Highmark Insurance Coverage for Addiction Treatment
Discover how Highmark Insurance covers drug rehab and mental health treatment in the Northeast. Verify your plan for recovery options.
Highmark Insurance Coverage for Addiction Treatment
Discover how Highmark Insurance covers drug rehab and mental health treatment in the Northeast. Verify your plan for recovery options.
Highmark Insurance started in 1996 after two of the oldest health insurance companies in the U.S. merged. The two companies were Blue Cross of Western Pennsylvania and Pennsylvania Blue Shield. Now known as Highmark, they offer plans in four northeastern states.
Where Does Highmark Insurance Operate?
The four states that Highmark Insurance works out of are Pennsylvania, New York, Virginia and Delaware. This means they cover people and companies based in these states, but it doesn’t mean that the services they cover are also limited to these states.
Does Highmark Insurance Cover Drug Rehab?
Most Highmark Insurance plans cover drug rehab and mental health because the 2010 Affordable Care Act (ACA) requires most plans to cover 10 essential health benefits. These benefits include both substance use treatment and mental healthcare.
However, there are exceptions to the law, so be sure to review your insurance coverage before you start treatment. You’ll also want to work with your doctor to create a treatment plan because that will be the guide your Highmark plan uses to determine medically necessary care.
AlcoholismDrug AddictionDual DiagnosisOpioid AddictionSubstance AbuseMental Health And Substance Abuse
Adult ProgramYoung Adult ProgramProgram For MenProgram For Women
Private insuranceSelf-Pay Options
I can't recommend All-In enough. There's no real way to phrase a review like this that doesn't sound sappy and trite, but I firmly believe I wouldn't be where I am today without them. Love y'all ❤️
Squid Jabine
1 week ago
I had a great experience with All In Solutions The staff is nice, knowledgeable and helpful, I would like to give a special shout out to my Therapist KAREN CASTON she is a awesome therapist and an amazing caring, loving women. She really went above and beyond to get me through my obstacles
Tanya Brooks
2 weeks ago
All In Solutions (AIS) in Cherry Hill, NJ is an exceptional facility, and we give complete credit for our son’s sobriety and vastly improved mental and physical health to the excellent staff and therapists at AIS. They were truly the best!
All in Solutions provided our son with the best support and right tools he needed to guide him in the right direction in his recovery. The care provided by the staff is exceptional, they are kind, knowledgeable, authentic, and can relate to their patients’ addictions and recovery process. Every staff member that we dealt with was professional, compassionate, and genuine.
Services and support provided by AIS were numerous and very effective. We so appreciated the weekly calls from his therapist on his progress, being able to always reach someone at the AIS facility where he was located, and the weekly zoom family support sessions. The support groups, AA meetings and his AA sponsor has all been invaluable to our son then and now as he is transitioning back into life outside of AIS.
We are forever grateful for the support our son received at All In Solutions and we highly recommend All In Solutions in Cherry Hill, NJ to anyone with drug and alcohol addiction.
What can I say? My stay at Gratitude Lodge was beyond my expectations. This was my first exposure to treatment so I was nervous; nonetheless, I was treated with the utmost respect and compassion. ❤️
From the start, the house was definitely a second home for me having traveled from the Midwest. I was warmly received on the first night and settled in comfortably.
So many staff members impacted my experience...from the start, Ryan, meeting my at the airport and providing sound advice for tlnext steps in my recovery, Peter for his fantastic music therapy sessions, James for his sincere commitment to my casework, Mario always for his listening skills, Trinity, Justin, Andrew...and everyone beyond.
Jesse Emswiller
2 weeks ago
Best experience of my sober life. I want to personally thank, Trinity, Justin, Mario, Ryan, Eli, Megan, Andrew, Lee, Kyle, James and Peter for everything and that they do. The best staff at any program I’ve ever been to (and I’ve been to a bit over my fair share). They actually care, they love you and they truly want to see you succeed. A special shout out to James, for always and I mean ALWAYS being in my corner. A shoutout to Trinity for being my confidant when I felt alone in the beginning. To Peter, who listened to all my bullshit with a smile on his face and some music in the background. The best place to get sober and the best people to ever be around. Truly a sober environment, where you learn how to be sober. Not just get sober but BE sober. I’ll forever remember my time here with love, respect and of course plenty of GRATITUDE!!!!!!!
Vivi
3 weeks ago
I had such a great experience here. I've been to alot of rehabs and I cant say the same for most of those. I didn't know if I wanted to come in or even be sober and James and Megan stayed out front with me for a long while, patiently helping me to make the right decision to come in and I am so glad I did. They have such a great team of people and I couldn't thank you guys enough. Shout out to James for always staying late and convincing me to not AMA lol i even decides to stay longer, you can tell he really pours his heart into his job and wants to help. Same goes for Megan and Ryan you guys are really the best.
