Does Premera Blue Cross in Washington Cover Mental Health Therapy and Treatment?

A MISSION FOR MICHAEL

13 minutes read
Psychologist writing notes during a mental health therapy appointment.

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Mental health concerns affect an estimated one in four adults in the United States. Psychiatric conditions can vary in symptoms and severity and generally benefit from personalized and comprehensive care. A Mission For Michael (AMFM) offers residential treatment programming within a safe and welcoming environment. We are located in Washington, California, and Virginia.

Our comprehensive programs offer treatment for a range of mental health and dual diagnosis conditions. This includes mood disorders, personality disorders, bipolar disorder, and schizophrenia spectrum disorder. We use various evidence-based therapies, holistic approaches, and wellness programs to provide care focused on improving your cognitive functioning and overall emotional well-being. For many, mental health treatment is accessible through health care policies, such as Premera Blue Cross. We will explore how health coverage can impact your treatment and the steps you can take to ensure that you use your coverage.

Who is the Insurance Provider Premera Blue Cross Washington?

Premera Blue Cross is a popular health insurance provider based in Washington, since 1933. Since its development, Premera has focused on providing cost-effective medical coverage for policyholders. Core values that they abide by include acting with urgency, challenging conventional methods, working together, and doing the right thing.

Premera operates under the Blue Cross Blue Shield brand. Blue Cross was originally developed to provide coverage options for hospital services, whereas Blue Shield focused on physician services. These two companies merged in 1982, now providing comprehensive insurance coverage options.

Premera BCBS serves over two million members. Examples of available products and services include individual and group plans, Medicare, Premera for Business, and Premera HMO. Within each of these categories, you can choose plans based on your medical and mental health needs, as well as your budget.

There are notable differences within available policies in the different areas of Washington State. Examples of group and individual plans that may be available include:

  • Preferred Provider Organization (PPO): PPOs allow you to see both in-network and out-of-network providers without obtaining a referral.
  • Exclusive Provider Organization (EPO): EPOs require policyholders to use in-network providers, generally except for emergencies.
  • Health Savings Account (HAS): A HAS is a tax-advantaged savings account linked to high-deductible plans. These funds can be used to pay for medical expenses.
  • Dental Coverage: Dental coverage often includes preventative, basic, and major dental care.
  • Health Maintenance Organization (HMO): An HMO requires you to choose a primary care physician, and see in-network treatment providers.
  • Medicare Advantage Plans: Also known as Part C, these are private insurance alternatives for traditional Medicare.

Health insurance companies typically provide insurance coverage for mental health treatment. Health plans can provide you with coverage for some, if not more, of the costs associated with treatment services for a range of mental health disorders. Your healthcare coverage may include counseling, therapy, and medication management services in both inpatient and outpatient treatment settings.

Health benefits are a component of the 2010 Affordable Care Act. This legislation requires that insurance companies offer health plan options for mental health treatment. There are notable differences among different insurance companies, which is why we encourage you to verify your insurance with an AMFM admission counselor.

Premera Blue Cross Blue Shield currently has 2.9 million members. They have spent an estimated 77 million dollars since 2017 to support local communities, including over 400 nonprofit organizations. Additionally, they have a service excellence score of 89.7%. In addition to serving Washington residents, Premera BCBS has been providing coverage to Alaska residents since 1952.

From 2017 to 2021, BCBS Premera had several social impact investments. This included rural healthcare, behavioral health and homelessness, grants and sponsorships, and health equity, respectively. In 2021 alone, Premera donated $6.9 Million to 86 nonprofit organizations. These nonprofit organizations were located in Alaska and Washington.

How To Check My Premera Blue Cross Coverage Levels for Therapy at AMFM?

The simplest and most efficient way to learn about the details of your healthcare policy is to complete our AMFM insurance verification form. This provides us with the information we need to contact BCBS Premera directly and learn about the bounds of your coverage. We will ask about your out-of-pocket expenses, limitations, exclusions, and required authorizations.

The admission counselors at AMFM are here to support you through the admission process. Call us today for personalized support.

Do Premera Blue Cross Policies Cover for Mental Health Therapy and Treatment?

Yes, Blue Cross Premera policies can provide insurance coverage for mental health therapy. Your Premera Blue Cross Washington therapy coverage may include inpatient and outpatient treatment services. This enables you to access treatment appropriate for a range of psychiatric conditions.

