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.
As you search for reputable rehab centers or verify insurance participation, you can learn more about rehab options to discover programs that meet your clinical and financial needs.
By Michelle Tavares
Michelle Tavares is a registered nurse with over 15 years of experience in mental health nursing. She has worked in inpatient and outpatient settings as well as in bedside and administrative roles. She is a fighter of stigma and an advocate for getting people the mental health services they need.
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.
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 AddictionDual DiagnosisOpioid AddictionSubstance AbuseMental Health And Substance Abuse
Adult ProgramYoung Adult ProgramProgram For MenProgram For Women
Private insuranceSelf-Pay Options
The clinical building being separate from the housing is a detail that sounds small but makes a big practical difference. You go there to work, and you come back to somewhere calmer when the day is done. That separation gave the whole experience a clearer shape.
Brian Saunders
3 weeks ago
Friday afternoons they bring in alumni speakers. Sitting in a room listening to someone who's been through it and come out the other side is different from any group session with a counselor. It was one of the parts of the week I genuinely looked forward to.
Thomas Navarro
3 weeks ago
The weekly family group, held online so family can join from wherever, is something I wasn't expecting. My family had been through a lot and being able to include them in the process, even from a distance, changed how I felt about what I was doing here. Recovery doesn't happen in a bubble and a program that actually acknowledges that is worth noting.
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.
Wow, were to start. Casco Bay saved my life literally! I was at my lowest of lows when I called for info. It was the scariest calls I have ever made. The staff was so welcoming and understanding of my situation. From the day I showed up to the day I left all the staff were totally incredible. I instantly felt comfortable and truly trusted these people that I just met. I felt safer with the staff than any other person including my best friends. There hole mission was to help me and in the first time in my life I felt Like I belong and feel safe. I have never in my 56 years have ever felt peace like that and I still feel that way. They have given me not my old life back but a much better one. One that I never knew I could have. I can't say enough about the sober living provided by Casco Bay too. The house managers played a huge role in my recovery. From having coffee every morning to after dinner and going to meetings they were great. Everybody including the owners and managers are all in recovery. That being said, they are not just giving you the textbook knowledge. They lived it. They know what it's like to be in your shoes. They are proof that their program works. I did a lot of research before I committed and am verry glad to pick Casco Bay. After living in the Portland area for a while I realized how the whole community respects Casco Bay. Clients from all over and from other facilities all said Casco Bay is the best. This is coming from clients that have been to places all across the country. Not one single person said they found a better place to rehab. I'm not a salesperson or marketer. I am a real person with real issues the Casco Bay helped. I have 3 mor days of a 15-week program and I'm happier than I ever have been! I have regained my family, career, and my sole back. Thank you, Casco Bay!
gerald milot
1 month ago
Casco Bay Recovery has truly been life changing for me. The staff genuinely cares about the people they work with, and I have always felt supported, heard, and treated with compassion and respect.
This program has helped me build a strong foundation for my recovery while giving me a sense of community and connection that I didn’t know I needed. I’ve learned so much about myself, my recovery, and how to keep moving forward one day at a time.
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.
I was a client at AdCare in North Kingstown, RI in the fall of 2026, for both detox and residential. Considering my personal situation and circumstances, I am very grateful for my experience. The facilities and staff surpassed my expectations; they made my recovery journey relatively painless and one that will be looked upon fondly. The facilities are clean, modern, and well organized. The staff was welcoming, helpful, and very understanding of myself and also my peers. I've learned many tools and strategies to assist me through many troubles I may encounter in my life. My case manager Lacey was as pleasant and always willing to help whenever she could and was always supportive. My counselor Victoria was amazing and has given me the tools, resources, and confidence to continue on my path in recovery. I am very hopeful and confident in my future life in recovery. I would highly recommend AdCare for anyone who needs or think they need assistance on their own personal recovery journey. Personally, I would like to say a big "thank you!" to AdCare for helping me out with everything.
Kevin Smith
1 week ago
Since admitting to Adcare earlier this month it’s been nothing but warm and welcoming. From the staff to the patients as well, everyone is understanding and wants to see you do better no matter what your situation is. The group meetings that occur everyday I find the most beneficial to the one on one work done as well. I had the pleasure of working with Scott, who is one of the case managers here at Adcare and he has been able to help me greatly with my circumstances. Then Nick as well who provides one on one care making sure my mind, body, spirit, and goals are all set straight. The facility is in great shape as well from the different amenities (gym, rec room, cafeteria, etc…) to again just an overall comfortable feeling. I would recommend Adcare to anyone who is going through a difficult time with drugs and or alcohol and I’m sure you won’t regret it. Blessed to be able to admitted into this facility and I will continue to use the skills I’ve learned here in the outside world. Thank you Adcare!
Kaan Ispir
2 weeks ago
My experience at AdCare Addiction Treatment Center has genuinely changed my life.
Joe, Lacey, Scott, Nick, Amy, the counselors, case managers, TAs, nurses, and the entire staff all played a role in my recovery and influenced me tremendously. What stood out most to me was that they actually care about me as a person and about my genuine well-being. I never felt like just another patient.
Coming here also helped me realize just how dark of a place I was in before I arrived. Once I made it through the first two days of detox, I started feeling better, and I’ve continued to feel better every day since.
