Florida Blue Coverage for Mental Health & Addiction Treatment
Florida Blue subscribers may be eligible for coverage for drug rehab, alcohol rehab, mental health services, and other rehabilitation services. Although this is not guaranteed, it is always best to check your coverage before seeking any form of rehabilitation services.
What Florida Blue members should know:
- Verify Coverage Quickly
- No Obligation
- Confidential
Does Florida Blue Cover Drug & Alcohol Rehab?
Plans offered by Florida Blue generally include behavioral health and substance abuse treatment as covered benefits. This is because the Affordable Care Act recognizes behavioral health and substance use disorder treatment as essential health benefits.
The extent of coverage for treatment of drug and alcohol addiction may differ based on whether the rehab center is in-network or out-of-network, the type of plan chosen from Florida Blue, and the nature of the treatment needed. In most instances, prior authorization or medical necessity may be required for services such as inpatient treatment and medical detox.
Due to the different types of plans offered by Florida Blue, there may be variations in benefits among the marketplace plans, employer-sponsored plans, and other types of plans.
What Addiction Treatment Services May Be Covered by Florida Blue?
Insurance coverage under Florida Blue plans may include several services that are deemed necessary for addiction recovery.
Medical Detox
Medical detox is often the first phase of treatment for individuals struggling with substance use dependency. Detox services may be included under Florida Blue plans, provided that medical professionals deem that such services are medically necessary for the detoxification process.
Inpatient / Residential Rehab
Inpatient care involves around-the-clock care and structure, treating both substance abuse and mental health disorders simultaneously.
Residential services may be included depending on the severity, previous treatment, and approval for authorization.
Partial Hospitalization Programs (PHP)
PHPs offer intensive treatment services during the day while allowing the patient to go home at night. Some Florida Blue plans may offer partial hospitalization programs as a step-down service from inpatient services.
Intensive Outpatient Programs (IOP)
Intensive Outpatient Programs offer therapy sessions on multiple days per week within a structured environment and may be eligible for coverage when inpatient services are not deemed necessary.
Telehealth Intensive Outpatient Programs (IOP)
Certain plans offered by Florida Blue may include coverage for telehealth IOP services when medically necessary. Online intensive outpatient programs provide organized addiction and mental health treatment via secure online sessions. Banyan Treatment Center can help you determine your benefits coverage for telehealth.
Standard Outpatient Treatment
Outpatient rehab programs offer therapy and other support services. Florida Blue may offer coverage for an outpatient rehab program within a substance abuse or behavioral health plan.
Aftercare/ Continuing Care
Aftercare services such as relapse prevention planning and long-term recovery support may also be included, depending on the individual's insurance plan.
Note: Length of stay and level of care are typically determined by medical necessity and clinical evaluation.
Does Florida Blue Cover Mental Health Treatment & Therapy?
Florida Blue insurance plans typically include coverage for mental health services, which are often integrated into addiction treatment programs.
Coverage may include:
- Individual therapy and counseling
- Group and family therapy
- Dual diagnosis treatment
- Ongoing mental health support
Florida Blue plans may also provide benefits for psychiatry and medication management, including evaluation, prescription medications, and monitoring as clinically indicated.
Inpatient Mental Health Coverage
Inpatient mental health treatment may be included in many Florida Blue plans, which can include residential treatment for serious mental health issues or dual diagnoses. Prior authorization and medical necessity may be required.
How Much Does Rehab Cost With Florida Blue?
The cost of rehab with Florida Blue will depend on the coverage details of the plan. While Florida Blue may cover a large portion of addiction treatment services, out-of-pocket costs will depend on the individual plan benefits.
Factors That Affect Your Out-of-Pocket Cost
- In-network vs. out-of-network providers
- Deductibles, coinsurance, and copays
- Prior authorization and medical necessity review
- Level of care (medical detox, inpatient treatment, outpatient treatment)
- Location, state regulations, and plan type
What You Can Do Right Now
Banyan Treatment Center can assist you with determining your Florida Blue insurance benefits prior to admission. When possible, we can provide you with an estimated cost based on your insurance plan.
If You Call Florida Blue Directly, Ask:
- Is medical detox covered?
- Are inpatient or residential programs covered under my plan?
- Is PHP or intensive outpatient programs covered?
- Do I need prior authorization?
- Do I need a referral (HMO plans)?
- Is this facility in-network?
- What are my deductibles, coinsurance, and copays?
- Are there any restrictions on days, sessions, or visits?
Or, We Can Verify for You (Recommended)
- We contact your insurance provider directly
- We review coverage details and medical necessity requirements
- We explain the benefits clearly and confidentially
How to Find Treatment That Accepts Florida Blue
"Accepting" Florida Blue could mean that a facility is in-network or that they offer out-of-network benefits, depending on the insurance plan.
Getting Matched to the Right Level of Care
A clinical evaluation is also useful in identifying the best treatment program depending on the level of substance use and mental health.
Next Steps: Check your Florida Blue benefits or contact an admissions representative today.
Frequently Asked Questions
- Banyan Pompano
950 N Federal Hwy
Pompano Beach, FL 33062 954-866-4486 - Banyan Stuart
201 SE Osceola St
Stuart, FL 34994 888-422-2139 - Banyan Sebring
1062 Lake Sebring Dr
Sebring, FL 33870 888-659-7463 - Banyan Gulf Breeze
4400 Hickory Shores Blvd
Gulf Breeze, FL 32563 - Behavioral Health of the Palm Beaches
7859 Lake Worth Rd
Lake Worth, FL 33467 888-432-2467
Coverage varies by Florida Blue plan and state. Insurance verification is required to confirm eligibility and benefits.
Verify Your Florida Blue Insurance Benefits Today
Specific benefits may vary depending on the insurance carrier, type of policy, and specific location. Banyan Treatment Center is here to assist you in determining your benefits through Florida Blue and what would be appropriate care.
Banyan Facilities for Drug, Alcohol, & Mental Health Treatment
Banyan Castle Rock
Located in Castle Rock, CO
Substance Use Inpatient
Mental Health Inpatient
Telehealth Virtual IOP
Banyan Heartland
Located in Gilman, IL
Substance Use Inpatient
Mental Health Inpatient
Substance Use Outpatient
Telehealth Virtual IOP
Banyan Palm Springs
Located in Cathedral City, CA
Substance Use Inpatient
Telehealth Virtual IOP
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