Your health benefits will comply with mental health parity laws. This ensures that you have equal access to mental health treatment for psychological health concerns. Premera BCBS prioritizes the needs of its policyholders by offering comprehensive health care policies. For help understanding the details of your insurance coverage and how it applies to mental health support options, dial (866)478-4383 today. Our admission counselors can also review various ways to pay for treatment if necessary.

Which Mental Health Treatment Programs Are Covered by Premera Blue Cross?

Premera Blue Cross Washington provides coverage for a range of wellness and mental health treatment programs. This allows you to access care appropriate for your symptoms, and current level of distress. Treatment programs vary in intensity, duration, frequency, and in the psychotherapy techniques used. Treatment options that are used to address the diverse needs of policyholders include:

Residential treatment programs are designed for those who are experiencing moderate to severe psychological distress. These are immersive and structured programs that offer therapy sessions, holistic approaches, and medication management services. You’ll learn about coping strategies and self-care practices that can improve your emotional well-being.

Premera BCBS works with health insurance providers who offer residential care services. Your coverage will be dependent on the details of your health policy.

Outpatient treatment programs provide flexible treatment options for those who are experiencing mild to moderate symptoms. Your treatment can include behavioral therapy, stress management techniques, and various mental health resources to help you navigate the day-to-day challenges of psychiatric conditions.

BCBS Premera often provides coverage for members who require outpatient therapy. Some outpatient services may require a prior authorization. Additionally, your policy may have specific health insurance deductibles, copays, and premiums.

Partial Hospitalization Programs (PHPs) are available in some outpatient treatment facilities. These programs provide you with intensive day treatment while allowing you to return home in the evenings. It is commonly used for mood disorders, trauma-related disorders, and some personality disorders. These programs can be used as a bridge from inpatient care, to outpatient services.

Premera Blue Cross Washington treatment coverage can include PHPs. You may be subject to out-of-pocket expenses including health insurance premiums, copays, and deductibles.

Intensive Outpatient Programs (IOPs) are another intensive form of outpatient treatment, which is less intensive than a PHP. These programs are flexible, and often available in morning and evening sessions to accommodate your professional, academic, and other responsibilities. IOPs include several hours of group therapy multiple times each week, with supplemental individual therapy sessions.

Premera Blue Cross Washington mental health coverage can include IOPs. You may be required to obtain prior authorization for the health insurance claims process.

Treatment Centers That Take Premera Behavioral Health Insurance

A Mission For Michael (AMFM) has multiple treatment centers that take Premera Blue Cross Washington Health Insurance. We offer comprehensive residential care that includes a range of therapeutic approaches, holistic therapies, and wellness programs. We encourage you to dial (866)478-4383 to explore available treatments near you.

Mental Health Disorders Premera Behavioral Health Insurance May Cover?

Premera Blue Cross Washington does cover treatment for a range of mental health disorders. Mental health conditions are individualized and caused by several factors. Because of this, individualized care is needed to reach your ideal cognitive function. While this is not an exhaustive list, here are examples of psychiatric conditions Premera may cover: 

Depression

Depression is a mood disorder that can range from mild to severe, affecting many aspects of your life. Common depression symptoms include persistent feelings of sadness, guilt, and worthlessness. You may have a loss of interest in hobbies and other activities. Treatment for depressive disorders can occur in both inpatient and outpatient treatment settings. Blue Cross Blue Shield Premera typically provides coverage for depression health insurance claims. This may include counseling, therapy, medication management services, and other interventions.

Post-Traumatic Stress Disorder (PTSD)

Post Traumatic Stress Disorder (PTSD) is a mental health condition that can develop after witnessing or experiencing a traumatic event. Common symptoms include flashbacks, anxiety, hypervigilance, and avoidance symptoms. The emotional distress with this condition can range from mild to severe and may require intensive treatment. Trauma sessions can utilize DBT, TF-CBT, or EMDR. Premera Blue Cross coverage often includes coverage for PTSD treatment. Coverage includes counseling, medication management services, and evidence-based therapies.

Anxiety Disorder

Anxiety disorders are a grouping of mental health disorders that commonly cause excessive worry, fear, or nervousness. These conditions can range in severity and the challenges, they create in your daily life. Treatment approaches can vary based on the symptoms you're experiencing but may include CBT and exposure therapy. BCBD Premera medical insurance typically covers anxiety treatments. You may be subject to health insurance copayments and deductibles, based on the details of your health plan.

