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.
I love it here! The staff are very friendly and I enjoyed my time here
Gillian Torres
1 week ago
I highly recommend gratitude lodge. All the staff are extremely nice and caring people who want to see you exceed. It is comfortable, and the food is great.
Max Steinberg
2 weeks ago
Had a great experience here! Everyone on staff was incredible! Very kind and empathetic people doing God’s work. Taija is a great therapist with seasoned experience and advice. And James, the case manager is one of the best workers I’ve ever seen. Very professional, and an excellent case manager. I’d come again, but only to say hi and not get high.
Profound wow it was a wild ride but a great one the staff here are amazing they truly care about every single patient! They truly get to know you on a personal level and meet you needs. Take care of you in every which way. Thank you for making my first time in recovery great! Im going to give back to the program the treament that saved my life
Aaron Ramirez
2 weeks ago
My experience at Profound was truly transformative, healing and life changing. I feel truly blessed by having the opportunity to be surrounded by such an exceptional team of talented professionals, meet extraordinary people that became an incredible support system, experience a renewed sense of inner peace, strength, hope, inspiration, insight, spirituality and confidence I haven’t felt in years. The staff here is excellent, thank you Juls, Gillian, Josh A, Josh I, Doug, Katie, Jesse, Michelle, Rodney, Rachel, Dalton, Gilbert, Jenn, David, Becky, Cher, Lindsey, and Kaila. You’re all amazing!
In 2020, I went to the Aloha house in West Palm, after treatment. I was a chronic relapser and out of hope. The structure and support at the house set my feet on a path of victory and recovery. I'm almost 5 years sober today, reunited with my husband and 3 children, and helping others out of addiction. I'm not sure where I would be if I had not found Aloha. There was just enough structure and freedom to allow me to safely start rebuilding my life. I highly recommend. There is HOPE.
Jessica Wilging
1 week ago
LEONARDO ADRIAN IS THE BEST MAN IN THIS PLACE !! Thank you LEO YOU REALLY CHANGED MY LIFE THANK YOU !! 🙏🏽
Michael Cortez
3 weeks ago
My experience at Beachway was not perfect, as nothing truly is. However, I would not change a single thing. I learned so much and was embraced and understood for what feels like the first time in my life. Words can not express how thankful I am for the staff, the therapist, and the facility as a whole. I want to specifically thank Tripp, my primary therapist, and Brandon, my trauma therapist. Without these two gentleman I would not be living the life I am today. As I write this I have almost 7 months sober, moving into my own place, have a great job, and so many connections within the recovery community. I go to sleep often without worry, I breathe more calmly, and I am at peace almost daily. I love my life today, and that is in part thanks to Beachway! They will forever have a place in my heart. Thank you Beachway.
A Transformative Path to Recovery: Runway and Treehouse Recovery
My journey to sustained sobriety began at Runway, a premier short-term stabilization facility in Santa Ana, California. Designed for individuals in crisis, Runway offers 24-hour monitoring in comfortable, well-appointed accommodations, including private bedrooms, an on-site cook, and a dedicated nursing staff. A compassionate team of five to six professionals provides individualized care, preparing patients for a seamless transition to long-term treatment. Runway’s structured yet nurturing environment makes it an exceptional choice for immediate, high-quality intervention.
After stabilization, I transitioned to Treehouse Recovery to address a complex history of alcohol addiction, combat-related injuries, and a rare psychotic episode triggered by marijuana use. The Treehouse staff’s expertise in treating combat veterans navigating reintegration and substance abuse was remarkable. Their swift, targeted response to my unique challenges laid a critical foundation for my recovery.
Treehouse’s program distinguishes itself through a robust team-based approach, which fosters accountability, camaraderie, and personal growth. Patients are organized into small, cohesive units that collaborate on daily tasks, from meal preparation and facility maintenance to group sports and weightlifting. This model mirrors the discipline and interdependence of military teams, which was particularly resonant for me as a veteran. For example, morning team raft exercises in the surf required synchronized paddling, teaching us to trust one another and communicate effectively under pressure. These activities were more than physical; they instilled a sense of shared purpose and mutual reliance, reinforcing the skills needed for long-term sobriety. By working closely with peers, I rebuilt self-esteem, learned to embrace responsibility, and developed a support network that extended beyond the program. This team dynamic was a cornerstone of my recovery, providing a safe space to confront vulnerabilities and celebrate collective achievements.
Beyond its team-based framework, Treehouse emphasizes the physiological and biological aspects of addiction, moving beyond traditional talk therapy. Physical training restored my strength and confidence, while the program’s focus on leadership in its latter half prepared me for a successful return to everyday life.
