I have spotify premium. Been streaming via bluetooth in my car fine for sometime now. Drove to dinner listening to spotify...couldn't on the way home. Spotify plays, but music is output to the Iphone speakers vs. bluetooth (and over car stereo). I can control spotify with car controls (change songs, etc.) just can't hear it. Car bluetooth works fine with same device (controls spotify, displays music that is playing and other info, can use phone via bluetooth, etc.). spotify just outputs to speaker not to bluetooth.
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My car allows me to make calls but it will not allow me to stream music which pisses me off to no end. This is just how the stereo is made and there is no way to change it unless you buy an other stereo unit.
My solution: I bought a Bluetooth gadget that plugs into my AUX plug which is that small 3.5mm hole in the front of your car stereo for those of you who do not know.
You can get it here at this site where they are super cheap.
Now I can play my music from my phone and make calls hands free. Best few dollars i have spent in a long time!