ADHD

Attention-Deficit/Hyperactivity Disorder is a neurodevelopmental condition that can lead to inattention, hyperactivity, impulsivity, or a combination of more than one. ADHD typically begins during childhood and can continue into adulthood. This condition can create challenges within academic, professional, and social settings. BlueCross BlueShield Premera typically provides coverage for ADHD treatment. Your plan may require that you stay within your health insurance network for treatment. Coverage often includes behavioral therapy and medication management services.

Bipolar Disorder and Cyclothymia

Bipolar disorder is a mood disorder that can lead to intense mood swings including mania, hypomania, and depressive episodes. Cyclothymia is another mood disorder, that causes mild symptoms that do not meet the criteria for bipolar disorder. Both mood disorders can have a significant impact on your overall level of functioning. Premera BCBS provides coverage for bipolar and bipolar-related disorders. Treatment for these conditions can include therapy, mood stabilizers, and specialized programs.

Borderline Personality Disorder (BPD)

Borderline Personality Disorder (BPD) is a personality disorder known for causing unstable moods, behavior, and relationships. These symptoms can be driven by an intense fear of abandonment. Impulsivity and other symptoms can lead to significant disruptions in your daily life and a pattern of unhealthy or unstable relationships. Treatment for BPD is typically included in your Premera BCBS health benefits. This allows you to get the support and care you need to improve your cognitive functioning and emotional well-being.

Psychosis

Psychosis is a condition associated with several mental health disorders including schizophrenia spectrum disorder, delusional disorder, and schizoaffective disorder. Psychosis is known for causing a disconnection from reality. This can occur with hallucinations, delusions, and impaired thinking. Psychosis is a serious mental health concern that can have a significant impact on your daily functioning, relationships, and health. Psychosis treatment is commonly included in the BCBS Premera healthcare plan. Coverage often includes inpatient care, medication management services, and therapy sessions.
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    We accept most major insurance providers and can check your coverage levels for you.

    If we are not an appropriate provider for care, we will assist in finding a care provider that can help. 

    How Much is Treatment with Premera Blue Cross Washington Health Insurance?

    Mental health treatment can vary in cost for those who have Premera Blue Cross Washington Health Insurance. Varying levels of care have different costs, due to the intensity, duration, and frequency of the care provided. Additionally, your healthcare coverage is based on the details of your plan. You may be responsible for health insurance premiums, deductibles, or copayments.

    You may be able to modify the details of your medical insurance during health insurance enrollment periods if you are expecting to engage in long-term treatment. During health insurance open enrollment, you can inquire about health insurance quotes based on your mental health needs. If you have been struggling with your mental health, we encourage you to contact an AMFM Mental Health Treatment Center for a free mental health assessment. This allows us to provide you with a personalized treatment recommendation, and begin supporting you through the admission process.

    mental health doctor holding hand of patient while giving psychological support to her during therapy

    How To Get My Premera Blue Cross Policy to Cover My Treatment

    The first step in accessing your Premera Blue Cross Washington therapy coverage is to understand your policy’s coverage details. Verifying your insurance can help you understand your specific mental health benefits, required authorizations, and network provider requirements. Additionally, your plan may also require prior authorization may be needed for some services.

    Your healthcare provider should be able to help you understand your insurance benefits. Additionally, they can help you submit your health insurance claims. This allows you to focus on your treatment, instead of worrying about the health insurance claims process. Contact AMFM today for support about using your health coverage.

    Coverage limits with Premera Blue Cross often depend on your health plan. As an example, some policies offer unlimited sessions, while others may cap benefits for certain therapies or programs. The best way to learn about limitations or exclusions associated with your coverage is to contact AMFM and ask for assistance verifying your insurance.

     We will help you understand the full scope of your coverage so that you can make an informed decision about your care. Call us today for support and guidance.

    • The National Institute of Mental Health reported that an estimated 15.4 million people were living with a serious mental illness, and over 59 million were living with any mental illness in 2022. About half of those living with a mental health condition during this time received treatment.
    • Women are more likely than men to engage in mental health treatment.
    • The National Alliance on Mental Illness (NAMI) reported that 10.6% of those living with mental illnesses in 2021 did not have access to health insurance
    • The cost of treatment is a significant barrier for Americans experiencing psychological distress.
    • Dual diagnosis conditions are a common experience for adults in the U.S. This commonly includes a depressive illness co-existing with an anxiety or substance use disorder.

    Check if your health insurance will cover the cost of mental health treatment.