Explore UPMC Health Plan’s coverage for addiction treatment, including inpatient and outpatient options, plus mental health support.
UPMC Health Plan Coverage for Addiction Treatment
Explore UPMC Health Plan’s coverage for addiction treatment, including inpatient and outpatient options, plus mental health support.
UPMC Health Plan is the insurance arm of the UPMC (University of Pittsburgh Medical Center) health company that provides integrated health care and insurance coverage to residents of western and central Pennsylvania plus parts of Maryland and Ohio and West Virginia. They are headquartered in Pittsburgh Pennsylvania.
UPMC has their own network of hospitals and doctors and they also contract with other providers including the Cigna PPO network to serve members who live or travel outside of their main service locations. UPMC actively supports Pennsylvania community arts and education groups such as the Pittsburgh Promise, an educational scholarship fund to which they donated $10 million in 2023.
By Rita Milios
Rita Milios, The Mind Mentor, is a recently retired psychotherapist, freelance author (recovery, mental health, spiritual growth), seminar leader, and podcaster from Kissimmee, FL. She provided counseling in rehab facilities in Ohio and Florida, as well as in her private practice. Rita also served as a DOT Substance Abuse Professional (SAP) consultant.
Medically Reviewed by Danielle Letenyei
Danielle Letenyei is a freelance writer living in Madison, Wisconsin. She specializes in personal finance and insurance topics, including medical insurance and Medicare. Her work has appeared in FinanceBuzz, Market Realist, U.S. News & World Report, and more.
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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.
AlcoholismDrug AddictionMental Health And Substance AbuseOpioid AddictionSubstance AbuseDual Diagnosis
Adult ProgramYoung Adult ProgramProgram For MenProgram For Women
Private InsuranceSelf-Pay Options
Awesome staff and great facilities. All my needs were met and they got me on the road to recovery.
Brian Mckinney
1 day ago
Everything here was really great. The stars and medical team was very helpful. I left here with a new life
Lucas Deters
1 week ago
Great Staff helping you learn about your addiction and how to beat it.
There is nothing wrong with struggling or being afraid.. They will help you through everything and help you set goals for your future.
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.
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.
AlcoholismDrug AddictionMental Health And Substance AbuseOpioid AddictionSubstance AbuseDual Diagnosis
Adult ProgramProgram For MenProgram For WomenYoung Adult Program
Private InsuranceSelf-Pay Options
My wife completed residential treatment here for alcohol addiction and the change has been remarkable. Family therapy sessions helped all of us understand how to support her moving forward.
Rosalind Actongale
1 week ago
Attentive medical staff during detox, comfortable rooms, board-certified providers who explain everything clearly.
Tobias Kingsley
1 week ago
The residential mentors actually check on you, not just clock in and out. Small thing but it made a real difference during a hard stretch.
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.
Wellbrook changed my life and has done phenomenal things in the community
James Taylor
1 month ago
It was an amazing time! Thank you to Wellbrook and the sponsors for hosting this event! Special thanks to Ricky Marinelli and Sonya. I can’t wait to do it again next year!
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.
Really changed my life. Feel like a completely different person leaving than when I first got here. The group facilities are fantastic and really are able to help you on a deep level. The community overall is phenomenal and recommend it to anybody who is struggling
Aiden Muska
2 weeks ago
★★★★★
I would highly recommend Indiana Center for Recovery. No treatment facility is perfect, and there are a few things I think could be improved, but overall my experience was very positive. In talking with residents who had been through treatment before and experienced relapses, I repeatedly heard this was the best facility they had been to. After my experience, I understand why.
The biggest area for improvement is communication. There can be a lot of redirection between staff when trying to get an answer, and expectations aren't always communicated clearly. When someone is already in a difficult place and there to heal, even small communication issues can become frustrating.
For example, there's a sign-up sheet for cleaning the lunch area that I didn't know about until I discovered I was on it. It's no big deal—about 15 minutes with several people—but knowing beforehand would help. Mail is another example: you need to check the office after sessions each day if you're expecting something. Small things, but clearer communication would make the experience easier.
A few practical recommendations: bring an inexpensive wristwatch because you won't have your phone and clocks aren't always readily available. If you smoke, you can't bring a lighter, although techs are readily available to light cigarettes. A small, dim flashlight is useful for finding things at night without disturbing roommates. A blanket can also help in a cold room or with getting comfortable in a chair.
Where Indiana Center for Recovery really shines is the people and treatment. Syndey, Greg, and Dave are excellent facilitators. Classes cover a wide range of subjects and include traditional groups along with activities such as art and music. I learned a great deal about recovery, myself, and how I look at life. They also offer acupuncture and a variety of other therapeutic activities.
