Dealing with mental health issues can be tough, and figuring out health insurance and therapy coverage can feel overwhelming. But, with the right info, you can take charge of your mental health. Make sure your Blue Cross Blue Shield (BCBS) plan supports you.
This guide will help you understand BCBS therapy coverage. We’ll cover different plan types and the mental health services they offer. If you need individual therapy, family counseling, or specialized treatment, this guide will help you make smart choices and stand up for your health.
Key Takeaways
- BCBS usually covers various counseling and therapy services as part of their mental health care promise.
- Coverage details, like how many sessions and therapy types, can change based on the BCBS plan and state.
- BCBS needs providers to get pre-authorization to make sure the treatment fits your plan.
- Knowing your BCBS plan, including deductibles, coinsurance, and copays, is key to handling your costs.
- BCBS offers telehealth for easy access to mental health care, but it depends on your plan.
What is Blue Cross Blue Shield?
Blue Cross Blue Shield is a top health insurance provider in the U.S. It offers many insurance plans for people, families, and businesses. With its wide coverage, it’s one of the biggest insurers, including mental health services.
Overview of Blue Cross Blue Shield as a Health Insurance Provider
Blue Cross Blue Shield works through 35 independent Blue Cross and Blue Shield companies. Each one serves a specific area. This setup lets them make plans that really meet local needs. They aim to give affordable, quality healthcare, focusing on preventing illnesses and managing chronic diseases.
Different Types of Plans Offered by Blue Cross Blue Shield
Blue Cross Blue Shield has many insurance plans for different needs and budgets, including:
- HMO (Health Maintenance Organization) plans
- PPO (Preferred Provider Organization) plans
- EPO (Exclusive Provider Organization) plans
- Individual and family plans
- Employer-sponsored plans
- Medicare plans
- Medicaid plans
Each plan type has its own rules, network, and costs. This lets members pick the best plan for their health and budget.
Does Blue Cross Blue Shield Cover Therapy?
Yes, most Blue Cross Blue Shield (BCBS) plans cover therapy services. This is thanks to the Affordable Care Act (ACA). It makes sure that individual and small group health plans include mental health coverage.
Under the ACA, plans from the Marketplace or small employers must cover mental health and substance abuse treatment. This means BCBS members get access to important mental health services with their insurance.
Exceptions to BCBS Therapy Coverage
Even though BCBS usually covers therapy, there are some exceptions:
- If your BCBS plan started before 2014, it might not have therapy benefits.
- Large employer-sponsored BCBS plans don’t have to cover mental health by law, but many do it anyway.
It’s key to check your BCBS plan details to know what your therapy coverage includes. Look at the “Outpatient Mental Health” section of your Summary of Benefits to start.
“Blue Cross Blue Shield covers therapy for the vast majority of its plans, including mental health services required by the Affordable Care Act.”
How to Check if Your Blue Cross Blue Shield Plan Covers Therapy
Are you curious if your Blue Cross Blue Shield (BCBS) health insurance covers therapy? Start by looking at your Summary of Benefits. This document details your plan’s coverage, including mental health services like therapy.
Finding the “Outpatient Mental Health” Section
Search for the “Outpatient Mental Health” section in your Summary of Benefits. Here, you’ll find details on BCBS’s therapy and mental health service coverage. It should state if these services are covered and list any copays, deductibles, or other requirements.
Example of a Summary of Benefits
| Service | In-Network | Out-of-Network |
|---|---|---|
| Outpatient Mental Health | $20 copay per visit | 50% coinsurance after deductible |
| Inpatient Mental Health | $250 copay per admission | 50% coinsurance after deductible |
This example shows BCBS covers outpatient mental health services, like therapy, for $20 per visit with an in-network provider. For out-of-network, you pay 50% coinsurance after meeting the deductible.
By looking at your BCBS Summary of Benefits, you can see what’s covered for how to check if blue cross blue shield covers therapy and other mental health services.
blue cross blue shield therapy coverage
Blue Cross Blue Shield (BCBS) covers therapy services for mental health and behavioral health. The coverage varies by plan, but most plans include therapy for mental health issues.
BCBS of Texas covers substance use counseling and support for chemical dependency. Members can use virtual care services to talk to therapists or psychiatrists. This includes help for stress, child issues, and behavioral problems.
Headway helps BCBS members find therapists based on location and care type. Members can book appointments quickly. Learn to Live offers free support for anxiety and depression.
