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.
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
1 week 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.
Lucy Lopez
2 weeks ago
Review for Megan at Gratitude Lodge
When I first arrived at Gratitude Lodge, I was scared and completely lost. Megan picked me up from the airport and immediately made me feel at home. She goes above and beyond every single day — she keeps the house spotless, drives us to the best meetings where we can actually find real sponsors and real help, and mentors us through some of the hardest moments.
Megan sets such a powerful example of strength, compassion, and dedication. Because of her support and the environment she’s helped create, I’m about to hit 30 days sober — something I never thought I’d be able to say.
Thank you, Gratitude Lodge, and thank you, Megan, for helping me find my footing and start a new chapter of my life.
I would like to thank the Profound Team from the owner to the cleaning ladies for making my stay there as easy and comfortable as possible. Detoxing was a mental, emotional, and physical struggle that they helped me over come successfully. I will never forget my time there, and will always be grateful for Profound helping me on this road to sobriety.
Brickri Cadle
2 weeks ago
Profound has been a Life changing experience for me. Thanks to Sena, Rachel, Yumi, Arin, Mele, Travis, Louie, Noah, Both Antony's, Tez, Brian, Charlie's Angels, The Chefs, Mrs Bigglesworth and the rest of the Staff Especially Lindsay and the maintenance crew for keeping the grounds up to date (Hot tub and Putting green) It is a 5 star ⭐⭐⭐⭐⭐ Treatment Program. Beyond Grateful For Everyone involved . John and Marty
THANK YOU
Paul Adams
2 weeks ago
my name is Tyrone I'm from dc and Baltimore and OMG this place is heaven....I walked in and Jessica greeted me with the best smile and Diana always positive and outgoing funny Arin Sarah Jennifer Rachael Tez Alexis myumi Travis when I tell you they the best ppl on the planet for recovery the therapist sooooo smooth and caring the food 8.810 outings 10/10 groups 8.9/10 outside meetings 10/10 houses 10/10 relax time 10/10 someone is always there to talk to about anything without judgement and from their experiences this is my family now Katie and Doug makes sure of it they don't just kick you out they check on you the rest of ur life they not money grabbing they tryna grow your life not just save it......thank you sooooo much I can't put in words the impact what I will say if you reading this considering to come here I'll be around too to pass on what they gave me I'll prove it to you.
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
1 week 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.
Caroline Harper
1 week ago
Beachway Therapy Center was a blessing for our family. My loved one went in during a really difficult time, and the care they received made all the difference. The therapists were attentive, patient, and genuinely invested in helping them heal. Communication with our family was consistent and compassionate, which helped us feel supported throughout the process. We’re incredibly grateful for the progress they’ve made and for the people at Beachway who treated them with dignity and respect. I would recommend Beachway to any family looking for real help and real change.
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
1 week 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.
matthew DeWitt
2 weeks ago
Tree House Recovery has proven to be a lifesaver for my son. My son had been using heroin for about 10 years, and his life was looking bleak. My family and I decided to step in and look for a rehab he couldn't Uber home from. We live in the east, and Tree House is in California. We liked the fact that it was a 5 month program, too.
Matt was our first person of contact. He made us feel like we were no longer alone. He was always there to guide us. My son was in a detox here which wasn't going as planned, and Matt wanted to get him to a detox in CA that he trusted. To get my son from the east coast to the west coast was challenging. He missed his first flight because he needed to buy heroin, not wanting to be in pain. We were able to get him on another flight that day, and Matt had someone waiting for him at the airport. It was a harrowing day, but Matt took care of all of the logistics and planning.
My son is now on the road to recovery. He actually likes the program, and after a few months, he is doing well. I worry less about him now that he is in the care of Tree House Recovery.
Spring Hill and its amazing staff has changed my life dramatically for the better. I learned more in 30 days here about addiction and recovery than the previous 5+ years of seeking help for alcoholism and depression. KEEP COMING BACK, IT WORKS IF YOU WORK IT! Thank you all from the bottom of my heart for saving my life.
Vaughn Tucci
2 weeks ago
Spring Hill is a special place to me. It’s peaceful, beautiful, and comfortable. While I was there everyone was so kind and helpful to me. All staff, from recovery specialist, nurses, caseworkers, clinicians and chefs to housekeeping. I learned so much about myself and my addiction. It is truly a place of healing. I’ve been in treatment before and I would recommend this place over any other place I have been to. I bet it’s the best in the country. Spring Hill will always hold a special place in my heart. Thank you.
Iraida Cabana
2 weeks ago
Springhill Recovery Center is a great spot for a loved one to received treatment for drugs, alcohol and mental health! Safe, clean and welcoming!
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
2 weeks 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.
eric bower
1 month ago
NEVER thought I would be healed in WASHINGTON, God had other plans for me. The Center a Place of Hope was the Way. Thank you too all the Amazing staff who know how to center PEOPLE and their WHOLE PERSON.
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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!!
MarySue
2 months ago
Brittnay was so helpful with placing my son in a perfect environment for him to heal!
Clean facility knowledgeable staff overall you learn a lot about yourself and you end up taking away with you a lifetime of fun positive memories
James LoPresti
2 months ago
They really helped me find the reasons for my alcoholism, and more importantly what to do with this knowledge. I came in hopeless, anxiety ridden, and lacking in any self confidence. Today, I'm happy with my life, accept myself for who I am, and see a bright future. I can't express my gratitude enough to the staff at Paramount who are passionate about what they do, truly care, and have authentic joy in seeing people like myself thrive in sobriety.
marc oliveira
2 months ago
Being a client at Paramount Recovery Centers, makes me feel dignified and like I have hope. The staff here are absolutely amazing and are willing to go to any length to help in any way they can. From the BHT's to the therapist even going all the way to the top. Everyone who works here has everyone's best interest at heart and it shows with every interaction you'll have. All in all I'd highly recommend PRC to anyone who struggles with substance abuse or mental health.
I have had the opportunity to refer folks to Wellbrook. The facility is first rate. It is clean and welcoming. the staff is extremely professional and knowledgeable. The facility is small so individuals get a lot of hands on encouragement. They stay with you after your discharge. First rate !!!
Mark Saffran
1 month ago
Very good environment, Great Staff, Proud to be a part of this program. Helped me alot to find myself and reconnect.
Aj Crisostomo
2 months ago
Tour the facility as an employee of another recovery facility and I must say I was thoroughly impressed with the clinical staff, Curriculum and amenities that is offered by Wellbrook tontheir clients! Their alumni support is above and beyond as well!
Great environment and staff. They make me feel welcomed and are very supportive.
Anthony Mascorro
2 weeks ago
This place is is amazing. Trish is the best counselor around, she guides with love and a firm hand, always there to help you overcome the difficult parts! The Techs Jayden, Robby, Devyn, Taylor, and so many more are wonderful people who really care about you and help along the way! Lia is an amazing chef and friend. The facility is beautiful and well kept! This place takes rehab and recovery to a whole nother level! They make the hard part as easy as they can and definately want only the best sober life for everyone!
Joy Bomar
1 month ago
This place has helped me with giving me a new sense of hope and community. I will be forever grateful for what I have learned here.
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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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