Best place ever and the staff are always there for you a 10 out of 10 place
Nick Staehly
1 day ago
I’m at a crossroad in my life where I finally acknowledged I needed professional help for my drinking. I called the 1st number I googled. It landed me with Profound. I just finished my 30 days in California at one of their incredible homes located in one of the most prestigious areas in Los Angeles. The home was nothing short of amazing. The staff was top notch and all have been in my shoes. They were very easy to talk to, and the environment was comfortable and accommodating. I was not anticipating going to another State for treatment. They covered my flight there and back. After finishing my 30 days, I now feel equipped with what I need to stay sober for my family and myself. Thank you Profound for giving me sobriety and a new outlook on life.
Ben P
1 week ago
If you are ready this is the place to go, the staff is out of this world they care, they love and they want what you want. Take the leap and you will not regret it. The food is amazing and the location is beautiful, you are treated as an adult that is looking to better their selves. The Staff and facilitators go above and beyond.
2 years later and I definitely got my moneys worth. Treatment is the easy/fun part... the hard part is following up on what they teach you here, when you leave.
My Channel
1 week ago
I had a wonderful experience at Beachway. Highly recommend. They helped me in so many ways and I am forever grateful for the experience
Chloe Davis
3 weeks ago
Beachway Therapy Center supported someone dear to me as they navigated personal challenges with genuine care and patience. The staff made them feel safe and supported from the start. I’m deeply grateful for the kindness and professionalism at Beachway.
I was dealing with severe cocaine and alcohol addiction. After serving in the military and coming home, I needed help. And I knew that the average rehab and recovery program wouldn’t work with me. I needed something challenging, something different. Treehouse provided that. With a wide range of different and unique approaches to treating addiction like challenging workouts, team building, riding waves on the beach of Costa Mesa on rafts with other men struggling with the same disease, addiction education to help me better understand my disease on a scientific level, and outdoor adventures like going camping, taking trips to cool beaches to surf at. This place isn’t just a recovery center, it’s a family. I am now 6 months sober and graduated the program and I couldn’t feel more grateful and proud of myself. And I know my family could say the same. Anyone struggling with addiction and looking for a program that heals you both mentally and physically NEEDS to give this place a shot.
k to the roc
1 day ago
My son has been struggling with alcohol for years which grew into a full blown addiction. He tried a 30-day program which didn't last. Only when we found Treehouse Recovery in Costa Mesa did we find a place that could really help him. The staff are exceptional and they have cared for our son's success long after he completed his program. If you or your son need help look no further.
Kris Kazarian
3 weeks ago
I’ve been to so many treatment centers. I swore last time I relapsed I wouldn’t go back to another because there all the same. But I had a friend reach out and tell me about treehouse. They told me it was drastically different and maybe something to ge the off the hamster wheel of treatment. They came out and met me and vetted me and made me feel important when I felt as low as possible. This place isnt a place where they stick you in a room and make you do group from 9-5. They teach you how to live again. There is an education group on addiction but it’s only an hour. The rest of the time you’re doing therapy. Which is 4 times a week. Or your lifting, in the gym, or learning how to be social again. I can’t recommend this place enough. If you want to do something different and stay sober. This is the place.
Absolutely changed my life for the better. I went in arrogant and with my head on backwards. They supported me through every step of the process and when you leave you really do “get your power back”, the choice to make the right decisions. If I ever had to go to rehab again I would choose this place again immediately. Hats off to Lead RS Justin and my clinician Sandrea for they gave me the deepest level of support and I wouldn’t have made it the full program without them. Thank you Spring Hill.
nick capparella
20 hours ago
This is one of the greatest recovery centers to regain control over your life. The groups are very informative and welcoming. The criteria was open and well covered. The RS go above and beyond to make the clients feel comfortable. I would highly recommend anyone to come here and experience the healing vortex that surrounds Springhill
Corey
4 days ago
I’ve never been in recovery, or in any form of rehab and being here / making this decision saved my life entirely.
As a first timer, I was overwhelmed with the amount of support that I received during my stay here, everyone is more than nice & outstanding individuals. From the staff, to the maintenance crew, to the phenomenal chefs AND Maybel the therapeutic pup everyone here is there to help you during your sobriety journey!
I didn’t want to leave, this place WILL change your life.
My 4 weeks here at the center honestly saved me. My first day I was so anxious about the new environment I had to have EMS called for me because I had a panic attack, and my second day I was throwing up the whole day. All that to say I wouldn’t have been able to make it through the first week if it wasn’t for the loving and wonderful and caring staff and clients. Everyone comes here with pain and it leads to a bright, warm, positive environment where people are able to bond and be their authentic selves completely. It’s been wonderful to have such tailored care for my needs, and now I have the ability to cope with the difficult times and move past them healthily. I truly could never thank them enough!
