Empire Bluecross BlueShield

Understanding Your Empire Plan Rehab Coverage

The jargon surrounding insurance policies can get confusing, so let’s define some basic terms before we get into the details.

Premium: A monthly payment to the health insurance provider by the policyholder to maintain their coverage. For people with employer-provided insurance, the company often picks up part or all of this cost.

Deductible: A fixed amount the policyholder needs to pay before their health insurance begins to cover a larger portion of their care costs. It resets annually. A plan that comes with a deductible of $1,000, for instance, means paying $1,000 out-of-pocket for your care in any given year before insurance kicks in and covers a higher percentage of costs.

Coinsurance: A cost-sharing arrangement for health care services such as prescription medications. It’s a percentage of the service’s cost paid by a member who’s reached their deductible (see above).

Out-of-pocket maximum: The ceiling on the amount of money you can be expected to pay out-of-pocket in any given year before coinsurance covers the entire bill.

Review our most common frequently asked questions below. If you have further questions, call us directly at 855-299-4472 or complete our insurance verification form. 

Does Empire Insurance cover mental health?

Yes! The Affordable Care Act requires most insurance companies, including empire to cover mental health. Behavioral Health Centers can help you research your coverage for services like diagnosis and treatment. Insurance assistance could potentially take thousands of dollars off your out-of-pocket cost or cover your entire program.

Does Empire cover behavioral health treatment?

Because the Affordable Care Act requires insurance companies to cover some mental health services, your Empire plan may cover therapy for the following: depression, anxiety, bipolar disorder, obsessive-compulsive disorder (OCD), schizophrenia, post-traumatic stress disorder (PTSD), and borderline personality disorder (BPD). Insurance typically covers traditional therapy, but you might have to pay for alternative services, such as yoga, meditation, and nutrition classes.

What if my Empire plan benefits aren’t enough?

We are committed to assisting you in your recovery journey, so an appointed caseworker will help you understand the complexities of insurance coverage and your treatment plan. Most insurance providers offer tiers with different coverage levels. If you don’t have enough coverage, we can help you consider upgrading to a different plan. A new plan might have higher premiums, but it could save money in the long run by covering more services. Other plans may have lower deductibles, reducing the amount of time you pay up front.