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A few years ago I recieved treatment at a methadone clinic. At the time I had BCBS. The treatment center did not take insurance at the time. A few months ago a friend of mine, with the same insurance, was able to get reimbursed. She went to the same treatment center. The treatment center now takes BCBS. I have BCBS now but not through the same company. At the time I had Mountain State BCBS. Now I have BCBS of Illinois. How can I be reimbursed?

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Hi Mstilla,

Call BCBS and ask them about filing a claim.

Even if the clinic didn't accept BCBS then, if you had to pay it yourself then BCBS may have been able to reimburse YOU directly for what you paid.  Whether or not such a claim would be paid is entirely up to them.

Call them and don't just accept "no" for an answer.  If necessary speak to a supervisor.  Be sure to have your documentation handy. 

Good luck.
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Hey mstila,
Getting reimbursed by BCBS for a methadone clinic depends on several factors. Is your insurance PPO or HMO? Is your clinic "in-network" or "out-of-network?" If your clinic now accepts BCBS, then it is "in-network." If you have a PPO, and BCBS is accepted, all you need to do is pay the co-pay. There's nothing to get reimbursed for. Do you mean: how do I get reimbursed, for when I attended, prior to the clinic accepting BCBS?

FYI— I provide ALL the necessary steps to have BCBS reimburse you for attending a methadone clinic on this website. The discussion is titled: "HOW DO I GET BCBS TO PAY FOR METHADONE GIVEN AT A TREATMENT CENTER?" Feel free to send me questions. I'll do my best to give you the correct answers.

Take Care!
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I don't go to the clinic anymore. I quit going almost five years ago. My friend was able to get reimbursed and she quit around the same time I did and she had the same insurance I had at the time. I don't have BCBS of Mountain State. I have BCBS of Illinois now.
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i really could use your help, I have filed a claim and submitted all information but they cannot submit my claim because the CPT code h020 does not run through their system. Is there another code i can use
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Hi. I'm from NJ and just started going to a methadone clinic just over a month ago, but I really can't afford to pay out of pocket. I'm still trying to catch up on all the shut-off notices and bills I got so far behind on when I was using. I have Anthem BCBS and it's a PPO. From what I understand, I have both in-network and out of network coverage, but I'm new to the ins. The clinic I go to doesn't actually take ins, but I think I'm able to submit a claim to them and get reimbursed. They told me I have substance abuse treatment coverage, but they gave me places that don't give methadone. They just don't seem to get it when I try explaining further. Is there any way you can help me out through this process? I'm a wife and mother and right now methadone is keeping me living a "normal life" but I cannot afford out of pocket...ANY HELP WOULD BE GREATLY APPRECIATED!!! Thank you, Meaghan 

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I have bcbs ppo with a 2000 deductible... my clinic is in network. Will i have to spend 2k at my clinic before they cover a thing? I've heard mixed stories
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