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

National Doctor Hospital Finder

BCBSWY Doctor Finder

Visit Availity
Providers may submit authorization requests here.

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Wyoming Blue Circle of Excellence 

For Ambulatory Surgical Centers Knee and Hip Replacement

As part of our commitment to you, we established the Wyoming Blue Circle of Excellence program, a local designation program recognizing health care facilities that demonstrate expertise in delivering quality and affordable health care to meet your specialty care needs—safely, effectively and resulting in cost savings to you.

Powder River Surgical Center

906 W 6th St Ste C, Gillette, WY 82716 · (307) 696-8240

Networks include Blue Select, Wyoming Select, Wyoming Total Choice, Participating Provider

Frequently Asked Questions

Wyoming Blue Circle of Excellence (WYBCE) is a local designation program, awarded by Blue Cross Blue Shield of Wyoming, recognizing health care facilities that demonstrate expertise in delivering quality and affordable health care to meet consumers’ specialty care needs needs—safely, effectively, and cost-efficiently.

Blue Distinction Centers are required to have an intensive care unit (ICU) and an emergency room, neither of which are required for Wyoming Blue Circle of Excellence Centers. Wyoming Blue Circle of Excellence Center’s do not supersede Blue Distinction if your health plan requires services to be obtained at a Blue Distinction Center.  

Currently, total knee and hip replacement surgeries are the only procedures included under the Wyoming Blue Circle of Excellence Center program.

This program is available for all networks – Blue Select, Wyoming Select, Wyoming Choice, Wyoming Total Choice, and Participating Provider. To benefit from the cost savings, your procedure must be performed at a surgical center that is in your network.

If your deductible has been met for the year, you’ll benefit from additional cost-savings with any applicable coinsurance amounts.

Yes. The surgical facility could determine that your health conditions warrant additional safety measures, and you would be better managed at another location with an emergency department and/or intensive care unit. If this occurs, standard plan benefits would apply.

No, prior authorization is not required for knee and hip replacement surgeries.  

No. You will not be penalized for using another facility. However, you will not have access to additional cost-savings.

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Frequently Asked Questions

Table of Contents

Not Finding What You're Looking For?

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1-800-442-2376

Customer Service

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Using YourWyoBlue

What is the member site and how do I get there?

Your member site is the easiest way for you to manage your account electronically from your computer, laptop, or mobile device. You’ll be able to find the details of your plan, see how much you’ve spent, review claims information, get more ID cards, send us a secure message, and more.

With your member ID number, go to YourWyoBlue.com to register and see how easy it is to find the information you want, when you want it.

How long will I be able to access claims information online?

Claims information will be available at YourWyoBlue.com for up to 18 months, even if you cancel your plan.

Am I able to see claims for everyone who is on my plan?

For privacy purposes, you will see claims for you and your dependents under 18 years old. Your spouse and dependents 18 years of age or older can register to view their own information online.

Members Who’ve Enrolled through BCBSWY or Healthcare.gov

I signed up on Healthcare.gov or directly through BCBSWY. How do I find out when my health coverage is in effect?

There are three ways that you can confirm your health coverage with BCBSWY:

Mail – If you’re a new member, you will receive a confirmation letter after you enroll, which includes your plan’s effective date your member ID number. After that, you will receive two other mailings: your welcome kit and your member ID card.

Online – If you have your member ID number (which is included in your confirmation letter), you can find your coverage start date and view what your plan covers through your member account. Sign in or register at YourWyoBlue.com (to register, have your member ID handy).

Phone – Contact Member Services: 800-442-2376. Member services is available Monday – Friday, 8 a.m. to 5:00 p.m.

Will I get a new ID card with a new number if I change my plan during open enrollment?

No, if you are an existing member and decide to change your plan during open enrollment you will not get a new ID card and your member ID will stay the same.

If I don’t have any plan changes, how do I re-enroll from one year to the next?

Current enrollees who don’t update their application and enroll in a plan by the open enrollment deadline will be automatically enrolled in the same plan or one that matches as closely as possible. You are strongly encouraged to update your application, shop, and pick a plan that best suits your health care needs before the deadline.

When should I call the Marketplace for assistance and when should I call BCBSWY?

If you need to change your address, cancel your ACA plan or apply for financial assistance go to Healthcare.gov or call 800-318-2596. If you have a billing or claims issue call BCBSWY at 800-442-2376.

How can I make a payment and when is it due?

Payment is due by the 1st day of each month and posted the day it is received. You have several ways to make a payment. Note, we do not accept payments made using a credit card.

Online – Quick, Easy, Anytime
  • Sign in to your member account at YourWyoBlue.com
  • Click on the button on the home page that says “Pay my Premium” or click on the “Spending” tab
  • Make a one-time payment or set up auto (recurring payments)
Over the Phone – Automated, No Waiting, Self-Service
  • Call 844-570-5080 and pay with a debit or prepaid card, check or savings account
Mail
  • Pay with check or money order made to BCBSWY
  • Include your ID number on the check or money order
  • Send the payment stub with your payment

Blue Cross Blue Shield of Wyoming
PO Box 173704
Denver, CO 80217-3704

I received a bill, even though I’ve already paid it. Why did that happen, and how can I notify BCBSWY?