The ComPsych EAP gives counseling and work/life services to BCBS members and their families. It’s part of the BCBS network at no extra cost.
| Quality Goal | Patient Population |
|---|---|
| Ensure patients with schizophrenia taking antipsychotics stay on their medicine for at least 80% of their treatment time | Patients age 18–64 with schizophrenia |
| Ensure patients with cardiovascular disease and schizophrenia have a yearly low-density lipoprotein cholesterol (LDL-C) test | Patients age 18–64 with schizophrenia and cardiovascular disease |
| Ensure eligible patients are screened for diabetes yearly | Patients 18–64 years of age prescribed antipsychotic medications for schizophrenia or bipolar disorder without a diabetes diagnosis |
| Ensure patients with schizophrenia and diabetes have a low-density lipoprotein cholesterol (LDL-C) test and hemoglobin A1c (HbA1c) test each year | Patients between age 18–64 with schizophrenia and diabetes |
Blue Cross Blue Shield offers a lot of therapy coverage. Members can choose from many options, like in-person and online care, and self-help programs. The focus on quality care for mental health shows BCBS cares about its members’ well-being.
Costs of Therapy with Blue Cross Blue Shield
It’s key to know the costs of therapy with your Blue Cross Blue Shield (BCBS) plan. The cost can change a lot, depending on if you see an in-network or out-of-network therapist. The blue cross blue shield therapy cost varies a lot.
In-Network Therapy Costs and Copays
Choosing a therapist in the BCBS network means your therapy sessions cost between $15 to $50 per session, after you’ve met your deductible. This is your blue cross blue shield therapy copay. It’s the fixed amount you pay at each visit.
Out-of-Network Therapy Costs and Coinsurance
But, if you pick a therapist not in the BCBS network, costs go up. You’ll pay between $50 to $100 per session, or 20% to 50% of the full cost. This is your blue cross blue shield out-of-network therapy cost. You pay the full fee, and your plan covers the rest.
The final cost of therapy with BCBS depends on your plan, the therapist’s fees, and if they’re in-network or not. Always check your Summary of Benefits to know your coverage and what you might pay out-of-pocket.
Mental Health Conditions Covered by Blue Cross Blue Shield
Blue Cross Blue Shield (BCBS) covers many common mental health conditions. These include anxiety, depression, OCD, PTSD, bipolar disorder, and schizophrenia. Your therapist will give you a diagnosis and share it with your insurer if you’re using insurance for therapy.
BCBS plans offer a network of mental health experts. This includes therapists, psychologists, and psychiatrists. You can get help for substance use disorder both inpatient and outpatient. BCBS also has digital mental health tools and virtual care for easy access to therapy.
- BCBS plans cover common mental health conditions like anxiety, depression, OCD, PTSD, bipolar disorder, and schizophrenia.
- Therapists must give you a diagnosis and share it with your insurer when using BCBS coverage.
- BCBS plans give you access to mental health specialists, including therapists, psychologists, and psychiatrists.
- Coverage includes inpatient and outpatient support for substance use disorder.
- BCBS offers digital mental health tools and virtual care for easy therapy access.
“Blue Cross and Blue Shield of Illinois (BCBSIL) offers coverage for mental health counseling, psychiatric therapy, substance use counseling, Headway services, digital mental health resources, virtual care, and an Employee Assistance Program.”
The mental health conditions covered by BCBS can vary by plan and location. Always check your Summary of Benefits or contact your BCBS provider to know your mental health coverage details.
Types of Therapy Covered by Blue Cross Blue Shield
Blue Cross Blue Shield plans cover many types of therapy, including individual and child therapy. This ensures members get the help they need for mental health issues.
Individual Therapy and Child Therapy
Members can get individual therapy sessions with a licensed therapist. This is great for dealing with depression, anxiety, trauma, and relationship issues. Child therapy is also covered, helping kids and teens with their mental health.
Different Therapy Approaches
- Cognitive-Behavioral Therapy (CBT): This therapy is often covered. It helps change negative thoughts and behaviors.
- Psychodynamic Therapy: Many plans include this therapy. It looks into the deep emotional and psychological reasons behind mental health issues.
- Dialectical Behavior Therapy (DBT): This therapy is for those who struggle with managing emotions, self-harm, or suicidal thoughts. It’s often covered by Blue Cross Blue Shield plans.
Blue Cross Blue Shield makes sure members can get the mental health care they need. This helps improve their overall well-being.
| Therapy Type | Coverage by Blue Cross Blue Shield |
|---|---|
| Individual Therapy | Covered for treatment of a wide range of mental health conditions |
| Child Therapy | Covered for children and adolescents in need of mental health support |
| Cognitive-Behavioral Therapy (CBT) | Commonly covered as an effective, evidence-based approach |
| Psychodynamic Therapy | Many plans provide coverage for this depth-oriented therapy method |
| Dialectical Behavior Therapy (DBT) | Covered for individuals struggling with emotional regulation, self-harm, or suicidal ideation |
Therapy Not Covered by Blue Cross Blue Shield
Blue Cross Blue Shield (BCBS) covers many mental health services, including therapy. But, some types of therapy aren’t covered. Couples counseling is one example.