The staff deserves a lot of credit. Toni, Justin, Sarah, Carter, the nursing staff, and many others do a great job. The atmosphere among both staff and residents is remarkably nonjudgmental and supportive. Everyone has a story and is working through something.
The facility has a gym, arcade, and plenty of outdoor areas for walking or sitting when the weather cooperates. Those things matter when you're temporarily removed from your normal life and routine.
Treatment isn't easy. Being away from home, without your phone and outside your normal environment, can be difficult. But Indiana Center for Recovery gives you an opportunity to step outside that environment, learn about yourself, work on what brought you there, and figure out what comes next.
I especially appreciate that treatment doesn't feel one-size-fits-all. They continually assess where you are, work closely with you, and help determine appropriate next steps for treatment, sobriety, recovery, or mental-health care.
There are communication and organizational details I would improve, but they don't outweigh the quality of the people, treatment, support, and overall experience.
For someone who genuinely wants help and is willing to participate in the process, I would absolutely recommend Indiana Center for Recovery. It earned five stars from me—not because everything is perfect, but because what matters most about the place is very good.
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.
Had a great experience at The Haven Detox. They helped me stay comfortable throughout the process and helped me with my second step in the recovery process
Neil
2 days ago
I have nothing bad to say about this place. First of all, I wanna say the staff is amazing! Of course you have Roni, her beautiful face and smile is the first one you see as you walk through the doors, she works hard and is always running around and getting things done. Ashley is the same, Getting stuff done and go, go, go All well-being super friendly. All the nurses And providersare amazing, I never had a bad experience with them. My case manager Lauren was another one of my favorites, Lauren got everything done and quickly and efficient manner. The chefs were amazing and they always had a good variety, also they had snacks so if you get hungry at night, there was always something to eat. and last, but not least the text. Matt, Mark. and all the others (I can’t remember all of their names) were super friendly and helped you get your stuff when you needed it. They were quiet and respectful at night. And then you have the groups, they were all amazing. They were the perfect size anywhere from 10 to 15 people. And they didn’t just take easy route, they actually had us to work and challenges. And with our free time, there is plenty of stuff to do whether it was playing pool, racquetball, basketball, beautiful gym, TVs in every single room, including your own, books and magazines, and board games everywhere. I would highly recommend The Haven! I hope I never have to see them again lol, but if I do, I know where to come.
Matthew Dean
5 days ago
M experience at the Haven was nothing short of amazing. From the staff to administration, I was treated with kindness and humility.. I want to especially thank Jose , my therapist who was so instrumental in getting to the crux of the problem. Thanks guys!!
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.
Amazing place. Top to bottom. And yes the food is amazing.
28 day retreat in the poconos. I leave a changed person.
NBI therapy is amazing.
Hunter Farmer
2 weeks ago
I had an incredibly positive experience at STR Silver Pines. From the moment I arrived, I felt genuinely supported, respected, and valued. My therapist, Zac, was especially helpful and played an important role in my experience. He created a space where I felt comfortable being open and authentic while working through the things I came there to address.
What really sets STR Silver Pines apart is its commitment to LGBTQ+ inclusion. The HRC designation is truly meaningful—not just as a label, but because you can see that the values behind it are reflected in the culture. Being queer isn’t simply “tolerated”; it is genuinely valued and embraced. The staff is knowledgeable and intentional about creating an environment where LGBTQ+ identities are respected, affirmed, and celebrated.
It made a significant difference to be in a place where I didn’t have to explain or defend who I am in order to receive quality care. I’m incredibly grateful for my experience at STR Silver Pines and would highly recommend it to anyone looking for compassionate, affirming, and inclusive care.
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.
AlcoholismDrug AddictionMental Health And Substance AbuseOpioid AddictionSubstance AbuseDual Diagnosis
Adult ProgramProgram For MenProgram For WomenYoung Adult Program
Self-Pay OptionsPrivate insurance
The alumni support program is something I don't see mentioned enough when people talk about what makes a rehab worth considering. Getting through treatment is one thing. Having some kind of structured support afterward is a completely different conversation, and it matters.
Michelle Grant
1 week ago
Simi Valley was a good fit location-wise, and the residential setup is a structured 24/7 environment away from the usual triggers. That's exactly what the early stages of serious recovery tend to require.
Thomas Hale
2 weeks ago
Checked on insurance before anything else and the process was quick and pressure-free. Knowing coverage before committing takes a lot of the financial stress out of a decision that's already hard enough.
