Member Mental Health and Substance Abuse Resources
Overview
At Blue Cross Blue Shield of Wyoming, we understand that the resources within our state for Mental Health and Substance Abuse (MHSA) services are limited. We want to provide members with tools to understand their benefits and to help them find a provider or facility that suits their needs. Deciding to reach out for MHSA help can be difficult, and we want to assist you.
Note: Prior authorizations may be required for the types of care listed below. For assistance with starting your prior authorization, please get in touch with our Mental Health and Substance Abuse Team at 844-946-6319 or contact your provider.
Understanding Your Benefits
Inpatient hospital care is covered based on the severity and needs of your condition. BCBSWY will cover this care like any other hospital stay under your coverage. If you have questions regarding your financial responsibility, like deductible, co-insurance, or co-pays, please call Member Services at 800-442-2376.
Detox care is covered based on the severity and needs of your condition. BCBSWY will cover this care like any other hospital stay under your coverage. If you have questions regarding your financial responsibility, like deductible, co-insurance, or co-pays, please call our Mental Health and Substance Abuse Team at 844-946-6319.
Note: Some BCBSWY plans restrict the number of days you can be admitted to care outlined below. Please call our Mental Health and Substance Abuse Team at 844-946-6319 to ensure you understand your coverage.
Residential treatment care is covered based on the severity and needs of your condition. BCBSWY will cover this care like any other hospital stay under your plan coverage. If you have questions regarding your financial responsibility, like deductible, co-insurance, or co-pays, please call our Mental Health and Substance Abuse Team at 844-946-6319.
Note: Take into consideration when selecting a facility for treatment that choosing an out-of-network provider may result in significant financial responsibility.
Partial Hospitalization care is covered based on the severity and needs of your condition. BCBSWY will cover this care like any other hospital stay under your coverage. If you have questions regarding your financial responsibility, like deductible, co-insurance, or co-pays, please call our Mental Health and Substance Abuse Team at 844-946-6319.
Note: When selecting a facility for treatment, choosing an out-of-network provider may result in significant financial responsibility.
Intensive Outpatient care is covered like any outpatient service like office visits, x-rays, and laboratory services. BCBSWY will cover this care if you have a diagnosis. If you have questions regarding your financial responsibility, like deductible, co-insurance, or co-pays, please call our Member Services at 800-442-2376.
Outpatient care is covered by your plan. There are services like office visits, counseling sessions, and drug testing. If you have questions regarding your financial responsibility, like deductible, co-insurance, or co-pays, please call our Member Services at 800-442-2376.
Some services your provider may suggest for you may require authorization. Before receiving any services from your provider, we recommend you speak our Member Services Department to ensure no authorization is required.
Examples of common services include:
Transmagnetic Stimulation (TMS), Electroconvulsive Therapy (ECT), and certain Medications.
Note: Telehealth services may be available to you. Please contact Member Services at 800-442-2376 for availability under your Plan.
BCBSWY is here to help you reintegrate after treatment into your community. Our mental health and substance abuse team can assist you in finding a facility or provider to meet your specific needs. For assistance call 844-946-6319.
If you need assistance regarding your treatment, from scheduling appointments, coordinating your care, or simply understanding what to ask, give us a call. You can also visit https://www.bcbs.com/SURC for support in your recovery journey.
- Look for a facility that is right for you.
- Consider the staff and treatment outline of the facility. Each program is different. Many programs use licensed professional providers like counselors and social workers, while others use behavioral technicians or peers for counseling.
- Make sure the services the facility provides are a benefit of your plan. Standard exclusions include:
- Wilderness programs.
- Lifestyle programs.
- Art therapy programs.
- Music therapy programs.
- Equine therapy programs.
- Hippotherapy programs.
- Therapeutic boarding schools.
- Consider the transition from your provider or facility to your daily life. Think about the difference in lifestyle and support systems. Upon transition from one care facility to the next, consider options in your area.
- Consider your family involvement. Can your family visit for visitation in the location selected?
- Consider the cost Out-of-network services can lead to significant costs. You may ask the facility you find on any website if they are in-network or contracted or participating with BCBSWY Shield plan in the state they are located. This confirmation will ensure you can use your in-network benefits for services.
What types of treatments are available?
Treatment options can vary depending on the severity of addiction and specific needs of the individual. It is recommended that you seek professional guidance on treatment from your doctor or a treatment provider. A clinical assessment is typically used to determine the recommended treatment option, but for general information, the following are some examples of potential options that may be considered.
Note: Check your benefit booklet or call our Mental Health and Substance Abuse Team at 844-946-6319 to determine your eligible treatments.
Involves a process with three essential components: evaluation, stabilization, and fostering readiness for and entry into a substance use treatment and recovery program.
Involves treatment and counseling for individuals that attend appointments at a treatment facility, but continue to live in their own homes.
Involves 24/7 treatment in a hospital or clinic where the individual is admitted and may stay for multiple days or multiple weeks.
Involves an individual living at a facility and receiving treatment that runs over a longer course of time, such as a month or a full year.
Involves treatment and counseling services delivered remotely (over the phone or the internet) to an individual, especially when local treatment resources are not readily available.
Involves the use of FDA-approved medications, in combination with counseling and behavioral therapies, to provide a “whole-patient” approach to the treatment of substance use disorders. Click here for more information about medications used to treat Opioid Use Disorder.
Provider Resources
Your provider or facility should submit authorization through Availity. Our clinical staff will review your admission for medical appropriateness through our clinical criteria set. This could take up to 14 calendar days. If you have any questions or concerns, please our Mental Health and Substance Abuse Team at 844-946-6319.
- Inpatient Hospital Care
- Detox Care
- Residential Treatment Care
- Partial Hospitalization Care
- This type of care may require an authorization request.
You may visit Availity to submit an authorization request, or you may fax the authorization request to 307-432-2917.