BCBS doesn’t cover couples counseling. It’s not seen as a treatment for mental health issues. Also, life coaching and career coaching aren’t covered. They’re not linked to treating mental health disorders.
BCBS might not cover therapy outside a therapist’s office. This is because off-site therapy can be riskier.
“Blue Cross Blue Shield is also unlikely to cover therapy sessions occurring outside the therapy office, due to the greater potential for risk involved.”
It’s key for BCBS members to check their plan details. They should know which therapies and services are covered. This helps them plan for any costs they might have to pay out-of-pocket.
Does Blue Cross Blue Shield Cover Online Therapy?
Yes, most Blue Cross Blue Shield insurance plans cover online therapy. Many chapters have teamed up with virtual therapy networks. This means members can get telehealth therapy sessions.
Partnerships with Online Therapy Networks
These partnerships mean members get blue cross blue shield online therapy coverage and blue cross blue shield teletherapy coverage. They can talk to licensed therapists and counselors through video sessions. These sessions are often just as affordable as seeing someone in person.
For instance, LiveHealth Online lets Blue Cross Blue Shield members book appointments with mental health pros from home. This is great for people in remote or hard-to-reach areas.
| Online Therapy Provider | Blue Cross Blue Shield Partnership |
|---|---|
| LiveHealth Online | Offers video therapy sessions covered by BCBS plans |
| GeoBlue | Provides telebehavioral health solutions for BCBS members overseas |
| Independence Blue Cross | Offers an online program to improve emotional well-being |
| Highmark BCBS | Introduced a digital tool to reduce hospital admissions for panic attacks |
With more people needing mental health help and the rise of online therapy, Blue Cross Blue Shield is boosting their support for virtual therapy. This makes it easier for people to get the help they need.
Does Blue Cross Blue Shield Cover Couples Counseling?
Blue Cross Blue Shield (BCBS) plans may not cover couples counseling. This is because relationship issues are not seen as a mental health condition. But, your BCBS plan might offer some coverage for couples therapy services.
BCBS of Illinois supports members’ mental health with their HMO plans. These plans have a $65 copay for therapy sessions. But, they usually don’t cover couples counseling, focusing on individual mental health instead.
However, some BCBS PPO plans might cover couples counseling partially. For instance, Couples Counseling Associates works with BCBS PPO plans. The coverage and costs depend on your plan, deductibles, and benefits.
If your BCBS plan doesn’t cover couples counseling, don’t worry. You can use a Medical Service Account or Flexible Spending Account to pay. Or, therapists like Dr. Sara Schwarzbaum might offer lower rates for out-of-network counseling.
Make sure to check your BCBS plan details, talk to your insurance, and work with your therapist. With some research and flexibility, you can find ways to support your relationship’s health affordably.
| Couples Counseling Coverage by BCBS | Details |
|---|---|
| HMO Plans | Usually do not cover couples counseling, focus is on individual mental health treatment |
| PPO Plans | May provide partial coverage for couples counseling, in-network providers available |
| Out-of-Network Providers | Can be covered, but reimbursement rates and out-of-pocket costs may be higher |
| Alternatives | Use Medical Service Account, Flexible Spending Account, or find discounted rates from therapists |
Even if Blue Cross Blue Shield doesn’t always cover couples counseling, there are ways to get help. Know your plan’s coverage, look into other payment options, and work with your therapist. This way, you can find support to make your relationship stronger.
Do You Need a Referral for Therapy?
When you want to get therapy covered by your Blue Cross Blue Shield (BCBS) health insurance, the rules for referrals change based on your plan type. It’s key to know these rules to make sure your therapy is covered and paid for.
Referral Requirements for Different BCBS Plan Types
If you have a Health Maintenance Organization (HMO) or Point-of-Service (POS) plan with Blue Cross Blue Shield, you’ll need a referral from your primary care doctor for therapy. You must see your doctor, talk about your need for therapy, and get a written referral before seeing a therapist.
But, if you have a Preferred Provider Organization (PPO) or Exclusive Provider Organization (EPO) plan, you don’t need a referral. You can see a BCBS-approved therapist without a prior authorization from your primary care provider.
Always check your Blue Cross Blue Shield Summary of Benefits to see if you need a referral for mental health services. This info is in the “Outpatient Mental Health” section of your plan documents.
| BCBS Plan Type | Referral Requirement for Therapy |
|---|---|
| HMO | Referral required from primary care physician |
| POS | Referral required from primary care physician |
| PPO | No referral required |
| EPO | No referral required |
Knowing the referral rules for your Blue Cross Blue Shield plan helps you get through the therapy coverage process smoothly. This way, you can get the mental health care you need without any surprises or delays.