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.
As a community partner, it has been incredible to watch the work Never Alone has done to create a welcoming, supportive environment for adolescents during an incredibly important period in their lives. The investment in the facility itself, from renovations to amenities like the gym and movie theater, reflects a larger commitment to making young people feel valued, safe, and cared for.
What stands out even more is the programming and the people behind it. Never Alone is helping adolescents learn self-care, build confidence, develop healthy coping skills, and understand that they do not have to internalize the stigma often associated with seeking help or going through a difficult chapter.
These young people are so much more than a brief period of struggle in their lives, and they deserve the opportunity to move forward without allowing that period to define who they are or who they can become. It has been meaningful to see a program committed not only to treatment, but to dignity, growth, and helping young people recognize their own potential.
I’m grateful to have Never Alone as a community partner and to see the positive work happening there firsthand.
Michael Burke
3 weeks ago
Great facility for a great cause. Beautiful location in the woods of New York State.
Margarita
3 weeks ago
Great staff, have heard only good things about this place
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.
The campus is stunning and the staff really care about what they do. It’s a beautiful place filled with beautiful humans I will forever be grateful for them
Alexandria Kiezle
2 weeks ago
Hands down the best treatment facility I've ever completed. If you're expecting perfection, you're wasting your time because it doesn't exist in this world. However, if you're looking for dedicated staff as well as amazing community there is placed in an amazing rural environment. Every facility has its issues, so I'm sure you will find whatever you're looking for here. My experience here was top tier, as I stated, the staff is very respectable and dedicated to their jobs. The community can sway
As is life. WE DO RECOVER..!!!
Kiefer
4 weeks ago
I'm from NYS and have been to several rehabs in PA . By far St. Joe's is the best. Offering a holistic approach to recovery with physical therapy , sound bath , swimming, tia chi and so much more. The clinical , RA, and nursing staff are all amazing, person centered and caring! They have a well put together humongous facility for freetime activities as well. Then after completion, its not over. They contact you with follow-up and if willing connect you with the best Alumni program and peer ran staff Melissa. Who could ask for anything more from rehab!!!
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Frequently Asked Questions
Does UPMC Health Plan Cover Addiction Treatment?
As required by the 2010 Affordable Care Act (ACA) most UPMC Health Plan insurance plans offer mental health and substance abuse treatment along with other medical care. However there are exceptions to the law and every insurance plan is different, so be sure to check with your insurance provider to find out which addiction treatments are covered by your specific plan.
Most UPMC in network substance abuse rehabs are in Pittsburgh, but there are some UPMC covered rehabs in Maryland and New York.
If you have a Cigna PPO plan or other out of network plan that has a partnership with UPMC Health Plan, you may have other rehabs available to you as well. Check with your insurance provider to find out which addiction treatments are covered by your specific plan.
What UPMC Health Plans Are Available?
UPMC offers individual and family plans through the state Insurance Marketplace and through employers. If you qualify you can also get Medicare or Medicaid plans through UMPC.
The individual and family plans have several different options. They have Exclusive Provider Organization (EPO) plans, which require you to get care in the provider network but you don’t need a referral to see a specialist such as an addiction counselor.
They also have Health Maintenance Organization (HMO) plans, which require you to stay in network and to get a referral for specialist care. However, HMOs are often the least expensive on a monthly basis. Finally, a Preferred Provider Organization (PPO) gives you the most flexibility with some out of network coverage and no referrals required. However these plans tend to cost the most each month.
UPMC Health Plan offers Medicare Advantage (“Medicare part C”) HMO and PPO plans. Medicare plans by UPMC healthcare are called UPMC for Life. These plans provide the same services as regular Medicare, including coverage for addiction care, but they generally offer extra benefits like prescription coverage and vision and dental care.
Your Medicare Advantage plan will have its own coverage limits and requirements to get addiction treatment, so be sure to work with your doctor and get the referrals and preauthorization you need before you commit to treatment.
Medicaid plans by UPMC healthcare are called UPMC for You. Like regular Medicaid, these plans cover medical treatment and substance abuse treatment. However, they also cover prescriptions and dental and vision care.
If you qualify for both Medicare and Medicaid, UPMC for Life Complete Care offers $0 premium fees and $0 copays on medical care and $0 copays for prescriptions. It also offers dental and vision and hearing benefits. Members can get free transportation to healthcare providers and grocery stores along with fitness centers and adult day care centers. There’s also an allowance you can use to buy over the counter products.
What Inpatient Addiction Treatment Does UPMC Health Cover?