Similar to a utility bill, BCBSWY will mail your monthly bill to the address on your account on the 5th of every month prior to the date it is due (the 1st of each month). If you have already paid your bill, or you set up automatic payments, you don’t need to do anything. If you have questions about whether a payment has been received, please contact Member Services at 800-442-2376.

Why did I receive a past-due notice in the mail when I never received a first notice?

BCBSWY mails monthly bills on the 5th of every month prior to the date it is due (the 1st of each month)—if we don’t receive a payment by the due date, we will send a reminder. If you didn’t receive your first bill, please contact Member Services at 800-442-2376, so we can confirm your account information is correct.

How do I find what network I belong to?

If you’re unsure of your provider network login to your member account at YourWyoBlue.com or use the Find a Doctor tool by entering the first 3 characters of your member ID.

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Empowering members

As a member, you have the freedom to do more of what you love and spend less time on the other stuff.

Live The Journey

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What to Expect

Once you’re a member of BlueSelect, here’s what you can expect

What to Expect Once You Enroll

Processing Your Enrollment

Once you complete your application, several things happen at BCBSWY to ensure your enrollment is finalized and processed accurately. The details aren't important, but they take time - around two weeks. Sit back and relax knowing that we are handling your application with much care to ensure that your coverage with BCBSWY is in place when you need it, just as you expect.

ID Card

As soon as we finalize your enrollment, expect your BCBSWY ID Card(s) to show up in the mail. Helpful information about your new coverage will arrive separately. This information will be useful to you over time, so be sure to hang on to it.

Online Member Account

As a BCBSWY member, expect to find what you need online. As soon as you have your BCBSWY ID card, be sure to register on YourWyoBlue.com. to easily manage your account from home or on-the-go. See your claims and benefits, find a doctor, make a payment, print an ID card, get a picture of your health and more.

Make a Payment

There’s no rush. You can expect to find an invoice in the mail soon. The due date and information about payment options will be on your invoice, including paying online or over the phone.

Just for You

You come first! Expect professional service from experienced people right here in Wyoming. We’re available online, on the phone and from nine locations around the state. Always feel free to contact us. We are here for you!

Manage your account online anytime

Take advantage of 24/7 access to your personal coverage information.
Rx Tools for Members
Learn more about your prescription drug benefits.

What's inside YourWyoBlue Account?

Registering for your account puts you in control of your benefits and coverage. 

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What’s Inside YourWyoBlue?

Fast. Easy. Anytime.

Your member site makes it easy to manage your account from home or on-the-go using your desktop, phone, or laptop. Register for YourWyoBlue.com using the number on your new ID card.

Manage your account online anytime.

Log in or register for your online account. Your spouse and dependents 18 years of age or older can register for an account to view their own information online.

Putting you in Control

YourWyoBlue allows you to…

  • View your benefits
  • See real-time claims activity
  • Order or print more ID cards
  • Get your EOBs and Benefit Booklet
  • Find a doctor, urgent care or hospital
  • Access the pharmacy guide
  • Get a picture of your health
  • Send us a secure message
  • Search a library of health topics
  • Make a payment
  • Compare costs for care
  • Find forms
  • Access your FSA, HRA or HSA
  • Learn how your insurance works

Some tools may not be available based on your benefit plan.

Getting Started

Step 1: Have your new ID card ready.
Step 2: Go to YourWyoBlue.com 
Step 3: Click Register to sign up for your account today.

Your spouse and dependents 18 years of age or older can register for an account to view their own information online.

Need Help?

Download the YourWyoBlue registration guide.

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Ways to Pay

If you purchase your own health insurance, making a premium payment has never been so easy.

Take a look at the ways you can pay:

Online

  • Quick, Easy, Anytime.
  • Pay with a Checking or Savings Account.
  • Make a one-time payment.
  • Review your billing and payment history.
  • Change your method of payment.
  • Set up auto recurring payments and notifications by text and email.

Over the Phone

  • Automated, No Waiting, Self-Service.
  • Pay with a Debit or Prepaid Card, Checking or Savings Account.
  • Make a payment for premiums: 844-570-5080, anytime it’s convenient for you.

By Mail

  • Pay with a check or money order made to BCBSWY.
  • Include your ID (Contract) Number on the check or money order.
  • Send the payment stub with your payment.

Bank Bill Pay

Send Payment to…

Blue Cross Blue Shield of Wyoming
PO Box 173704
Denver, CO 80217-3704

Important Reminders
  • Payment is due by the 1st day of each month.
  • Payment is posted the day it is received.

Manage your account online anytime

Take advantage of 24/7 access to your personal coverage information.
Rx Tools for Members
Learn more about your prescription drug benefits.

