Harvard Pilgrim Health Care Coverage for Drug Rehab

Discover how Harvard Pilgrim Health Care covers addiction rehab and mental health services. Find the right plan for your needs today.

Harvard Pilgrim Health Care Coverage for Drug Rehab

Discover how Harvard Pilgrim Health Care covers addiction rehab and mental health services. Find the right plan for your needs today.

Harvard Pilgrim Health Care came into being after the merger of Harvard Community Health Plan and Pilgrim Health in 1994. They offer plans in Massachusetts, Maine and New Hampshire. You can get individual and family plans from Harvard Pilgrim directly or through your employer. They also have Medicare Advantage and Medicare Supplement plans for people who are eligible.

Does Harvard Pilgrim Health Care Cover Addiction Rehab?

Yes, may Harvard Pilgrim plans cover addiction rehab and the company has a number of treatment centers in their network. They also make it easy to find out what care providers they cover through their substance use services webpage. There are many levels of addiction treatment included in their network.

However, every insurance plan is different so be sure to verify your coverage details before you start treatment. You’ll want to get a treatment plan from your doctor as well because that will let you know what’s medically necessary in your case.

Name / Address / Rating	Description	Treatments / Payments / Programs	Review / Contact	Images
The Recovery Team – Cape Cod Ad This is an ad and The Recovery Team – Cape Cod 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 279 Brick Kiln Road Falmouth, MA 02536 4.8 (250 reviews) Claimed 4 Top 10 Rehab In Massachusetts	Recovering Champions is an addiction treatment program that specializes in substance use and co-occurring disorders. They offer partial hospitalization, outpatient, and medication assisted treatment from a facility on the serene Cape Cod near Falmouth, Massachusetts. You’ll have a peaceful environment for recovery. The structured rehabilitation p	Treatments Programs Payment Options AlcoholismDrug AddictionDual DiagnosisMental Health and Substance AbuseOpioid AddictionSubstance AbuseMental Health Adult ProgramProgram for menProgram for women Private InsuranceSelf-Pay OptionsSliding Scale Payment Assistance	View Website (888) 270-7241	The Recovery team was great, all the staff was very friendly and Jess was an amazing help! Robert Bishop 1 month ago Phenomenal place more than what I expected RTC has truly changed my life. From the moment I walked through their doors, I was met with compassion, professionalism, and unwavering support. Every member of the team—from the counselors to the support staff—was not only knowledgeable, but genuinely invested in my recovery journey. The individualized care I received made all the difference. They didn’t treat me like just another patient; they listened, tailored my treatment plan, and helped me build the tools I needed to stay clean and take back control of my life. The therapy sessions were impactful, the group environment was supportive, and the relapse prevention strategies were practical and empowering. What stood out most was the sense of community and hope. I never felt judged—only understood. If you're struggling with addiction and looking for a place that will truly help you heal, RTC is the place to go. I can honestly say I wouldn't be where I am today without them. Thank you, RTC, for helping me find myself again. - Andy 1 month ago I don’t usually write public reviews about something as personal as substance use treatment, but the care I’ve received at Recovery Team - Cape Cod is worth breaking that rule. I came here after a 20-day detox, thinking I had my substance use disorder under control and didn’t really need a PHP program. But I figured, “What the hell, I’ll give it a shot.” That decision turned out to be one of the best I’ve made in my recovery journey. The group sessions are truly engaging, and the exposure to different tools and coping strategies has been invaluable. The recovery community here is one of the strongest in the nation. I initially committed to just two weeks—but ended up staying for the full four, and I’m even considering sober housing now. The staff have shown me nothing but genuine care and commitment. I’ve never once felt like just another “client.” They’ve treated me like a real person—with hopes, struggles, and a future worth fighting for. If you’re on the fence about starting a PHP or IOP program, I couldn’t recommend this program more. Sure, there might be flashier or more luxurious programs out there—but ask yourself: are you looking to be pampered, or are you ready to gain the tools you need to build the best life possible? alexander fleming 2 months ago	8 8
Spring Hill Recovery Center – Massachusetts 250 Spring Hill Rd Ashby, MA 01431 4.7 (259 reviews) 1 Top 10 Rehab In Massachusetts	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. Most of the day in their program is structured with therapeutic activities. They use treatment models that have been proven to work, like cognitive	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	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 Will G 2 weeks ago	5 5
