BlueCare Tennessee is a wholly-owned subsidiary of BlueCross BlueShield of Tennessee. Founded in 1993, the Chattanooga-based company focuses on managing care and providing quality healthcare products, services, and information for government programs. BlueCare Tennessee currently serves more than 500,000 members.
The mission of BlueCare is to provide healthcare solutions to members by building relationships among members and their communities in the effort to improve overall health and quality of life.
BlueCare and the Opioid Epidemic
BlueCross BlueShield of Tennessee, BlueCare’s parent company, has taken important steps in the ongoing opioid crisis, which has hit Tennessee hard. In late 2018, Tennesseans continue to die from opioid-related causes in record numbers, even as total prescriptions and dosages have decreased.
Since 2015, BCBST has worked with an independent panel of medical experts from across the Volunteer State. This panel enriches the company’s decision-making process to ensure that decisions related to opioids are based on agreed-upon best practices.
Starting in January 2019, BlueCross BlueShield of Tennessee will:
– place new restrictions on short-acting opioids
– change its list of drugs covered under their medical insurance plans
– reduce daily dosing limits
– install safeguards to protect members against potentially lethal drug combinations
– add a seven-day limit for new short-acting opioid prescriptions and require prior authorization when short-acting drugs are being used for an extended period
– replace OxyContin, one of the most overprescribed opioids in the country, with the less addictive Xtampza and Morphabond. Xtampza and Morphabond use abuse-deterrent formulas, making them safer and have less resale value. Member co-pays for these drugs will remain the same as they were for OxyContin
– expand coverage of acupuncture to give members living with chronic pain another treatment option
Beyond these efforts, BCBST has addressed the opioid crisis by collaborating with charitable organizations across the state. The company has invested more than $5 million in prevention and treatment support efforts over the past five years.
BlueCare and Addiction Treatment
While BlueCare covers many of the costs associated with treatment for substance use disorders, these services often require pre-authorization. Copays and coinsurance cost sharing may vary, depending on factors such as the type of plan, deductible, and the facility that a member is attending.
BlueCare, along with Amerigroup and United Healthcare, has determined the need for a comprehensive network of providers who offer Medication Assisted Treatment (MAT) for members with opioid use disorder. This provider network has agreed to provide MAT under guidelines drawn up by the three companies.
MAT involves the use of medications—in combination with counseling and behavioral therapies—to provide a whole-patient approach to the treatment of substance use disorders. Research has shown that, when treating substance-use disorders, a combination of medication and behavioral therapies is safer and more effective than therapy alone. The Food and Drug Administration (FDA) has approved several medications for MAT use, including buprenorphine and naltrexone.
Verifying Coverage and Finding the Best, Most Appropriate Treatment
Studying insurance options can be overwhelming, especially if you or someone you know is suffering with addiction. Knowledgeable advisors are available with BlueCare; they can verify your coverage and find the best substance use or mental health treatment for you or your loved ones.