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.

By Cary Damerow

Cary holds a BA in Liberal Arts and over 30 years of nursing experience as a Licensed Practical Nurse. During her career she has focused her work on high risk populations including pregnant women, children and adolescents, and those facing healthcare disparity.

Medically Reviewed by Anna Spooner

Anna has 10 years of experience in insurance and has been a content and copywriter since 2011. She strives to make all of her writing approachable and easy to understand while drinking copious amounts of tea. Anna writes about accessing addiction treatment, insurance, and finance.

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Avenues Recovery Center at Prince Frederick Ad This is an ad and Avenues Recovery Center at Prince Frederick is a paid advertiser. Paid advertisers may be listed first in search results. This ad may contain content provided by the advertiser. Rehab.com does not verify ad content or any reviews that are displayed. Learn More Prince Frederick, MD 4.4 (384 reviews) Claimed	Avenues Recovery Center at Prince Frederick, in Prince Freferick, Maryland, is an alcohol and drug rehab center offering levels of care including medically assisted detox, outpatient treatment, a partial hospitalization program, an intensive outpatient program, medication assisted treatment, an inpatient residential program and aftercare. Treatment	Treatments Programs Payment Options AlcoholismDrug AddictionDual DiagnosisMental Health and Substance AbuseOpioid AddictionSubstance Abuse Adult ProgramYoung Adult ProgramLGBTQ Program Private InsuranceSelf-Pay OptionsSliding Scale Payment AssistanceMedicaidMilitary Insurance	View Website (410) 535-8930	Avenues Recovery Center at Prince Frederick has no reviews yet. Leave a review.	5 5
All In Solutions Detox 1 Top 10 in Highmark Rehab Score Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now. 8.79 / 10 4.9 (610 reviews) Claimed	All In Solutions Detox in Simi Valley is one of the best ranked inpatient detox facilities in California providing safe, medically supervised care for individuals beginning their recovery from drug or alcohol addiction. As part of the All In Solutions Behavioral Health network, this facility serves as the first step in a full continuum of care. Cli	Treatments Programs Payment Options AlcoholismDrug AddictionMental Health And Substance AbuseOpioid AddictionSubstance AbuseDual Diagnosis Adult ProgramYoung Adult ProgramProgram For MenProgram For Women Private InsuranceSelf-Pay Options	Clean facility, structured environment, and people who don't treat you like a problem to be managed. That's the short version. Rachel Kim 1 day ago Amazing staff! Amazing place! Abbe Infelise 2 days ago Mark is one of the best therapists I've ever had he really shows that he cares Rueben Sandoval 3 days ago	5 5
All In Solutions Counseling Center 2 Top 10 in Highmark Rehab Score Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now. 8.78 / 10 4.9 (359 reviews) Claimed	All In Solutions Counseling Center is a mental health center and addiction treatment program in Boynton Beach, Florida. They provide a partial hospitalization program, an intensive outpatient program (IOP), an outpatient program, medication-assisted treatment, and mental health care for adults with substance use disorder. All In Solutions Counseli	Treatments Programs Payment Options AlcoholismDrug AddictionOpioid AddictionSubstance AbuseDual DiagnosisMental Health And Substance Abuse Adult ProgramYoung Adult ProgramProgram For MenProgram For Women Self-Pay OptionsPrivate insurance	The trauma group runs three times a week, Tuesday, Thursday, and Friday. I'd been to programs that mentioned trauma-informed care and then gave it maybe one session. Here it was built into the schedule in a real way, with a dedicated trauma therapist. That frequency made a difference because you actually had time to open something up and then come back to it before too much time passed. Daniel Harrington 1 day ago Overall great faculty, would definitely recommend patients to commit to PHP IOP here, all the facilitators are super helpful and hold very informational groups, Dr Nicole and Pastor Dan played a big role in my recovery and pushed me to do better every step of the way I highly recommend seeking help advice and opinions from them as well. Robert Mckasty 3 days ago Thirty-nine clients. That's the max here. South Florida has a lot of rehabs and a lot of them feel like they're processing people in bulk. This one didn't feel that way. Kevin Doyle 4 days ago	4
