Blue Cross Blue Shield Partial Hospitalization Addiction Program (PHP) in Tennessee

Exploring Local TN and its Favorite Local Spots

Middle Tennessee offers explorers a delightful blend of historical landmarks, cultural attractions, and natural beauty. Within Nashville, the notable sites include the Grand Ole Opry, Ryman Auditorium, and the Country Music Hall of Fame and Museum. Each of these pays homage to the role Nashville, Tennessee, plays in the history of country music.

Those who love nature will enjoy the Nashville Zoo at Grassmere, Percy Warner Park, Montgomery Bell State Park, and Old Stone Fort State Archaeological Park. Each offers abundant outdoor activities, including hiking and enjoying nature. The Cumberland Caverns offers an adventurous spelunking opportunity, while the Cheekwood Botanical Garden and Museum of Art showcase gardens and art collections, making it a perfect spot for tranquility and inspiration. For those who enjoy history, Andrew Jackson’s Hermitage and Belle Meade Historic Site offer a unique perspective on the area’s antebellum past.

Tennessee Info & Stats on Partial Hospitalization Programs and Health Insurance Claims

According to the Tennessee Department of Mental Health & Substance Abuse Services, the top three substances abused in Tennessee are opioids, alcohol, and marijuana. Data indicates that partial hospitalization programs are effective and the greater the number of follow-up visits and 12-step meetings, the better the outcomes measured by consistent abstinence. 

Medicare also covers partial hospitalization programs for people discharged from an inpatient hospital program or those who, in the absence of a PHP, would have a reasonable risk of being admitted to an inpatient program. Fifteen years of data show that treatment in a partial hospitalization program is a sensible alternative to residential care. In one study of 38 people with borderline personality disorder, researchers found that psychoanalytically oriented partial hospitalization programs had better outcomes than standard psychiatric care.

BCBS Insurance Brands, Services, and Product Offering Information

Blue Cross Blue Shield of Tennessee offers several types of healthcare plans to meet the needs of Tennessee residents. They offer several ways for members and non-members to get in touch and ask questions. The following are some of the plans that they offer.

• Individual and family plans: Individuals and families can sign up during open enrollment, which is typically from November 1 to January 15th of each year. This applies to plans that are offered through the Health Insurance Marketplace. Individuals can enroll in a new plan or change their existing plan. Certain life changes allow you to change the plan at any time during the year. Individual and family plans include free preventive care and screenings, coverage when you travel out of state, and discounts on health and wellness programs.
• Medicare plans: Blue Cross Blue Shield of Tennessee offers several Medicare Advantage and Supplement plans designed to meet the needs of a range of individuals. The plans include $0 drug and $0 medical deductibles, no referrals needed for care, and a wide choice of doctors and hospitals.
• Medicaid: Individuals with special health and budgetary needs may be enrolled in Medicaid. Blue Cross Blue Shield of Tennessee has a variety of BlueCare plans and programs to help manage Medicaid coverage. Plans include free preventive care and screenings, medical and behavioral healthcare, and prescription medications.
• Medicare and Medicaid plans: For individuals who are enrolled in Medicaid and eligible for Medicare, the Blue Care Plus plan helps you stay covered and manage your benefits including dental and hearing coverage, extra help with special needs, and transportation services.
• Employer and group plans: Blue Cross Blue Shield of Tennessee offers employer-sponsored healthcare plans that include medical, dental, and vision on one identification card. Members have access to one of the largest networks of physicians and specialists in Tennessee as well as discounts and savings.

What is the difference between BCBS TN Network S and P?

BCBS of Tennessee offers different network options for members, including Network S and Network P. Each is designed to meet various healthcare needs and budget considerations. Network S has a more restricted provider network, including a select group of hospitals and doctors. It’s cost-effective with lower premiums in exchange for more limited choices, typically suitable for people prioritizing lower costs.

Network P provides a broader range of hospitals and doctors. This network is generally more expansive and allows greater flexibility in choosing providers. Network S includes nearly the same physicians and hospitals as Network P, but Network P has more options.

Does BCBST Health Insurance Cover PHP for Drug & Alcohol Treatment in Tennessee?

Blue Cross Blue Shield Tennessee (BCBST) typically covers behavioral health services, including partial hospitalization programs (PHPs) for drug and alcohol treatment. This is part of the company’s mental health and substance use disorder benefits. However, the cost of php addiction rehab with BCBS insurance varies significantly depending on the individual’s health plan and policy details. 

When a PHP is medically necessary, it’s typically covered as part of the outpatient treatment coverage options in the insurance policy. PHP BCBS insurance coverage details vary based on multiple factors. Contact us for clarification.

PHP Treatment for Opioid (e.g., Heroin, Opiate, Prescription Painkillers) Addiction Covered by BCBST

Blue Cross Blue Shield of Tennessee (BCBST) generally offers coverage for PHP that treats opioid addiction, including dependencies on heroin, prescription painkillers, and other opiates. The treatment program typically includes medical detoxification for safe withdrawal from an addictive substance, medication-assisted treatment, therapy and counseling, education about addiction and recovery, and support groups to provide emotional support and shared experiences. 

As the PHP program concludes, individuals are transitioned into an aftercare program to support continued recovery. Coverage for opioid PHP addiction treatment typically falls under the mental health and substance use disorder benefits of your Blue Cross Blue Shield of Tennessee policy. You may need prior authorization before treatment can begin. The easiest way to verify your insurance coverage and estimate your out-of-pocket expenses is to call Freeman Alcohol and Drug Addiction Center.