Peaks Recovery Centers 6430 Brook Park Dr. Colorado Springs, CO 80918 4.6 (95 reviews) 4 Top 10 Rehab In Colorado	Peaks Recovery Centers is a Joint Commission accredited drug and alcohol rehab located on 11 acres of land in Colorado Springs, Colorado, with breathtaking scenery. Here at this rehab, they offer treatment to adults who are struggling with co-occurring and substance abuse disorders. Levels of care include medical detox, residential, partial hospita	Treatments Programs Payment Options AlcoholismDrug AddictionDual DiagnosisMental Health and Substance AbuseOpioid AddictionSubstance Abuse Adult ProgramYoung Adult Program MonthlySelf-Pay OptionsPrivate insuranceFinancial Aid	Peaks Recovery is family! My story didn’t start or end here just part of my wonderful journey. An amazing recovery center based on community. Proud to be alumni! Tyler holloway 1 month ago What a great experience. People come here from all over the US because of how great Peaks is. Everyone was wonderful and I'd recommend to anyone in need Chelsi Odden 1 month ago Best rehab I’ve been to and I’ve been to 17 my therapist was great I’ve healed so much in such a short period of time I am truly grateful. Patient staff, great meetings all around great place to change your life. sean witte 1 month ago	6 6
Casco Bay Recovery 989 Brighton Ave Portland, ME 04102 4.9 (78 reviews) 1 Top 10 Rehab In Maine	Casco Bay Recovery in Portland, Maine, is an addiction treatment center for men and women. They offer individualized outpatient treatment for alcohol and substance use disorders. Holistic therapies, family involvement and one-on-one counseling are a few of the methods used to help clients heal. They strive to help every individual become the healt	Programs Payment Options Adult ProgramYoung Adult ProgramLGBTQ ProgramMilitary Program Private InsuranceSelf-Pay OptionsFinancial AidMilitary InsuranceMedicaid	FROM THE MOMENT I WALKED IN, I WAS GREETED WITH SUCH KINDNESS AND PROFESSIONALISM. THE 10 WEEK CLASS WAS WONDERFUL!!! THE COUNCELORS WERE THERE FOR YOU EVERY STEP OF THE WAY. YOU COULD CALL THEM ANYTIME YOU WANTED TO, FOR ANY REASON. I HIGHLY RECOMMEND CASCO BAY. THANKS FOR EVERYTHING, I'M STILL SOBER!!❤️❤️❤️🥰🥰🥰👏👏👏👏👏👏👏 Cynthia Ward 4 weeks ago I really enjoyed the counselors, professionalism and the program. Very well done and welcoming. I’d highly recommend Casco Bay to anyone looking for a healthier future and the tools and knowledge they provide to help. Thomas Puschock II 1 month ago Casco Bay Recovery was my first experience seeking treatment, and I couldn’t have imagined a more compassionate and supportive environment. From the moment I reached out, they responded quickly, got me into the program without delay, and treated me with respect every step of the way. Not once did I feel judged, rushed, or like just another name on a list. They were instrumental in guiding me to the recovery I have today. What makes this place stand out is the people — the staff come from a wide range of backgrounds, and every one of them brings personal insight and deep knowledge of recovery and addiction. Their stories were moving and relatable, and their support felt real and grounded. If you’re hesitant about treatment because of the religious elements you’ve heard about in AA, don’t let that stop you from coming here. Casco Bay Recovery centers its program on therapy-based recovery work. Any spiritual or religious connection you build is entirely up to you — nothing is pushed on you. They meet you where you're at. If you’re ready to take that first step, this is the place to do it. I’m so grateful I did. Samuel Whitaker 2 months ago	5 5
Granite Recovery Center 6 Manor Pkwy Salem, NH 03079 4.3 (151 reviews) 2 Top 10 Rehab In New Hampshire	Granite Recovery Centers is an organization with multiple addiction treatment centers throughout New Hampshire and Maine, including a location in Salem, New Hampshire where clients can receive addiction recovery services at New Freedom Academy. They offer an inpatient program, an intensive outpatient program (IOP) and a partial hospitalization prog	Treatments Programs Payment Options Substance AbuseAlcoholismDrug AddictionOpioid AddictionDual DiagnosisMental Health Adult ProgramMilitary Program Private InsuranceSelf-Pay OptionsFinancial AidMedicaidMedicare	Green Mountain Treatment Center saved my life. I was sick and scared when I arrived, but the transformation that occurred for me during the 80 days I spent on the mountain was nothing short of a miracle. I quickly recognized that hard work on my part needed to be done, or I'd be miserable and missing out on the gifts of the program. Thankfully, there is an incredible staff in place who walked with me through the introspection I had to do and showed me that recovery was possible. I marked 5 months sober yesterday and I truly believe that God removed my alcoholic obsession while I was on the mountain. Everyone's experience is different and I can only speak of my own, but I personally could not see myself succeeding as I did in any other facility. I'll be thankful to Green Mountain for the rest of my life. Courtney 7 months ago GRC changed my life for the greater good! Justin Haskins 7 months ago The most caring recovery team that works there. Awesome accomodations. All around though really good program. First time to rehabilitation center and was my favorite stop on my recovery road. Glad I choose to go there. Hands down best place to go for real recovery survivors 100% Bob Burnell 8 months ago	4