All In Solutions Counseling Center Cherry Hill 3 Top 10 in Highmark Rehab Score Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now. 8.74 / 10 4.8 (454 reviews) Claimed	All In Solutions Counseling Center is a mental health and addiction clinic in Cherry Hill, New Jersey. They provide outpatient addiction treatment and mental health care. They offer options like an intensive outpatient program, a partial hospitalization program, and medication-assisted treatment. All In Solutions Cherry Hill Drug & Alcohol Reha	Treatments Programs Payment Options AlcoholismDrug AddictionDual DiagnosisOpioid AddictionSubstance AbuseMental Health And Substance Abuse Adult ProgramYoung Adult ProgramProgram For MenProgram For Women Private insuranceSelf-Pay Options	The case manager assigned to me handled things I didn't even know I needed to deal with. FMLA paperwork, insurance questions, stuff related to my job. I came in focused entirely on getting sober and didn't have the headspace for logistics. Having someone specifically there to handle that made it possible to actually focus on the program. Daniel Kowalski 1 day ago One thing I didn't expect to care about was being able to keep my phone. After coming from a detox program where everything got taken away, having access to my cell made a real difference. I could check in with my family, stay connected to my life outside, and not feel completely cut off from the world while doing the actual work. Jason Reid 4 days ago I didn't know what to expect walking into PHP after finishing inpatient somewhere else. The transition can feel like a cliff, one day you're in a fully structured setting and the next you're just... out. Cherry Hill isn't like that. PHP here runs five to six days a week with a full schedule, and it gave me enough structure to feel supported without feeling locked in. By the time I moved into IOP and started going back to normal life, I actually felt ready for it rather than thrown into it. Marcus Holloway 6 days ago	4
Ascendant Detox Drug & Alcohol Rehab NYC Ad This is an ad and Ascendant Detox Drug & Alcohol Rehab NYC is a paid advertiser. Paid advertisers may be listed first in search results. This ad may contain content provided by the advertiser. Rehab.com does not verify ad content or any reviews that are displayed. Learn More New York City, NY 4.8 (304 reviews)	They offer supervised medical treatment to safely manage withdrawal symptoms during detoxification, residential care providing long term support for addiction recovery, as well as flexible outpatient addiction therapy allowing patients to live at home while receiving regular treatment. Additional levels of care offered include intensive outpatient	Programs Payment Options Young Adult Program Private InsuranceSelf-Pay OptionsSliding Scale Payment AssistanceMedicareMedicaid	View Website (917) 456-9288	Ascendant Detox Drug & Alcohol Rehab NYC has no reviews yet. Leave a review.	6 6
Spring Hill Recovery Center – Massachusetts 4 Top 10 in Highmark Rehab Score Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now. 8.56 / 10 4.8 (327 reviews)	Spring Hill Recovery is a luxury alcohol and drug rehab on a 70 acre campus in Ashby, Massachusetts. It’s a coed program with separate male and female residences. They treat adults 18 years and older. Here at one of the leading women’s rehabs in Massachusetts, most of the day in their program is structured with therapeutic activities. They	Treatments Programs Payment Options AlcoholismDrug AddictionDual DiagnosisMental Health and Substance AbuseOpioid AddictionSubstance Abuse Adult ProgramLGBTQ ProgramProgram For MenProgram For Women Private InsuranceSelf-Pay OptionsSliding Scale Payment AssistanceMilitary InsuranceMedicaidMedicare	Spring Hill is an excellent recovery center. I would recommend Spring Hill to anyone seeking addiction recovery. Stephanie H 2 weeks ago I am truly grateful for Springhill Recovery. Immediately I was made to feel at ease, safe & secure. I quickly realized that I was in competent, caring hands with all of the staff that I met. I learned so much about myself here! I can see where I need to work on a few things and I now have some of the tools to do that, thanks to the amazing groups, clinicians, RS staff & case managers at Springhill. I leave here confident in my sobriety & excited to continue my recovery program. I will seek connections with other people who are also in recovery because I’ve learned that absolutely nobody can do this alone! Thank you Springhill Recovery for teaching me how to like myself again! I am forever grateful for the gift & privilege of my new life ahead of me. Jackie Loewen 2 weeks ago Spring Hill is amazing! They have great staff, and programming. Everyone is kind, compassionate and caring. I am blessed to have had the opportunity to receive treatment here. Caissie Putnam 2 weeks ago	5 5