Finding In-Network Therapists with Blue Cross Blue Shield
Finding mental health coverage can seem tough, but finding in-network therapists with Blue Cross Blue Shield (BCBS) is easier than you think. BCBS has many resources to help you find qualified providers in their network.
Using BCBS Provider Directory
Start by using BCBS’s online provider directory. This tool lets you search for mental health professionals in your area. You can look for therapists by specialty, location, and when they’re available. This way, you can find therapists who take your BCBS plan quickly.
Contacting BCBS Member Services
If you’d rather talk to someone, call BCBS member services. Their team can help you find therapists that fit your needs and preferences. They’ll give you a list of providers and details about coverage and costs.
Local BCBS affiliates also offer resources to find mental health providers in your area. These resources are great for finding therapists in specific areas like child therapy or couples counseling.
| Resource | Description |
|---|---|
| BCBS Provider Directory | Comprehensive online tool to search for in-network mental health providers |
| BCBS Member Services | Knowledgeable representatives who can assist in finding the right in-network therapist |
| Regional BCBS Affiliate Resources | Specialized resources for locating in-network providers in your local area |
Using these resources makes it easy to find blue cross blue shield in-network therapists. This way, you can get the care you need and use your BCBS plan fully.
Conclusion
Blue Cross Blue Shield is a top health insurance company. It offers great coverage for therapy and mental health services. If you need counseling, child therapy, or help for a mental health issue, they often have you covered.
It’s important to know what your plan covers. Find providers in your network and understand how to file claims. This way, you can get the most out of your mental health benefits with Blue Cross Blue Shield.
Blue Cross Blue Shield is working hard to make mental health services more accessible. They use telehealth, support primary care, and add more providers to their network. These efforts show they care about giving people the support they need for mental health.
When looking at your Blue Cross Blue Shield plan, think about your mental health. Use the therapy and counseling options they offer. This can help you stay healthy and support your mental well-being.
Knowing about your mental health coverage with Blue Cross Blue Shield is key. It helps you get the care you need and manage mental health issues. With this knowledge, you can take charge of your health and well-being.
FAQ
What is Blue Cross Blue Shield?
Blue Cross Blue Shield is a big health insurance company in the U.S. It covers one in three Americans. They offer many insurance options, like plans for individuals, businesses, Medicare, and Medicaid.
Does Blue Cross Blue Shield cover therapy?
Yes, most Blue Cross Blue Shield plans cover therapy. Plans from the Marketplace or small employers must include mental health services by law.
How can I check if my Blue Cross Blue Shield plan covers therapy?
Check if your plan covers therapy by looking for “Outpatient Mental Health” in your Summary of Benefits. You can find this by logging into your Member Services portal, calling member services, or checking your employer’s benefits portal.
What is the cost of therapy with Blue Cross Blue Shield?
Therapy with a Blue Cross Blue Shield in-network therapist costs – per session, after you meet your deductible. Therapy with an out-of-network therapist costs – 0 per session, or 20% – 50% of the full cost.
What mental health conditions does Blue Cross Blue Shield cover?
Blue Cross Blue Shield covers mental health conditions like anxiety, depression, OCD, PTSD, bipolar disorder, schizophrenia, and other mental health issues.
What types of therapy does Blue Cross Blue Shield cover?
Blue Cross Blue Shield covers many types of therapy, including individual and child therapy. They cover various therapy approaches like cognitive-behavioral therapy, psychodynamic therapy, and dialectical behavior therapy.
What types of therapy does Blue Cross Blue Shield not cover?
Blue Cross Blue Shield doesn’t cover services not related to a mental health condition, like couples counseling, life coaching, and career coaching. They also don’t cover therapy outside the office.
Does Blue Cross Blue Shield cover online therapy?
Yes, most Blue Cross Blue Shield plans cover online therapy. Many chapters have partnerships with online therapy networks, like LiveHealth Online, for virtual therapy sessions.
Does Blue Cross Blue Shield cover couples counseling?
No, Blue Cross Blue Shield usually doesn’t cover couples counseling. Relationship issues aren’t considered a mental health condition.
Do I need a referral to see a therapist with Blue Cross Blue Shield?
If you have an HMO or POS plan, you need a referral from your primary care doctor for therapy. But with a PPO or EPO plan, you don’t need a referral.
How can I find therapists in-network with Blue Cross Blue Shield?
Use the company’s online provider directory or call member services to find in-network therapists. Many local Blue Cross Blue Shield chapters also offer resources to help you find mental health providers in your area.