Immersion Recovery Center 3333 S Congress Ave #401 Delray Beach, FL 33445 4.7 (242 reviews)	Immersion Recovery Center is an alcohol and drug rehab center for adults in Delray Beach, Florida. They provide residential and outpatient services to help you address your addiction and create a foundation for long term recovery. They’re in network with most private insurance plans and also accept self pay. One unique thing about this facility i	Treatments Programs Payment Options AlcoholismDrug AddictionDual DiagnosisMental Health and Substance AbuseOpioid Addiction Adult ProgramYoung Adult Program Private InsuranceSelf-Pay OptionsFinancial Aid	I just want to say a big thank you to all the staff nurses,doctors,etc I was there last year going through a very rough time in my life everyone was extremely compassionate and sensitive to my care no one made me feel out of place everyone helps you get adjusted and gets you the proper care you need I highly recommend checking into immersion it absolutely saved my life! 🤙💪😁🥳🥳 **To the staff please feel free to contact me I would love to hear from yall updates went forward out of there and never went back to that lifestyle I 100% could not have done it without you thank you all so so so much 🤩😍👍👍👋👋 the programs that truly designed for success you just have to accept and surrender get outside your comfort zone and get better and the staff here will 100% make that possible above and beyond! THANK YOU 🤝 -Josh D. Josh 2 months ago I had no idea what was going to become of me when I was sent to Immersion’s PHP program from a different residential treatment center. I knew I was an alcoholic, but that’s pretty much it. It has been a month since I finished my program there, and looking back, I can say they saved my life. The entire staff legitimately cares. From the therapists, to the 12-step contacts, to the techs, they made me feel welcome and heard at all times. I have never been happier, healthier, and more determined to continue on this recovery journey. Immersion deserves a lot of credit for where I am in life. Alfredo Benatuil 2 months ago Absolutely beautiful facility with a kind and caring staff. I would highly recommend if you are in need of addiction recovery support. Barbie Lee 3 months ago	5 5
All In Solutions Counseling Center 1930 East Marlton Pike Building G Cherry Hill NJ, 08003 4.8 (328 reviews)	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. An intensive outpatient program is available for wha	Treatments Programs Payment Options AlcoholismDrug AddictionDual DiagnosisOpioid AddictionSubstance Abuse Adult ProgramYoung Adult Program Private insuranceSelf-Pay Options	All In Solutions has not only fulfilled the expectations but they exceeded them. Staff are the best. Come here to get your spirit and life right. Martin Hoak 3 weeks ago All In Solutions is a special place that sets itself apart from other treatment centers in the industry. I gained a wealth of benefits from working with my counselor awesome Rashini, who always kept a positive attitude and encouraged real growth in many aspects of my life. Groups with Mark, Chris, Kristen, Tom, Haylee (my incredible case manager) were all extremely beneficial and truly made All-In Solutions stand apart from other drug and alcohol treatments I've been to. My medical team, Ross and Leslie were amazing, they attentively listened to me and got me hooked up with a mental health regimen that has literally changed my life for the better. From housing Abe, Justin, Ray, Johnny, Jeff, Schmitty, Nick, Edwin, Ash all went out of their way to make my home away from home as comfortable as possible. Erica T. And Kristen greeted me with a smile on their faces and were shoulders to lean during times of stress. Kristen's nutrition classes were eye opening and have made a huge difference in the way I take care of myself (lost 25 pounds of fat since my intake and generally eat healthier and am more active). Lauren G and Miranda S coordinated activities that kept my time here fun and fresh. Kat made my intake a breeze and her caring attitude and love for our people made me feel welcome! Mark and Chris's 12 Step groups are the meat and potosi of what sets this place apart. Because of them i have a new perspective on recovery that I never received from any facility I've been to in the past. The people who work here are all made this experience extremely special and I will never forget them. You can truly tell that they care. I could go on but I think its important to convey what Ive gained through this program, a new relationship with my family and loved ones, including my daughter. I have a program of recovery that I work daily, a sponsor, a recovery support network and most importantly a relationship with a loving and caring higher power who guides me in this new life. None of these things would be possible without the help of those mentioned above and more, they held my hand through some of the darkest times and I cannot wait to experience what this new life has in store for me. Thank you All In Solutions, you helped me salvage this wonderful adventure we call life from the gutter, you will forever be in my heart 🖤🖤🖤 Austin Sims 4 weeks ago I cannot speak highly enough of Ms. Karen and the positive impact she has had on my life. From our very first session, she created a safe, welcoming, and non-judgmental space that allowed me to open up and truly begin the process of healing. Her empathy, insight, and professionalism are unmatched. Ms. Karen listens deeply, asks thoughtful questions, and provides guidance that feels both compassionate and practical. She’s helped me gain clarity, build healthier coping strategies, and better understand myself on a deeper level. I always leave our sessions feeling heard, empowered, and supported. If you’re looking for a therapist who is genuinely invested in your well-being and personal growth, I wholeheartedly recommend Ms. Karen. She’s a truly gifted professional who brings warmth, wisdom, and care into every session. Julius Fayall 1 month ago	6 6
