Drug and Alcohol Treatment

Boston University
Health Plan 		How services are covered
Outpatient Services
(calendar year benefit) 		Inpatient Services
BCBS PPO*
In-network Individual or group therapy:
Visits 1 – 20 @ $15/visit
Visits 21 – 30 @ $20/visit
Visits 31 – 40 @ $30/visit
A total of 40 visits (combined drug and alcohol treatment and mental health outpatient services) allowed per calendar year		 100% for up to 60 days/year for mental health plus 30 days for substance abuse
Out-of-network 80% coverage after deductible for 20 visits or $500 in benefit value, whichever is greater for individual and group therapy combined 80% after deductible for up to 60 days/year for mental health plus 30 days for substance abuse
Outpatient Services
(calendar year benefit) 		Inpatient Services
Network Blue
New England 		Individual or group therapy:
Visits 1 – 20 @ $15/visit
Visits 21 – 30 @ $20/visit
Visits 31 – 40 @ $30/visit
A total of 40 visits (combined drug and alcohol treatment and mental health outpatient services) allowed per calendar year		 100% for up to 60 days/year
Outpatient Services
(calendar year benefit) 		Inpatient Services
Boston Medical Center Preferred*
Inner Circle Covered up to 20 visits or $500 in benefit value, whichever is greater for individual and group therapy combined
Individual therapy:
Visits 1 – 8 @ $5/visit
Visits 9 – 20 @ $25/visit
Group therapy:
Visits 1 – 20 @ $5/visit		 100% up to 30 days/year
Expanded Circle** Covered up to 20 visits or $500 in benefit value, whichever is greater for individual and group therapy combined
Individual therapy:
Visits 1 – 8 @ $25/visit
Visits 9 – 20 @ $40/visit
Group therapy:
Visits 1 – 20 @ $25/visit		 70% up to 30 days/year
*Annual maximums are combined in-network and out-of-network.
**Primary care physician referral required for care received in Expanded Circle.