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How to Understand Your Claim

When you receive health care services, the charges are submitted to BCBSWY and processed by us according to your benefit plan. This process generates a claim and an Explanation of Benefits (also called an EOB). An EOB is a document designed to help you understand how your claim was processed and how much of the charges are your responsibility. Check out the Explanation of Benefits Guide.

Your EOBs are available from your account at YourWyoBlue.com 

If you have questions about your claim, please contact Member Services at 800-442-2376. For steps to submit an appeal request, please refer to our Appeals Q & A.

Manage your account online anytime

Take advantage of 24/7 access to your personal coverage information.

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How to Add a Family Member to Your Coverage

The steps you take will depend on whether you purchased your insurance coverage directly from Blue Cross Blue Shield of Wyoming, through the Health Insurance Marketplace, or you receive coverage through your employer.

Contents

I purchased coverage directly from BCBSWY

To add a family member to your coverage, log in to YourWyoBlue.com and select the SHOP tab at the top of the page. In most cases, you have a set amount of time to do this:

Birth of a Child?

You have within 61 days of the newborn’s date of birth to add a newborn child to your coverage.

Adoption of a Child?

You have within 61 days of the earliest date of either the petition file date, or the child’s date of entry into your home, to add an adopted child to your coverage. Please note: The adoption or legal guardianship papers must be provided.

Getting Married?

You can add your new spouse to your coverage before or after getting married as long as it’s within 30 days after the date of marriage.

For more information about enrollment periods, please review your Benefit Booklet by logging in to your account at YourWyoBlue.com. 

I purchased coverage through the Health Insurance Marketplace

Go to healthcare.gov  or call the Marketplace at 1-800-318-2596 to determine if you are eligible for a special enrollment period.

If you are eligible for a special enrollment period because you had a baby, adopted a child or got married, you have 60 days after the life event to add a family member to your coverage.

For more information about enrollment periods, please review your Benefit Booklet by logging in to your account at YourWyoBlue.com. 

I receive coverage through my employer

Review your Benefit Booklet or ask your Human Resources department or Group Leader for details about adding a family member to your coverage.

Manage your account online anytime

Take advantage of 24/7 access to your personal coverage information.
Rx Tools for Members
Learn more about your prescription drug benefits.

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How to Fill Your Prescription

Blue Cross Blue Shield of Wyoming has over 55,000 pharmacies in our network to make filling your prescription fast and easy, but how can you decrease unnecessary out-of-pocket expenses when it comes to your medications?

Here are some tips that can help you save money on your prescriptions.

Contents

Register with MyPrime

Registering with MyPrime is easy and only takes a few minutes! You will need to have your Blue Cross Blue Shield of Wyoming insurance card with your Member ID number.

Once you have registered and sign in with the username and password you create, the tools on the website will be tailored to you and your insurance coverage.

Prime Therapeutics (Prime) is an independent company that administers the pharmacy coverage for Blue Cross Blue Shield of Wyoming members in a role known as a Pharmacy Benefit Manager.

Ask your doctor about generic medications

Don’t be afraid to ask your doctor about generics. Generic medications are considered to be comparable to brand name medications in many ways. Ask your doctor to write prescriptions allowing substitution with a generic, if available. Taking generics is one of the most important things you can do to control costs.

Not only do generics save you money at the pharmacy (sometimes more than 85%), but they help hold down insurance premiums in the future. Use the Drug Cost Estimator to see the difference in cost for your brand name medication and its generic option.

Check the Preferred Drug List

When your doctor prescribes a medication, he or she should try to use medications that are included on the Preferred Drug List (also known as the Formulary or Prescription Drug List). Medications on this list have been selected to give you the best results while saving you the most money. You can use a medication that is not on the list, but you may pay more.

Check to see if the medication needs to be pre-certified

Certain medications may need to be pre-certified before they will be paid for by your health care coverage. If you do not have necessary pre-certification, it may result in a denial or reduction in the coverage for your medication. You should review your benefit document for details about pre-certification.

If a medication on the Preferred Drug List needs to be pre-certified (pre-authorized), there will be a column indicator. All medications on the Specialty Pharmacy Drug Management List need to be pre-certified.

Use an in-network pharmacy

In order to get the most from your insurance coverage, choose a pharmacy that is in our network. This will make filling your prescription easy and help you avoid unnecessary out-of-pocket expenses.

Use your membership card at the pharmacy

At a participating pharmacy simply show your BCBSWY member identification card to the pharmacist. Your prescription benefits will be applied automatically so you know right away what costs may be your responsibility. This service helps decrease unnecessary expenses and does away with the need to file a paper claim and wait for reimbursement.

When you use a pharmacy that is not in our network, you pay the full cost of your prescription up front. You will also have to submit a claim to get reimbursed. Reimbursement for prescriptions filled at non-network pharmacies is not guaranteed.

Use the Mail-Service Pharmacy Program

Home Delivery can offer added convenience, savings and services when it comes to filling your long-term medications.

Manage your account online anytime

Take advantage of 24/7 access to your personal coverage information.

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