PHP Treatment for Alcohol Addiction Covered by BCBST

Alcohol addiction is a chronic disease characterized by uncontrolled drinking and a preoccupation with alcohol. Partial hospitalization programs (PHP) for alcohol addiction are generally covered by BCBS of Tennessee under behavioral health services. PHPs provide an intensive level of care for those who don’t require 24/7 supervision but still need significant support and a highly structured setting to address alcohol dependency. 

Several key aspects of a customized PHP include a structured therapeutic environment with individual and group therapy and family therapy sessions. Medication management may be included when needed to manage withdrawal symptoms and prevent relapse. Individuals learn new coping skills and stress management techniques to maintain sobriety. Educational sessions are held about the nature of addiction and the tools for recovery that are common components of a partial hospitalization program.

PHP Treatment for Benzodiazepine (e.g., Xanax, Ativan, Valium) Addiction Covered by BCBST

Benzodiazepine addiction is a physical and psychological dependence on sedatives that results from long-term use beyond medical recommendation. Benzodiazepines may include Xanax, Ativan, or Valium. Partial hospitalization programs (PHP) for benzodiazepine addiction provide individuals with an intensive and highly structured outpatient environment.

Customized PHP may include medically supervised detoxification to help reduce the use of benzodiazepines gradually. Group therapy offers peer support and shared experiences while cognitive behavioral therapy helps individuals identify and modify their adverse behaviors and thoughts. Medication management may be used to manage withdrawal symptoms or co-occurring mental health issues while relapse prevention education is used to help individuals maintain their sobriety and prevent recurrence of benzodiazepine use.

PHP Treatment for Stimulant (e.g., cocaine, methamphetamine) Addiction Covered by BCBST

Addiction to stimulants involves a compulsive urge to use substances like cocaine or amphetamines. This leads to severe psychological and physical health issues. PHP treatment for stimulant addiction provides individuals with a comprehensive and structured approach to recovery while allowing them to live at home. A customized PHP typically includes intensive individual and group therapy sessions that focus on cognitive behavioral techniques to change drug use behaviors. 

Stimulant addiction is often accompanied by mental health conditions, including depression and anxiety. Psychiatric care is included to help monitor and manage these co-occurring mental health conditions. Educational workshops are used to teach individuals about the nature of addiction and strategies that can help manage cravings and avoid relapse. Customize PHP usually encourages support groups where people can share their experiences and skill-building workshops to help develop skills for stress management, emotional regulation, and healthy lifestyle choices.

PHP Therapy Options for Long-Term Addictions and Mental Health in Middle Tennessee

Long-term treatment typically includes programs that run from 30 days to 180 days. The 30-day programs are the shortest of the long-term options. They are often used for initial stabilization or to provide a transition between an inpatient stay and movement to an intensive outpatient program (IOP). The 30-day programs typically focus on crisis management, medication adjustment, and establishing a foundation for ongoing therapy. 

The 60-day and 90-day programs allow more time for comprehensive therapy and skill-building activities. During the 60-day and 90-day programs, individuals have a better opportunity to develop deeper therapeutic relationships, and the programs offer the extra support to cope with dual diagnoses. The 180-day or 6-month PHP is designed for individuals with more severe, long-term addiction and co-occurring mental health conditions. It allows for a gradual progression through the different stages of recovery and emphasizes relapse prevention and aftercare to develop a sustainable, healthy lifestyle.

PHP Treatment Options for Short-Term Addiction and Mental Health in Middle Tennessee

Short-term partial hospitalization programs offer greater flexibility and are designed for individuals who need support for dual diagnosis conditions on a more condensed timeline. These are ideal for people who need intense support and can then transition into an intensive outpatient program that allows them to maintain many of their work and family obligations. 

For example, a weekend PHP is tailored for those who need continuous treatment but cannot commit to weekday sessions five to seven days a week. Brief 3-day, 5-day, and 7-day treatment options provide a concentrated dose of therapy for initial stabilization and crisis intervention or for individuals who need a quick refresher on coping strategies. Slightly longer treatment duration is found in 10-day, 14-day, and 21-day treatment programs that also include individual and group counseling and possible family involvement. The extended time helps individuals develop and practice new skills to manage their conditions in a supportive environment.

Stats and Info on Substance Abuse and Mental Health Therapy Partial Hospitalization Programs in TN

• According to the Tennessee Department of Mental Health & Substance Abuse Services, the top three substances of abuse in TN are opioids, alcohol, and marijuana.
• Data indicates that while partial hospitalization programs (PHP) are effective, the greater the number of follow-up visits and 12-step meetings attended, the better the outcomes measured by consistent abstinence.
• Medicare covers partial hospitalization programs (PHP) for people discharged from an inpatient hospital treatment program and those who, in the absence of a PHP program, would have a reasonable risk of being admitted to inpatient hospitalization.
• The Tennessee Behavioral Health Safety Net provides coverage for TN residents who are three or older, have a qualifying mental health diagnosis, and have no behavioral health insurance.
• Fifteen years of data showed that treatment in a partial hospitalization program (PHP) was a reasonable alternative to inpatient or residential care, and was found to enhance social role functioning.
• One study of 38 people with borderline personality disorder determined that psychoanalytically oriented partial hospitalization programs had better outcomes than standard psychiatric care.
• A review of the literature revealed that high-risk transdiagnostic patients improved during partial hospitalization program treatment. A transdiagnostic diagnosis connects a group of mental health conditions, which increases the complexity of treatment.