Starbridge Recovery Center 3943 Fredonia Drive Los Angeles, CA 90068 4.9 (29 reviews)	Starbridge Recovery Center, located in Los Angeles, California, is an alcohol and drug rehab center that provides addiction treatment services to men and women seeking recovery. They offer a luxury environment equipped to help individuals through medical monitoring, emotional healing, and guided support during the initial stages of treatment. Indi	Treatments Programs Payment Options AlcoholismDrug AddictionDual DiagnosisOpioid AddictionSubstance Abuse Adult ProgramYoung Adult Program Private InsuranceSelf-Pay Options	I was worried about my loved one going out of state for treatment. But it was the best thing that he could have done. I am grateful for all of the staff and the great team that helped get him in the door. I know this is just the beginning and everything is a lot better than it was. PHM INC 3 weeks ago Amazing facility, staff, and resources. Not my first treatment center but definitely the most beneficial one. Would highly recommend to anyone struggling with substance abuse and/or mental health. Grace Arnold 1 month ago I just hit my 6 month mark of sobriety! Could not have done it without the tools provided for me at Starbridge. It was truly one of the best things I could have done for myself. The entire staff was amazing and really cared about all of us. I felt very loved there and left feeling confident that I could stay sober. Justine 2 months ago
Green Mountain Treatment Center – Inpatient Drug Detox & Alcohol Rehab 244 High Watch Road Effingham, NH 03882 4.2 (362 reviews) 5 Top 10 Rehab In New Hampshire	Green Mountain Treatment Center is a residential drug rehab program located on 77 acres in the White Mountains in Effingham, New Hampshire. They operate under the umbrella of Granite Recovery Centers. Their programs are for men and women who are 18 or older. They also offer treatment for co-occurring disorders. The center is an in network provider	Treatments Programs Payment Options AlcoholismDrug AddictionDual DiagnosisOpioid AddictionSubstance Abuse Adult ProgramYoung Adult ProgramLGBTQ Program Self-Pay OptionsPrivate insuranceMedicareMedicaidPrivate Insurance	To the Green Mountain Team, Words can never truly express how grateful and thankful I am for helping to save my daughter’s life. I was told that any one who comes to the mountain is never the same when they leave. The transformation from the evening I brought her to the mountain to the person she is today after leaving the mountain is a precious and priceless gift! Every person on this team shared their unique experiences and wisdom to help her embrace sobriety. The many phone calls and texts to and from staff, sometimes after hours and weekends helped me to understand the program and stay connected with her on this journey. Thank you Jermol, Robert, Anna and Star and the whole team in helping to save her life and supporting her on this journey to sobriety! Every day is a gift! Every life is priceless!! Thank you so much!! Sue Shevlin 1 week ago great staff and community abbi drew 3 weeks ago This place changed my life, lots of people say it but it’s so true for me! Unreal staff and healthy environment. I actually was sad to leave. Loved my experience here 💛 Jadie Lyn 3 weeks ago	6 6
Restore Health and Wellness Center 6918 Owensmouth Ave Canoga Park, CA 91303 4.3 (88 reviews)	Restore Health and Wellness Center offers medical detox, residential alcohol and drug rehab, and outpatient treatment for adults in Canoga Park, California. Services include dual diagnosis treatment, medication-assisted therapy (MAT), and holistic treatment such as art therapy, meditation, yoga, and exercise therapy alongside evidence-based modalit	Treatments Programs Payment Options AlcoholismDrug AddictionDual DiagnosisOpioid AddictionSubstance Abuse Adult ProgramYoung Adult ProgramLGBTQ Program Private InsuranceSelf-Pay Options	Detox was rough ngl but the medical team knew exactly what to do kept me safe the whole time Kyra Glover 1 week ago Restore Health and Wellness Center sangat bagus. Saya berada dalam situasi yang sangat buruk beberapa tahun yang lalu. Saya mengambil kesempatan itu dan terbang ke LA. Saya sangat senang melakukannya. Bahkan hingga hari ini, saya mengenang kembali sebulan yang saya habiskan di sana. Pengalaman itu benar-benar membekas di ingatan saya. Stafnya, Chef Paul, komunitasnya; semuanya membantu saya pulih dan belajar lebih banyak tentang diri saya sendiri. Kita mendapatkan apa yang kita usahakan, seperti apa pun, tetapi dukungan itu ada selama kita memercayai prosesnya Deja Freeman 1 week ago Insurance covered my entire stay removing financial stress so I could focus solely on getting better Micah Clayton 2 weeks ago	4