Over a year later, I remain sober, with strengthened family ties and renewed self-confidence. The ongoing support from Runway and Treehouse, through regular check-ins, reflects their commitment to clients’ long-term success. Their tailored, family-like approach creates a global network of support that empowers individuals to thrive post-treatment.
I wholeheartedly recommend Runway and Treehouse Recovery to anyone seeking a path to lasting recovery. These facilities not only saved my life but also provided the tools and community to build a brighter, more fulfilling future.
Sincerely,
Charlie
CB
1 week ago
I showed up to Treehouse ready to change but i didn't know how to make these changes. Anything i tried alone always seemed to fail until i was accepted into the treehouse family. They showed me how to handle simple to complex tasks with a rational clear thinking mind. They gave me the tools and confidence to stay in a state of gratitude day in and day out. They solidified my hard working ethics and gave me a place to call home. We worked hard and we had a lot of fun. I particularly love the ocean (surfing, diving, skimboarding) so being on the boats with the team was my favorite part of the physical modalities. I owe it big time to the clinical staff for listening intently, caring and asking the right questions at the right time to help me work through a lifetime of baggage.
Cruz Bokolas
3 months ago
Treehouse has made a huge impact on my life. The values, connections and education have given me an entire different perspective on life. They have given me the tools and knowledge on how to live a life in sobriety. The staff are all super cool and very supporting of whatever you are going through and will do the best they can to help you get where you need to be. Thank you treehouse !
Ive been here a few times and I love it. Its such a great place.🥹 I highly recommend choosing this place🥹
Hailey Pyenta
1 week ago
This place has been a magical, healing, life changing experience. I have struggled with addiction to serious drugs for over 20 years. I also struggle with mental health. I have been to 11 different treatment facilities. Some of them really good. This place blew them all out of the water. The setting is phenomenal. It’s located on 70+ acres of the most beautiful mountain setting that Mass has to offer. The sunrises are breathtaking. It’s like an enchanted forest. The bunnies and chipmunks and baby dear are adorable and amazing. I stayed in the ‘poets’, these amazing, spacious log cabins with cathedral ceilings. When I walked in the first time I cried in gratitude. The beds are comfy, you have plenty of privacy, and it’s a space I would stay at on vacation. The food is top notch. I don’t think I was served a single bad meal. The head cook, Matt, is so accommodating. It feels like home. You always have the option of a delicious salad bar, leftovers are available until 11 at night. I couldn’t asked to be better taken care of. Most of the RS staff are in recovery which is amazing. They are the most devoted caring staff I have ever had the privilege of knowing. And you do get to know them, their personal struggles and victories, they give you hope that this is possible. They were inspirational. Thank you to all of you: Chris, Justin, Lisa, Owen, Jess, Andrew, Steve, Brandon, Tim, Courtney, Moe, Ryan, Pete, Greg, Alina, Mark, Jamie. I hope I didn’t forget anyone. And of course I can’t forget the RS supervisor, John, who does an amazing job managing an amazing staff. You guys never ignored me, constantly asked how I was doing, and knew me well enough to know when I was down. I didn’t have a single request that wasn’t immediately dealt with in a kind way. Down to wanting printouts of watercolor painting ideas. I got ridiculous. Thank you. The classes were also amazing. We had groups six hours a day including women’s groups and process groups. I really thought that as much treatment as I have received that there was nothing left to learn. This place disabused me of that notion. Sarah’s groups were always fun and informative, plus she’s the best Clinician I’ve ever had. Thank you! Marcus, the family counselor, was like an injection of hope. He also does amazing family sessions. The man is a miracle worker. All of the case managers and clinicians are amazing. My case manager, Kelley, along with Sarah, helped me to set up aftercare that included IOP, a recovery coach, primary care appointments, MAT and psychiatry appointments, they helped my come up with a relapse prevention plan, deleted and block all dangerous contacts on my phone, disable my Facebook account, etc etc. I have never felt so prepared to go back to the real world. The executive director, Colleen, knows every patient by name, knows what your going through, and interacts with everyone on a regular basis. The nursing staff is also top notch. Headed by Kayla, they do a tremendous job. My favorite nurse was Scott but every one of them was endlessly available and truly stupendous. My needs were met in a timely and empathetic way. I was made to be comfortable and I’m so grateful. Then the clients, I don’t know what it is but the quality of client was truly wonderful. Everyone looked out for eachother, everyone was determined to grow and learn as much as possible. We had so much fun playing games, doing karaoke, riding horses, playing corn home and ping pong, hanging out at the fire making s’mores. It was truly like adult summer camp that saved my life and gave me the tools I needed to go out into the world and thrive. I cannot say enough about this place and it’s wonderful people it’s wonderful setting. I am forever grateful in a way I cannot express here.
tanya segura
2 weeks ago
Excellent environment. Great staff. Good clients. Would recommend to anyone in recovery
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Brittnay was so helpful with placing my son in a perfect environment for him to heal!