The Center – A Place of HOPE 5 Top 10 in Highmark Rehab Score Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now. 8.50 / 10 4.8 (263 reviews)	The Center - A Place of HOPE is a private luxury mental health treatment center located in Edmonds, Washington, in a secluded neighborhood. There are several treatment programs that include mental health and substance use disorder treatment. The center takes private pay of which the cost varies depending on the level of care and amenities you choos	Treatments Programs Payment Options AlcoholismDrug AddictionDual DiagnosisMental Health and Substance Abuse Adult ProgramYoung Adult Program Private InsuranceSelf-Pay OptionsSliding Scale Payment AssistanceMedicare	It has been one year since completing my journey at The Center. The Center-A Place of Hope exceeded all my expectations when I sought help for my mental health. I felt seen as a person and felt genuinely connected to the staff and fellow patients. I extended my stay and completed 5 weeks. I never imagined the healing I experienced. I am grateful for my experience and opportunity to focus solely on myself. Housing was fantastic and the whole-person care was remarkable. I highly recommend for anyone who is wanting something different than in-patient treatment! Adria Haugen 1 month ago The Center has been an oasis to me. This was my second visit (first in 2018). I needed a 2nd immersion. The staff is second to none. The Center exemplifies a warm and caring environment. I felt valued and supported. I highly recommend the Center as a flagship treatment center for all! Steven Shindler 1 month ago I am honored to share the experience I had at The Center  A Place of Hope, particularly the long-term impacts it has had on my life. My first day at The Center was October 9, 2023 – that was 1,000 days ago. I am proud to share that the skills I learned at The Center have provided me with long-term growth and healing. I attended The Center for PTSD, a complex eating disorder, depression, anxiety… you name it. My mental illness consumed my life. I went from being a vibrant, competent Neonatal ICU nurse to a shell of a human. Trauma had left me with debilitating PTSD. When my husband found The Center, I was at the end of my fight; I didn’t think anything could help. I am so grateful to say that I was wrong. The Center didn’t just save my life; they showed me that I was capable of healing in a meaningful way. They gave me hope for a life filled with value and worth. Something I never imagined was possible after the trauma I had experienced. Healing isn’t easy. It isn’t quick. The more painful the journey, the more powerful the healing. I promise that if you show up, the staff at The Center will work harder for you than anyone I have ever encountered in the medical field, let alone the mental health field. The staff at The Center is unlike anything I could have imagined. They truly care for your heart, for your soul. The work they are doing is sacred. For the last 5 years, I have trudged through misery. On this side of Heaven, trying to find meaning in your pain will drive you mad. But I can tell you this with my whole heart: if just one person goes to The Center and experiences healing because of my testimony, then my pain and trauma have served their purpose. I would not take back what I have had to go through if it means that just one person gets the opportunity to heal from their suffering. Whatever you are struggling with, no matter how severe or how “normal” you may think it is, there is healing for you at The Center  A Place of Hope. You are worthy of healing, and I promise, healing is possible, no matter how much you believe that it isn’t. Rachel Peters 2 months ago	6 6
Lantana Recovery Rehab 6 Top 10 in Highmark Rehab Score Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now. 8.40 / 10 4.8 (93 reviews)	Lantana Recovery Rehab takes a modern, community focused approach to helping men and women overcome substance use disorders. They’re located in Charleston, South Carolina. This facility has an incredible reputation for quality care. Their staff is said to be compassionate, experienced and knowledgeable. Their Joint Commission accreditation and Le	Treatments Programs Payment Options AlcoholismOpioid AddictionSubstance Abuse Adult ProgramYoung Adult ProgramMilitary ProgramProgram For MenProgram For Women Private insuranceSelf-Pay OptionsMilitary InsurancePrivate Insurance	My experience has been impeccable. They offer many groups and allow clients some options in choosing different group therapies in the afternoon. I was allowed to attended different 12 step meetings in the evening and encouraged to build my sober network. The support from all staff members has been expressed with genuine love and kindness. Lantana has a wonderful success rate and I believe this is do to the staff members who truly care about each individual client, providing care and compassion we need in such a difficult time. There is a strong community here. You can find friends and mentorship as you go through the program with clients who are also seeking support. Everyone’s experience is going to be different. Going through treatment can be challenging, many of us are learning a new way of life to find peace and serenity. 100% I recommend this program to those who are struggling and need some support. joe lopez 1 month ago It was very good place I learned a lot and the staff was awesome everybody John Jenkin 1 month ago Lantana has been a phenomenal experience. I couldn’t have asked for a better group of people to help me as I begin this journey. Jesse Huggins 1 month ago	6 6