Frequently Asked Questions

What Are Harvard Pilgrim Health Care Plans?

Harvard Pilgrim Health Care offers individual and family plans on the state insurance Marketplace in Maine and Massachusetts along with New Hampshire. These plans are generally either health maintenance organizations (HMOs) or preferred provider organizations (PPOs).

An HMO allows you to coordinate your care through a primary care physician (PCP) who gives you referrals for specialists like addiction or mental health professionals. Your doctor will also help you get preauthorization if necessary. You will need to seek care within the provider network.

For a PPO you can see in network specialists without a referral. A PPO also gives you the opportunity to see out of network providers but you will pay significantly more out of pocket. You may still need preauthorization for certain types of care.

If you have Original Medicare and need help with your out of pocket expenses you can get a Medicare supplement plan from Harvard Pilgrim Health. Another option is replacing Original Medicare with a Medicare Advantage plan. Advantage plans cover everything Original Medicare does and often offer additional benefits such as vision or dental coverage. However you generally need to use providers in the plan’s network and you may need preauthorization for certain services.

What Perks Come With Harvard Pilgrim Health Care Plans?

Harvard Pilgrim plans come with some helpful perks. For example you may have access to wellness programs and discounts and the Harvard Pilgrim mindfulness program. They also have telehealth options and experts such as nurses and social workers who can help answer your questions.

Another helpful perk is the discount they offer on complementary and alternative therapies. Certain plans allow you to get up to a 30% discount on alternative medicine services if you select a provider from the network they have partnered with.

What Inpatient Addiction Treatment Does Harvard Pilgrim Health Care Cover?

The first step to getting addiction care is for a provider or clinician to assess what level of care you need. If inpatient addiction treatment is the right level of care, they will recommend it to you. The assessing clinician will likely be the one who asks your insurance company for prior approval, but sometimes it’s your primary care provider who does that part. Either way, inpatient addiction treatment is very resource intensive, so most insurance companies want to make sure it’s the right place for you, thus the requirement for prior approval.

There are a couple of different types of inpatient addiction treatment that Harvard Pilgrim may cover for you. One inpatient treatment type is medical detox. The goal of detox is to get you safely through opioid or alcohol withdrawal. Treatment center staff medically monitor your progress and manage your symptoms. The length of time you’re there depends on how quickly you are able to detox, usually somewhere between three and ten days.

Once you’ve completed detox, you can start to focus on changing your behaviors to keep from relapsing. You may be referred to residential rehab to work on developing these skills. The structured environment of residential rehab is designed to help break behavioral patterns that lead to using or drinking. The groups teach you about addiction and how to prevent relapse. A stay most commonly lasts for three to four weeks but can go longer.

