Blue Cross Blue Shield (BCBS) Intensive Outpatient (IOP) Coverage for Mental Health & Addiction Treatment

What Disorders Can Be Treated At An IOP/Outpatient Treatment Center?

IOP and outpatient treatment centers can address a wide range of disorders, including substance abuse and mental health disorders. These programs offer flexible treatment options that allow individuals to receive intensive therapy while maintaining their daily responsibilities. The following sections will detail some specific disorders that can be treated in these settings.

How Much Do Intensive Outpatient Programs (IOP) Cost With Health Insurance Coverage?

The cost of intensive outpatient programming is dependent on the care that you receive, and your health insurance coverage. There are notable differences found among different insurance providers and the state in which you live regarding coverage options. These differences can significantly change the out-of-pocket costs that you can expect to pay for addiction treatment programming.

As an example, some policies require that you use an in-network treatment provider to use your insurance, whereas others allow you to access care from out-of-network providers. The details of your insurance plan will provide you with some clarification into the out-of-pocket costs you can expect, including your copayments, deductibles, and coinsurance. Since insurance plans provide customized plan options, it is difficult to say what your financial responsibility would be for an IOP program. Because of this, we encourage you to contact the Harmony Substance Abuse and Recovery Group or complete our online verification form, to learn more about your expected costs for IOP and outpatient programming. 

How Much Do Outpatient Programs Cost With Health Insurance Coverage?

The cost associated with outpatient treatment programs varies for the different levels of care and aspects of programming that you receive. As an example, intensive outpatient programs can be described as a more intensive, and often frequent, treatment option than other outpatient programs which helps explain why it often costs more than general outpatient programming. 

The National Center for Drug Abuse Statistics reported that the average cost for an IOP program can run between $500 and $650 per day, totaling an average of $17,250. This price can fluctuate based on where you are within the U.S. receiving care, and if you participate in any specialized treatment services. General outpatient programming often ranges from $1,400 to $10,000 per month. This care option ranges significantly because it is customized to your unique needs, and can include one to several, treatment sessions each week, which would affect the cost of care. Similar to IOPs, individuals who participate in specialized programs, such as dual diagnosis care or receive medication management services, outpatient care tends to cost more compared to those who don’t. Generally, outpatient programs are a more affordable option when compared to inpatient treatment programs.

Factors That Influence The Cost of IOP or Outpatient Programs

The cost of intensive outpatient programs and outpatient programs is influenced by several factors, including the severity and type of addiction, program duration, and the intensity of your program. Additional treatment features including medical services and staff expertise, facility amenities, location, and insurance coverage also play significant roles.

• Severity and Type of Addiction: Individuals living with severe substance use disorders often have greater impairment, and require intensive treatment programming to reach their recovery goals and improve their psychological well-being. 

• Program Duration: Treatment programs that have a longer duration tend to have higher costs to account for the additional treatment experiences you have. For outpatient programs, this would be apparent when you change the number of therapy sessions you attend each week.

• Intensity of Treatment: More intensive treatment options, such as IOP sessions, programs with frequent sessions, or specialized therapies tend to have higher costs associated with them.

• Medical Services and Staff Expertise: Programs with a multidisciplinary staff of qualified medical professionals and therapists with specialties, tend to have higher fees compared to programs that do not offer specialized options.

• Facility Amenities and Accommodations: Treatment centers that have a luxurious facility, or provide access to additional amenities tend to have higher costs for their treatment options.

• Location: There are notable differences among programs in different areas in the U.S., as an example, programs in metropolitan or high-cost areas often come with higher price tags.

• Insurance Coverage: The details of your insurance coverage can either reduce or increase out-of-pocket expenses for you, depending on the details of your insurance plan. Verifying your insurance with a treatment provider can help you understand more about what you can expect to pay for treatment.

Are There Payment Options For IOP and Outpatient Treatment?

Yes! If you find yourself concerned about the cost of treatment programs, we encourage you to review payment options that may be available to you. Many treatment centers offer several payment plan options to help you access the care you need for lasting recovery. Examples of some of the commonly used payment plan options include:

• Health Insurance: You can utilize private and government insurance programs for many treatment programs, including both intensive outpatient programs, and general outpatient care. Blue Cross Blue Shield IOP coverage can reduce your out-of-pocket expenses, providing you with a more manageable deductible or premium for treatment.

• Out-of-Pocket Payment: If you have the means, you can pay for treatment out of pocket. This can occur all at once, or as you participate in various aspects of your behavioral health program. This is not a realistic option for all individuals, and that’s okay!

• Sliding Scale Fees: Sliding scale fees mean that the fee you pay for programming is tailored to reflect your income, making treatment a more affordable option. This is a commonly used payment plan among outpatient treatment providers. 

• Payment Plans: Payment plans include having a set payment that is paid routinely for a set period of time. Payment plans give you the opportunity to adjust your payments to your budget so that the cost of treatment aligns with your finances. 

• Employee Assistance Programs (EAP): EAPs are available with some employers, and can provide you with financial assistance for substance use disorder and psychiatric treatment options. Additionally, you may be able to receive support in finding treatment and returning to work from an EAP representative. 

• Government Assistance Programs: Medicaid and Medicare are examples of governmental-funded programs that can help cover the costs of IOP and general outpatient care, for qualifying individuals. 

• Family Support: Some individuals are in a situation where they can receive financial support from friends. Family can also be a vital source of support for those who are experiencing mental health and substance use disorders. 

• Scholarships or Grants: Some treatment providers and other organizations offer financial aid or grants to help cover treatment expenses for individuals who are experiencing financial hardships.