of this form of treatment. Depending on the individual plan, exact coverage details may vary. Also depending on the plan, the organization may pay for an unlimited inpatient program stay as long as patients are also paying their co-pay.
Most of the organization’s plans cover intensive outpatient rehab programs which may include group therapy, psychiatric care and other forms of treatment. The exact specifications of coverage may vary depending on the plan.
Blue Cross Blue Shield offers different plans with multiple tiers. Although the tiers vary depending on the state the client is located at, the four options similar to all. The price for each plan or program a client is registered into varies and such co-payments, deductibles, and amounts per coverage vary.
The Bronze Tier – High deductibles are in this plan but monthly premiums for this tier are low. This tier also provides 60% of coverage.
The Silver Tier – The deductibles are not as high as the bronze plan but not as low as the gold plan so it falls right in the middle, same for the monthly premiums. Around 70% of coverage is provided.
The Gold Tier – The deductibles are low in this plan and monthly premiums for this tier are quite high. Around 80% of coverage is provided.
The Platinum Tier – This tier is not available in all the locations, but they provide the highest premiums monthly, having deductibles that are low, and 90% or more coverage is provided.
Blue Cross Blue Shield Advantages
The location of the treatment center chosen and the professionals that will be in charge of the client determines the kind of payment/price of payment that will be made. If the client has an HMO plan, then the facility will assign such client to their HMO-contacted facilities and also if you the client has a PPO plan, there is a larger range of insurance providers for the facility to work with. Clients can also visit out-of-network insurance providers but it will be at a higher rate.
President and CEO
Scott holds a Bachelor’s degree in Health Administration from Purdue University and from Washington University (School of Medicine) a Master’s degree in Health Administration and planning as well. Before holding the position of president and CEO, he served in an executive position for four years with two years as COO (Chief Operating Officer) and before that, served as the Executive Vice President for Strategy, System Development, and Business Planning.
Chief Financial Officer/Executive Vice President
Robert holds a Master’s degree in Business Administration (MBA) from the Notre Dame University where he graduated magna cum laude and a Bachelor’s degree from the Miami University. Before working with the association, he held previous executive positions with a Health System’s Company called ProMedica. He served as Senior Vice President of Operations and Chief Strategist at the company.
Chief of Staff/ Executive Vice President
Jennifer holds a Bachelor’s degree from the Union College in New York majoring in economics and graduated cum laude and a Master’s degree from The University of Chicago majoring in health policy. She has worked with the organizations for over two decades (Joined in 1995) and prior to that, she worked for Northwestern Memorial Hospital where she held the position of Manager of Business Development.