What Outpatient Rehab Does Harvard Pilgrim Health Care Cover?

You can find a number of outpatient addiction treatment centers with Harvard Pilgrim’s network. Below are some of the treatment types you might be able to find.

The most intensive type of outpatient treatment is partial hospitalization. This type of treatment looks very much like residential rehab. You’re usually there all morning and all afternoon. The one big difference is you go home in the evening and on weekends. Since you have large chunks of time when you’re not in a supervised setting, this is a good option for people who can go a few hours or days outside a structured program without relapsing.

The next level down is intensive outpatient. This level usually requires a two or three time a week commitment for a couple of hours each day. The programming usually consists of groups and individual sessions where you learn and practice relapse prevention strategies.

Standard outpatient treatment is the level of care that most people are familiar with. This usually involves enrolling in a program where you see a therapist and a psychiatric provider. They may offer some groups you can choose to attend. You and your providers will determine how frequently you’ll meet.

Does Harvard Pilgrim Health Care Cover Methadone & Suboxone (MAT)?

Methadone and Suboxone are two FDA approved medications that treat opioid addiction. They can be used to help you stop opioids or as a maintenance treatment to help prevent you from relapsing during treatment.

These medications and others are sometimes used within a detox program. When they’re used this way your insurance plan will have the same coverage as it has for detox.

Suboxone and methadone are also used for maintenance treatment. This is when you receive these medications to keep you from going into withdrawal. Suboxone can be prescribed by your primary care or psychiatric provider. If this treatment is appropriate for you, your insurance plan may cover it as an outpatient treatment.

Another way to get Suboxone and the only way to get methadone is to go to a specialized opioid treatment clinic. Harvard Pilgrim has several of these clinic types within their network, and may cover this service if you’re eligible. Be sure to check your insurance plan for details before starting treatment.

Does Harvard Pilgrim Health Care Cover Other Mental Healthcare?

Harvard Pilgrim may cover a variety of different mental health services. Some of the acute services you may find in their network include inpatient psychiatric hospitalization for people of all ages from children to older adults. Some emergency departments have specialized crisis services that Harvard Pilgrim may also cover.

Certain plans may cover in home behavioral interventions for children and adolescents where the service is available. They also have providers who work with people who have autism including providers who use applied behavioral analysis.

People who find it difficult to travel to appointments may appreciate Harvard Pilgrim’s telehealth services benefit. This benefit allows you to see a provider online instead of going in person. Harvard Pilgrim partners with a telehealth only service provider but many brick and mortar offices offer telehealth too.

If you’re having trouble finding a provider Harvard Pilgrim can help connect you to someone through their case management service. If you just want some reliable information about a health condition their website includes a library of information you can access.

How Long Will Harvard Pilgrim Health Cover Rehab?

The length of treatment in most levels of care can be very individual. There is often some level of reassessment happening every few days. It’s common for residential treatment to last for three to four weeks for most people but some may stay up to 90 days.

Other programs like partial hospitalization and intensive outpatient also have highly variable lengths of stay. These programs can continue from weeks to months. Together with your treatment team you’ll be involved in setting the treatment goals that will inform your length of stay. You’ll get the best results if you participate fully in the goal setting stage and the totality of your treatment.

Can I Travel Out of State For Treatment With Harvard Pilgrim Health?

Your individual plan will determine whether you can travel out of state for treatment. Harvard Pilgrim’s network tends to be more concentrated in the states they operate in which are Massachusetts and Maine and New Hampshire. They do have one plan that is specific for families with dependents living out of state such as those who have a child in college. That plan has out of state options.

Some of Harvard Pilgrim’s plans will not allow you to seek care out of network at all even within your state. Plans that do allow you to go out of network will usually have higher copays and deductibles if you go that route. Those fees are generally much more than what they would have been had you received care from inside their network. If you are able to stay within their network for care you will be able to avoid these additional fees. If you do decide to get care from out of network pay special attention to your plan details to avoid surprises.

How to Verify Coverage With Harvard Pilgrim Health

You have a few options to verify what services your Harvard Pilgrim plan covers. One option is to call their customer service line and ask about the service you’re interested in. You can also log in to your account online and check if a service provider is part of your plan network.

One more way you can check is to speak directly to the service provider you would like to see and ask them to verify that they’re covered under your plan. Whichever of these options you choose to use it’s important to check using the name of your specific plan since different plans within Harvard Pilgrim have different provider networks.