All insurance plans will focus on covering medically necessary care which is often defined by the treatment plan your doctor creates. It’s also important to verify your insurance and make sure you get a referral or preauthorization if necessary.
Some of the inpatient drug rehab treatment options that may be included in UPMC Health Plan’s behavioral health insurance policies are medical detox and residential treatment.
Detoxification is the process of letting substances leave your body. Many times you’ll get medical support to help you move through withdrawal symptoms. This may include medication assisted treatment (MAT). Commonly used MAT medications for treating alcohol or opioid addiction are methadone and buprenorphine along with naltrexone.
Inpatient treatment takes place in a clinic or hospital and residential care takes place in a non hospital facility and offers a more home like setting. Both options provide around the clock support and care.
Residential treatment often lasts 28 to 30 days or more. You’ll get a variety of therapy options which often includes holistic approaches like art or music therapy. Inpatient or residential treatment allows you to fully focus on your recovery without any distractions.
What Outpatient Rehab Does UMPC Health Plan Cover?
Outpatient programs, including intensive outpatient programs and regular outpatient programs, are available through UPMC Health Plan’s mental health benefits. Intensive outpatient programs typically involve up to nine hours of treatment each week, for between three to six weeks.
In a general outpatient program, counseling and education sessions may take place at a clinic or rehab facility. Addiction and relapse prevention education are provided, with individual sessions offered as needed.
There are multiple types of outpatient care. The most intensive outpatient treatment is a partial hospitalization program (PHP). This is a full day program that offers more than 20 hours of treatment per week. The treatment options are similar to inpatient or residential care.
At the next level are intensive outpatient programs (IOPs) which typically involve nine to 20 hours of treatment each week, with the hours spread over three to five days. Often 90 days of IOP treatment are recommended. The lowest intensity is general outpatient treatment, where counseling and education sessions may take place at a clinic or rehab facility once or twice a week. Addiction and relapse prevention education are provided, with individual sessions offered as needed.
Do UPMC Health Plans Have Additional Benefits?
Part of what makes UPMC Health stand out is the extra benefits members receive. For example preventive services may be free of charge and members can access virtual (telehealth or video) urgent care services to diagnose illness or prescribe medication.
They also have the MyHealth program that provides free health coaching for weight loss and smoking cessation along with tips on stress management and more. Finally, members can get six sessions of free counseling with a trained counselor through the Life Solutions program.
Does UMPC Health Plan Cover Methadone & Suboxone (MAT)?
MAT is covered by most UMPC plans. This treatment uses FDA approved medications to help those with alcohol and substance use disorder during the early recovery period. These medications such as naltrexone and buprenorphine along with methadone and acamprosate ease withdrawal symptoms and help to normalize brain chemistry. This is especially important during medical detox.
Some individuals only need MAT during the detox process while others need it throughout treatment to help manage cravings to reduce the risk of relapse and decrease the risk of overdose. Longer term MAT is combined with inpatient or outpatient treatment to help you establish long term recovery. Once treatment ends you can taper off the medication support and live a fully substance free life.
Does UMPC Cover Other Mental Healthcare?
In 2010 the Affordable Care Act was enacted into law. The ACA requires insurance plans to cover 10 essential health benefits which include mental health and substance use care. As a result most UMPC plans cover mental healthcare such as counseling and crisis intervention. You may get individual or group counseling along with mental health medication.
The extent of coverage differs from plan to plan. It is important to understand the details of your specific plan before starting treatment so you know whether you need a referral or preauthorization. You’ll also learn what out of pocket costs to expect.
Individuals with alcohol and substance use disorder often have co occurring mental health conditions. What’s most important in these cases is that you get treatment that addresses both mental health and addiction. That’s the only way to ensure you get the help you need to reach long term recovery.
Does Addiction Treatment Need to Be In Network?
Many UMPC plans require you to use an in network provider to get coverage. However some allow you to use an out of network provider although you’ll pay a lot more in out of pocket costs. For example your copayment and deductible may both be higher. Or you might have to pay a percentage of the cost instead of a flat copayment.
To maximize your insurance coverage it’s best to use high quality in network providers or facilities. To find out whether your plan allows non network care contact UMPC directly. This can be done by calling the phone number on the back of your ID card or by going online to their webpage at UPMC.com
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.
Calls to numbers on a specific treatment center listing will be routed to that treatment center. Calls to any general helpline could be forwarded to SAMHSA or a verified treatment provider.
If you wish to connect with non-sponsor centers, you can browse top-rated listings, visit our homepage and browse by state, or visit SAMHSA.
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