Marian S Moore
2 weeks ago
I had come and make a review. I was in distress and full of Anxiety (that I diagnosed myself with lol) trying to find my son an appointment in order for him to be discharged. I googled several places who did not accept his insurance. I felt defeated and said a prayer than I googled some more and found Provive Wellness. Not only was Tommy very knowledgeable, patient, and reached out to the social worker right away. My son was scheduled in no time. This is what I call superb customer service. And the best part of all I have no out of pocket cost, everything is covered by the insurance.
Wright Family
3 weeks ago
Provive Wellness is a genuinely caring and effective program for people facing substance use and mental health challenges. The staff create a safe, supportive environment where real healing can happen. It’s the kind of place I’d feel good about sending someone I care about.
I came to The Center in the lowest place of my life, and left 4 weeks later filled with a new found hope for my future. The stuff are all outstanding people who genuinely care for every client who walks in the doors. The housing accommodations were great and having good roommates made the experience even better. I can’t thank The Center enough for all the care and support. It truly changed my life.
Malia Reynolds
1 week ago
The Center has amazing staff and caters to your needs and wants! They care immensely about every individual and want the best for everyone that walks through their front door. They’ve helped me find my joy, love and purpose for life again!
neomi macmillan
2 weeks ago
The Center is a well-structured facility that fosters healing and recovery. Everyone was so kind and welcoming. The whole team of staff provided encouragement, empathy, compassion. The medical team staff have expertise in mental health treatment and care. They showed a deep understanding and concern for the my well-being and the care they gave exceeded my expectations. Highly recommend the Center to anyone considering getting help with any mental health issues you may be experiencing.
Great place! Thanks to all the staff for all the help and support !
Ryan Segura
1 month 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.
Danny Magana
1 month ago
Awesome place with awesome people! I truly felt like every staff member cared about me and my recovery journey every day. Justin the case manager always had an open door to talk when I needed. Karen the program director and David the operations director helping me get paperwork filled out as painlessly as possible. Jeramiah, Lisa, Winnie, Jessie, and Tony on the nursing staff always ready with a smile and positive attitude. JJ, Lane, and Isabel, the techs that put up with me daily with a smile on their face no matter what I did. I can't recommend Laguna View Detox enough. If you're ready to start your recovery journey I can't think of anywhere else better!
Lantana is the best place on earth and beyond! This place saved my life!! I’m so glad I chose this place to start my life over and learn to live again! The staff from therapist, recovery managers and beyond they care they have compassion for each of us! If you’re looking to get sober and recover look no further!!
Micheal Rich
1 week ago
I found recovery here. Its an amazing experience #10 months later and still counting
Destiny Harkins
1 week ago
Lantana gave me a chance at life again. I’m an alcoholic and an addict. I’ve lived inside places. I’ve been to dozens of treatments. The counselors and staff at Lantana gave me hope and shed a new light on recovery for me. I had reached the end of my rope; I was tired and sick of letting myself and my family down. Lantana showed me that recovery was possible for someone who had become as jaded about 12 step programs as me. I felt comfortable here and I got honest. I mean really honest and I got the help I needed. Thank you Lantana, I recommend this program for anyone who wants access into an all inclusive program that introduces its clientele to all forms of recovery from dharma to ACT, DBT, CBT and AA. Lantana gave me my life back.
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.
Sam Pastula
2 weeks ago
Paramount recovery centers has literally saved my life, when it came to recovery I was uncertain and afraid, but ever since the first day I set foot in this place I felt like part of a family and have been led through a powerful process of change! I was on the brink of losing everything due to my addiction, but with the love and care I have received here I've learned how to change my negative thought processes and keep my urges at a far distance! It is not said lightly that this wonderful facility has allowed me to keep my life, including my family, my job, and everything I hold dear. So a huge shout out to all the staff here and everyone who has personally been an endearing part of my recovery, im grateful for all of you! I don't feel alone in my recovery anymore and for the first time in a long time I can wake up and feel.the joy of hope and healing in my heart and soul!
David Duchesne
3 weeks ago
My time at Paramount has been amazing. Since day one I've been given the most amount of support I could ask for. Haley made my intake process smooth and stressless and she's always made herself available when ever I needed anything or just someone to talk to. My Case Manager Nia did all the heavy lifting with obtaining my EBT card and cash assistance. Everyone here made me feel safe, and understood without judgement. I truely feel I can stay sober with the tools I've been given 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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