Yes, We Accept BlueCross BlueShield Medicare Advantage (BlueAdvantage)

Restoration Recovery is in-network with BlueCross BlueShield Medicare Advantage (BlueAdvantage) for medication-assisted treatment (MAT), counseling, and related addiction recovery services at all four of our outpatient clinics across Tennessee and Georgia. If you have BCBS Medicare coverage, you can use your plan to access Suboxone, Sublocade, or Brixadi — along with counseling and follow-up care — at our Chattanooga, Cleveland, Soddy-Daisy, or Ringgold (GA) locations.

Our intake team verifies your specific BlueAdvantage plan benefits before your first visit.

What’s Covered Under BCBS Medicare for MAT

BCBS Medicare plans that cover addiction treatment generally cover the full continuum of care we offer:

  • Suboxone (buprenorphine/naloxone): daily film or tablet prescription. This is the most common MAT medication and the one most BCBS Medicare plans cover with a generic-tier copay.
  • Sublocade (monthly buprenorphine injection): administered at our clinic. Most BCBS Medicare plans cover it, though some require prior authorization because of the higher per-injection cost.
  • Brixadi (weekly, bi-weekly, or monthly buprenorphine injection): similar coverage picture to Sublocade; prior authorization may be needed depending on plan.
  • Vivitrol (monthly naltrexone injection): for alcohol use disorder. Covered by BCBS Medicare plans that cover SUD treatment.
  • Individual counseling and certified peer support: as part of your treatment plan.
  • Group IOP (intensive outpatient programming): structured group-based care for patients who benefit from a higher level of support.
  • Telehealth: secure video visits for medication management and counseling follow-up, typically covered at the same rate as in-person visits.
  • Behavioral health: psychiatric medication management and coordinated care for anxiety, depression, and co-occurring conditions.

Typical Cost and Copay

BlueAdvantage out-of-pocket for MAT is typically modest: $0–$45 specialist copay per office visit on most plans, and generic buprenorphine under the plan’s Part D benefit is usually on the lowest tier ($0–$10 for a monthly supply). Sublocade and Brixadi injections administered at our clinic are covered as Part B-type services. The plan’s annual out-of-pocket maximum caps your total spending.

Exact out-of-pocket cost depends on your specific BCBS Medicare plan, deductible status, and whether any prior-authorization requirements apply. Our patient services team verifies your benefits before your first visit so you know what to expect. Most BCBS Medicare patients find the real cost substantially lower than they expect.

Prior Authorization

BlueAdvantage typically requires prior authorization for extended-release injections (Sublocade and Brixadi) and sometimes for brand-name Suboxone if generic is the preferred option. Our team handles the prior-auth paperwork; it usually clears within a few business days. Daily generic Suboxone typically does not require prior authorization.

How We Verify Your BCBS Medicare Benefits

When you call us at 423-498-2000 or submit a contact request, here is what the intake process looks like:

  1. We collect your BCBS Medicare information. Member ID, plan name, and date of birth — the same info that’s on your insurance card.
  2. Our team calls BCBS Medicare directly to verify your benefits for MAT, counseling, and IOP.
  3. We confirm back to you — usually within one business day — what your copay, deductible status, and any prior-authorization requirements look like.
  4. You schedule your first visit with confidence in what it will cost. No surprise bills.

Four Clinic Locations

We operate four outpatient clinics across Southeast Tennessee and North Georgia. BCBS Medicare coverage is accepted at all of them:

Telehealth follow-up visits are available for established patients at all four locations, covered by BCBS Medicare at the same rate as in-person visits in most cases.

How to Start

Same-week appointments are typically available at all four clinic locations. To begin:

  1. Call 423-498-2000 or submit a contact request.
  2. Have your BCBS Medicare insurance card handy for verification.
  3. Tell our intake team you’d like to schedule an evaluation for Suboxone / MAT / counseling, and note what clinic location works best.
  4. We verify your benefits, confirm any prior-auth steps, and schedule your first visit — usually within the same week.

Your first visit lasts 60–120 minutes and follows a standard clinical flow: intake (DSM-5 assessment, COWS score if applicable), a counselor conversation, and time with a medical provider. If clinically appropriate, you can leave with a same-day Suboxone prescription. For the full walkthrough, see our first-visit guide.

BlueAdvantage HMO vs. PPO

BCBS TN sells BlueAdvantage in both HMO and PPO formats. HMO plans require you to use in-network providers (like us) and typically have lower copays. PPO plans let you go out-of-network with higher cost-sharing, but in-network visits are typically still the cheapest. Either way, Restoration Recovery is in-network.

BlueAdvantage vs. Commercial BCBS

BlueAdvantage follows Medicare rules, including the Part D formulary for oral Suboxone and an annual maximum out-of-pocket limit. This is different from commercial BCBS employer plans, which follow ACA/ERISA rules. If your card says BlueAdvantage or includes a Medicare contract number, this page applies. For commercial BCBS, see our BCBS Tennessee coverage page.

Related Links

  • Full insurance page — all accepted carriers plus verification form.
  • Suboxone Treatment — how MAT actually works at our clinics.
  • All services — MAT medications, counseling, IOP, telehealth, behavioral health.
  • FAQ — common questions about starting treatment.