Em
1 month ago
I went in feeling completely hopeless and that I needed to just accept the fact that I would be surviving the rest of my life. Fast forward 6 weeks and I feel a lot of hope and excitement for the future where I will be able to thrive not just survive. The staff are super supportive and caring I would definitely recommend going if you are struggling with mental health.
Excellent facility!! Their team is extraordinary and provide the best quality of care.
D Snelson Alexander Rex
2 days ago
When I came to Paramount, I felt I couldn’t trust anyone and had no belief I could be in recovery. This program and their staff helped me get through this. By offering a safe place to work on solid therapy and to better understand myself, I was able to gain confidence in my ability to be in recovery for life! Another highlight is the fact that paramount provides a worry free environment. This allows me to truly focus on my recovery work. I highly recommend this program to anyone who needs help with mental health or Recovery work.
Benjamin Graves
1 month ago
I have so much gratitude for everything paramount has done for me. The day I walk thru the door was the day my life changed forever. From client liaison to case manager, and therapist I really felt understood and cared for which made my recovery journey alot easier. I felt as though I was being given more than treatment. I was given another family and hope. I can now face life's struggles with a sober mindset and strength. It's all owed to the compassionate loving environment paramount has created. So thanks for seeing the good in me when I could not see it for myself. Much love
AlcoholismOpioid AddictionDrug AddictionDual DiagnosisSubstance AbuseMental Health
Adult ProgramYoung Adult ProgramLGBTQ ProgramMilitary Program
Private InsuranceSelf-Pay OptionsSliding Scale Payment AssistanceFinancial Aid
My names Anthony, I just gotta say I moved up to Pennsylvania from south Florida 2 months ago and I’ve been through others programs before in the past and at Provive I’ve been welcomed with open arms. The community of therapists and practitioners go above and beyond to provide guidance and support for me and patients as a whole. I love this program and have never been better in my life
Thanks Provive !!
ANTHONY ERNEST
3 weeks ago
Simply an awesome caring facility. The staff gives 100 percent and then some! They display a true genuine concern for those in their care. Communication is exceptional! My son has been in many facilities over the years and Provive Welles is the best place that he has been in and made the most progress. Everyone that I’ve communicated with was phenomenal.
However, the majority of my communications were with Megan, Emily and David. I must give them special recognition for my sincerest appreciation.
Thank you Provive Wellness for caring for my son above and beyond my expectations.
Tina & Thomas
Tina and Tom Roberts
2 months ago
I’ve been with Provive for about a month or so now. I was having urges to drink myself into a blackout state. Been this way for about a week….I mentioned it in front of the house manager and nothing happened. Today was the worst of my urges. Megan had reached out to check on me and she was able to help me through without relapsing…. Thank you, Megan for all your help!!
My first experience with anything drug related happened at age 58 when my husband decided to torpedo our life by smoking meth. Laguna View saved him from himself. He said the sounds of crashing waves from the porch gave him peace and helped him focus on what he had to do next. The staff was caring and the facility was very clean. He said they went to the beach, bowling and meetings several times a week. He highly recommends Laguna to others who need detox.
Shari Tomac
1 month ago
Great place! Thanks to all the staff for all the help and support !
Ryan Segura
4 months ago
The moment I walked in I felt welcome and never neglected. From the Program director, to the nurses and techs. Every person in this program will treat you like family. I also got everything I ever needed when I needed. I couldn’t have gone to a better place. I got all the support I needed and more everyday. I recommend this place to everyone looking for a place to change their life and future for the best. Thank you Laguna view detox and everyone apart of this wonderful organization.
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Frequently Asked Questions
What Are Highmark Plans?
If you have a chance to choose your plan, there’s a lot to consider. Certain types of plans give you more flexibility to get care outside the provider network. These plans also have more flexibility in how you access specialist care, such as a psychiatrist or addiction counselor. However, those plans tend to have higher monthly premiums.
Here are the types of individual and family plans available from either your employer or the Insurance Marketplace in your state.
Health Maintenance Organization plans (HMOs)usually have the cheapest monthly premiums but also the least flexibility. You’ll need to choose a doctor to be your primary care provider and you’ll need to stay in network with your care.
A Preferred Provider Organization (PPO) planusually has a higher premium than an HMO plan but you don’t need a primary care provider and you can go to any in network provider without a referral. A PPO generally offers some coverage out of network but you’ll pay more out of pocket for the care.
A Point of Service (POS) plan provides in network care without a deductible and will let you go out of network as long as you have a referral from your primary care provider.
Highmark also offers a variety of Medicare plans. You can get Medicare Part D to help with prescription drugs on Original Medicare, or you can get a Medicare Advantage plan to replace Original Medicare and give you additional benefits such as vision and dental care. However a Medicare Advantage plan will likely have a limited provider network.