The Haven Detox – New England Ad This is an ad and The Haven Detox – New England is a paid advertiser. Paid advertisers may be listed first in search results. This ad may contain content provided by the advertiser. Rehab.com does not verify ad content or any reviews that are displayed. Learn More Worcester, MA 4.7 (295 reviews) Claimed	Imagine recovering from addiction in an upscale environment that nurtures every aspect of your physical and mental wellness. That’s what you’ll find at The Haven Detox – New England. At our sprawling campus in Worcester, Massachusetts, we combine evidence-based therapies with innovative, holistic programs to offer a bespoke treatment experien	Treatments Programs Payment Options AlcoholismDrug AddictionMental HealthOpioid AddictionSubstance AbuseDual DiagnosisMental Health And Substance Abuse Adult ProgramProgram for menProgram for women Private InsuranceSelf-Pay OptionsSliding scale payment assistance	View Website (508) 257-1950	The Haven Detox – New England has no reviews yet. Leave a review.	20 20
Turning Point Recovery Center 7 Top 10 in Highmark Rehab Score Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now. 8.26 / 10 4.7 (216 reviews)	Turning Point Recovery Center is an Albuquerque, New Mexico drug rehab facility. They offer many levels of care from detox and residential treatment to recovery housing and alumni services. They accept clients who have co-occurring mental health disorders. Turning Point Recovery Center is a private treatment facility in Albuquerque, New Mexico. Est	Treatments Programs Payment Options AlcoholismDrug AddictionOpioid AddictionSubstance AbuseDual DiagnosisMental Health Adult ProgramSeniors programMilitary programProgram for menProgram for women MedicaidMilitary insurancePrivate insuranceSelf-pay optionsFinancing	Turning is an amazing center that helps in many areas. The staff is amazing and very personable and I would recommend the center for all recovery needs Renee Berry 1 month ago This place is amazing....was in the RTC program and now in IOP! Staff is unbelievably supportive and compassionate! Dorian Cruz 1 month ago TPRC is the best I went to the RTC program and now I’m in IOP. This place is amazing, I love it! Rachelle Alderete 1 month ago	15 15
Rocky Mountain Treatment Center 8 Top 10 in Highmark Rehab Score Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now. 8.15 / 10 4.7 (82 reviews)	Rocky Mountain Treatment Center is a drug and alcohol addiction treatment center in Great Falls, Montana. The organization is accredited by The Joint Commission and LegitScript certified. They are also members of The Association for Addiction Professionals. Insurance is accepted, but if you’re uninsured, they do have financing options available.	Treatments Programs Payment Options AlcoholismDrug AddictionDual DiagnosisMental Health and Substance AbuseOpioid Addiction Adult ProgramYoung Adult Program Private InsuranceSelf-Pay OptionsFinancial Aid	Rocky Mountain was the best experience. I came into treatment with some goals of things I wanted to tackle from a counseling perspective and was able to achieve them. I laughed, cried and made some lifelong friendships with both the counselors and other clients. Can’t wait to see everyone in September for the reunion! Michelle Ayers 2 months ago Amazing magical experience. Nicholas Schuh 2 months ago I’ve only been to one treatment center for my alcoholism. It was at Rocky Mountain Treatment in Great Falls, MT. It was a great experience! Most of the staff has been in treatment for addiction and so they know what you are going through. Your days are very structured and you’ll learn so much about your addiction and how to cope and get through the tough days. Thank you Rocky Mountain Treatment Center!!! Angela Sims 3 months ago	6 6
