Does Florida Blue Cover Rehab in Florida?

Does Florida Blue Cover Rehab in Florida?floridarehab.net

Florida Blue plans generally cover medically necessary addiction treatment, including detox, inpatient and residential rehab, subject to your plan's network, deductible, coinsurance and pre-authorization rules. Florida Blue is the Blue Cross and Blue Shield company in Florida, so its members can generally use Blue network providers in Florida, and many out-of-state Blue members can too. The only way to know your exact coverage is a benefits check for your specific plan.

What's usually covered

Medical detox
Inpatient and residential treatment when medically necessary
Partial hospitalization and intensive outpatient programs
Outpatient therapy and medication management
Dual diagnosis care for co-occurring mental health conditions

Your rights under federal law

If your Florida Blue plan covers substance use treatment, the federal Mental Health Parity and Addiction Equity Act requires its copays, deductibles, day limits and prior authorization rules to be no more restrictive than for comparable medical care. Plans must share medical necessity criteria on request and explain any denial. Marketplace plans must cover substance use disorder treatment as an essential health benefit and can't set yearly or lifetime dollar limits on it.

Not sure what to do next?

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How to check your Florida Blue coverage

Call the member services or behavioral health number on your card, or have a treatment program verify benefits for you.
Ask whether the program is in network, and whether you have out-of-network benefits.
Ask whether pre-authorization is required for detox and residential care, and how many days are approved at first.
Ask about your deductible, coinsurance and out-of-pocket maximum.

Coming from another state?

Network rules depend on your plan type. HMO and EPO plans often limit coverage to in-network providers; PPO plans may include out-of-network benefits. Confirm before you travel. Read traveling to Florida for rehab.

Florida Rehab is not affiliated with Florida Blue. Coverage varies by plan; this page is general information.

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