How to Verify Coverage With Highmark Insurance
Before you get started with treatment, it’s important to know the details of your insurance. To verify your coverage, you can call the insurance company directly or login to your online Highmark account to see what coverage is available.
You can also use the Highmark Find-A-Doctor Website to find an addiction treatment provider that’s within your plan’s network. You can start by clicking on the “Medical” link. Set the network to your specific plan, and enter your zip code in the location field. From there, browse by category: Behavioral Health and then select Addictions Medicine. To find more providers, expand the search radius.
Does Highmark Insurance Cover Other Mental Healthcare?
In 2010, the Affordable Care Act went into law. As a part of this legislation, mental health care was considered essential health care and must be a part of most health insurance plans.
There are exceptions to the law and every plan is different so be sure to check with your insurance provider to determine what services are covered. Some treatment may need a referral or preauthorization. Also treatment will need to be within the Highmark network for the greatest coverage and lowest out of pocket expenses.
For many with addiction, there is a co occuring mental health condition such as depression, anxiety, PTSD, and bi-polar disorder. Highmark recognizes that successful recovery not only means sobriety but that underlying conditions are also addressed. Most Highmark plans will cover the integrated care you need to address your mental health and substance use at the same time.
Mental healthcare can include both inpatient and outpatient care and you will get therapy and medication management along with other evidence based care.
What Inpatient Addiction Treatment Does Highmark Insurance Cover?
Highmark offers inpatient addiction treatment. These services include inpatient detox and residential rehab services. You will need to work with your primary care provider to determine what care you need and create a treatment plan that will guide you in the recovery process.
Inpatient medical detox is often the first step in the recovery journey. During inpatient detox individuals receive close medical observation and care that may include the use of FDA approved medications to ease withdrawal symptoms and reduce cravings. Medication assisted treatment (MAT) also helps to normalize brain chemistry and body functions. For some MAT is needed only during the detox period and for others long term use of medications such as methadone, buprenorphine, and naltrexone is necessary for successful long term recovery.
Inpatient or residential rehab centers include individual and group therapy in a structured setting with 24/7 support. In some programs you can continue with longer term MAT depending on your unique needs. Many inpatient programs also use other therapy methods such as music and art therapy along with holistic treatment options such as massage and yoga.
What Outpatient Rehab Does Highmark Insurance Cover?
Outpatient alcohol and substance use disorder treatment is covered by most Highmark plans. Outpatient care allows you to live at home or in sober living while attending treatment during the day.
Some outpatient care is more intensive and other programs are less so. A Partial Hospitalization Program (PHP) is a full day program that’s similar to residential care except you don’t live at the facility.
An Intensive Outpatient Program (IOP) is often the next step in recovery once residential or PHP treatment is completed. Understanding that early recovery can be difficult IOP offers individuals intensive treatment including nine or more hours of treatment per week and a structured plan for recovery. You might also be able to receive MAT during treatment.
General outpatient care only meets once or twice a week and is focused on reinforcing your new mindsets and habits as you continue long term recovery. Aftercare can give you additional support and treatment options to help you establish your substance free lifestyle. You may get help with job training and housing along with other social services. Aftercare is unique to each person because it recognizes that individuals’ needs differ.
Does Highmark Cover Methadone & Suboxone (MAT)?
The use of Methadone and Suboxone as a part of medication assisted treatment (MAT) is covered by most Highmark plans if it’s an appropriate part of your care. You may need to get a referral or preauthorization. You’ll also want to look for a treatment center within your plan’s network.
Medication Assisted Treatment is used along with evidence based treatment to help you manage cravings and stay focused on your treatment program. This allows you to avoid relapse and the danger of overdose while you lay a solid foundation for your recovery. Over time you’ll taper off the medication support and live a truly substance free life.
Can I Travel Out of State For Treatment With Highmark Insurance?
Whether you can travel out of state for treatment depends on your plan. Many plans require you to stay within the defined provider network unless you need emergency help. That means you can’t travel out of state and still use your Highmark insurance to get addiction care.
Some Highmark plans do have coverage for out of network care but you’ll pay far more in terms of your deductible and copayments. So in that case you may be able to go out of state but it will cost you a lot more.
It is important for you to speak with care representatives or check your insurance benefits online before you start a program. That way you know whether you have out of network coverage and what costs you can expect. You also may need a referral or preauthorization even if you use a non network provider. Get the details in advance to avoid surprises during treatment.
Calls to any general helpline will be answered or returned by a paid advertiser.
By calling the helpline you agree to the terms of use. We do not receive any commission or fee that is dependent upon which treatment provider a caller chooses. There is no obligation to enter treatment.
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Alcoholism
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