The Haven Detox – West Memphis 9 Top 10 in Highmark Rehab Score Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now. 8.09 / 10 4.8 (127 reviews) Claimed	The Haven Detox has a reputation for the most advanced addiction and mental health care in the country — with 6 locations and hundreds of positive reviews online. The programs are built on a foundation of science and mental wellness. Many of our innovative options are simply not available at most other treatment centers (like GeneSight Testing to	Treatments Programs Payment Options Dual DiagnosisSubstance AbuseMental HealthAlcoholismDrug AddictionMental Health And Substance AbuseOpioid Addiction Adult ProgramSeniors ProgramProgram For MenProgram For Women Private InsuranceSelf-Pay OptionsSliding Scale Payment Assistance	Super nice facility and good staff Merry M 3 days ago Glad I came here to get help with my mental health. Employees really care about everyone and want to help you get better. The facility is clean and very nice. Highly recommend Patrina Avila 2 weeks ago nice and friendly staff who put client care first and super nice and clean facility Cade Jackson 1 month ago	7 7
Engage Wellness Massachusetts Drug & Alcohol Rehab Ad This is an ad and Engage Wellness Massachusetts Drug & Alcohol Rehab is a paid advertiser. Paid advertisers may be listed first in search results. This ad may contain content provided by the advertiser. Rehab.com does not verify ad content or any reviews that are displayed. Learn More Acton, MA 5.0 (110 reviews)	Engage Wellness is a dual diagnosis substance use and mental health treatment center for adults in Acton, Massachusetts. They’re an LGBTQ+ inclusive facility with programs for veterans led by veteran staff. Flexible treatment options include both in person and remote formats for some programs. As a facility accredited by The Joint Commission, the	Treatments Payment Options AlcoholismOpioid AddictionDrug AddictionDual DiagnosisSubstance AbuseMental Health Self-pay optionsPrivate insuranceMedicaidMedicareMilitary insurancePer sessionMonthly	View Website (978) 699-9786	Engage Wellness Massachusetts Drug & Alcohol Rehab has no reviews yet. Leave a review.	9 9
Harmony Ridge Recovery Center 10 Top 10 in Highmark Rehab Score Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now. 8.04 / 10 4.8 (486 reviews)	Harmony Ridge Recovery Center is located in Walker, West Virginia. They specialize in treating young adults, adults, veterans, first responders, and pregnant women who are struggling with substance use and dual diagnosis disorders. Their levels of care include detox, residential, partial hospitalization, intensive outpatient, and aftercare. Holisti	Treatments Programs Payment Options AlcoholismDrug AddictionMental Health and Substance AbuseOpioid AddictionSubstance AbuseDual Diagnosis Young Adult Program Private InsuranceSelf-Pay OptionsMedicaidMilitary Insurance	If you or someone you know are thinking about going to a treatment center I’m happy to say the staff here have created something special. From the second I called I’ve been treated with love care and empathy by everyone at the facility. Even after completing the 28 program staff members like Joshua Haskiell reach out to check in on me regularly. They don’t make anymore money to do those things they are just genuinely good people with big hearts who have earned my trust. The main guy the director of operations Jacob May was there in the flesh 6 days a week with his door literally open all day. A man in his position doesn’t have to make your problems his problems but that’s exactly what he does for anyone needing help. He personally helped me with seemingly little things but important to me and he didn’t act like they were little he acted like they were important to him. That’s the kind of care you can expect to get at this facility top notch. Justin Hinerman 1 month ago Compiling the amount of gratitude I have for this facility into a couple sentences is near impossible. Being surrounded by nursing and clinical staff that did everything within their power to create a safe and peaceful environment was crucial for my first month in sobriety, and Harmony's Walker location made that a reality. Most facilities do not have the staff or patience to go the extra mile and accommodate the spiritual needs that some individuals have, but Harmony did that and some for me. I didn't interact with a single member of their team that didn't genuinely care and show that they had the experience to get me through what I was facing, and when I hit a point that I needed more than mandated groups Josh H.'s kayaking trips and hikes got me through. Feling alone and scared is natural during early sobriety, but being alone doesn't have to be. 💜🐇🐿️🪾 Arianna Clark 1 month ago I enjoyed everything they have thought me the people there and cooks were amazing everyone had a smile and was always there to help thank you so much harmony ridge jacob hise 1 month ago	6 6

Frequently Asked Questions

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.

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.

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.