The groups, clinical work, medication management, and overall structure gave me the tools and support I needed to begin rebuilding my life. AdCare helped make the transition back into society feel much smoother and gave me a different perspective on what my future can look like.
If you value your life and you’re struggling with addiction, don’t wait until things get worse. Give yourself a chance to change. AdCare gave me that chance, and I’ll always be grateful for the people here who helped me find my way back
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 AddictionDual DiagnosisMental Health and Substance AbuseOpioid AddictionSubstance Abuse
Adult ProgramYoung Adult ProgramLGBTQ Program
Private InsuranceSelf-Pay Options
Northpoint is the best place for my start of sobriety. I have been shown love, kindness, patience, pure help and for that I am forever grateful. Thank you Truly Northpoint Community for all your support. I’ve learned an amazing amount about myself and learning how to be sober in a safe environment.
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.
I cannot fully explain how grateful I am for this place. I can but I would be writing for days. Someone that I consider family needed my help. The day started with me driving from Boston to NH, when I found him we went to Portland Maine. I called detox after detox and all were packed. However, I was given wrong information when they said take him to Maine Health. We went there first and waited over an hour only to be told they would not give him a bed until one of the detoxes opened.
This was very disappointing. However, with the grace of God, I found Saint Mary’s in Lewiston Maine. So we drove another hour there and finally succeeded. The security, nurse and Doctor we talked to were phenomenal. It ended with an emotional hug and hope of recovery now linger.
Before I left, the guy at the desk even stopped me and handed me a piece of paper with the number to this department on it. I wish I wasn’t so far because I would have came back to visit.
Blessings to Saint Mary’s and their staff🙏🏼🙏🏼🙏🏼
Dennis Sena
2 weeks ago
Very good appointment. Came up with a plan for my knee.
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.
I absolutely love the staff at Spring Hill! The campus is gorgeous and healing. The ability to walk around and socialize in an open space is wonderful. I really felt cared for by the clinicians, case managers, nurses and RSes.
CORPORATE, however is obviously very greedy unfortunately. You are a number to them. It’s a common problem but something you should know. Do not listen to promises of recruiters, there are many things said to try to get you signed up (commission) that are untrue (ex/ pool, trails, what you can bring or not etc)
Know your rights. If you are sent for detox at BEDROCK, DO NOT LET THEM TALK YOU INTO STAYING. Go to Spring Hill and don’t waver
Sarah Landstrom
2 weeks ago
Springhill Recovery Center is absolutely the best! The staff are amazing. The facility is beautiful and tranquil. I left feeling confident and ready to begin a new chapter in my life.
Kathleen
2 weeks ago
Spring Hill is a wonderful facility. The staff is knowledgeable and caring. If you come prepared to do the work you will come out prepared to continue your recovery.
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.
New Freedom Academy saved my life. The staff and clinicians dedicated their time to make my sobriety journey one that I will live the rest of my life. If you know someone struggling with substance use please send them to this facility.
Manduh
2 weeks ago
If you are looking for a place that truly cares. Has compassionate people caring for. While also holding you accountable because they want the absolute best possible outcome for you. Then I would recommend this place to anyone. I was in and out of many facilities. Before I finally came across NFA and I had never been able to stay clean for more than a month maybe two at a time. Now over 3 years later I owe a lot to the Company and the people that work there
Chris Diamond
1 month ago
Thank you so much for everything 🙏.I couldn't do it with out All of You...
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.
I have a close friend who went there and the comparison from when he entered till now is like night and day. Im so impressed, happy, and overall grateful for what this program has done for his recovery and continues to do for others id recommend it to anyone who is serious about making a change in their lives as an addict. Thank you Green Mountain for giving my friend a life he can call his own again. Yall really do move mountains for sobriety!!!
Doorealias Doom Brown
1 week ago
Because of Green mountain treatment center I learned how to have my life back and be sober. They helped me realize that I can have fun and be happy well being sober. Special shout out to Dan Michael and Dwayne. They helped me through everything so amazingly. They gave me a chance to meet my higher power. Thank you to everyone on staff that helped every step of the way! P.S. food was amazing 😂
Ryan “Rya” Raboin
1 week ago
Green mountain treatment center is by far the best program that I have been to. It definitely helped save my life when I thought that was not a possibility anymore. They taught me the skills that I need to not only be successful but to truly believe in myself again. The staff there are like family to me and they are truly incredible people who just want to help each and every client. I would recommend this program to anybody that I can. If you have the opportunity to come here for treatment it’s the best thing that you could do for yourself! ❤️
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.
I started my sobriety journey at The Grainte House and I was scared and had no idea how I would live my life free of substances. The staff and case managers paved my way to be 104 days sober today. I can't say enough good things about this facility. Please save your loved ones or yourself and take the leap with them.
Manduh
2 weeks ago
I'm over 5 years sober now and I've been working in the Substance Use Disorder field for over 3 years now. I'm actually creating an updated resource sheet, which is why I ended up on here haha. But I figured while Im here, I should post a review about my own experience.
I went to Granite House back around 2020. My experience was great, I definitely had some ups and downs however the downs were 100% self induced. Although the staff and the group of people I was within were all incredible- I just wasn't ready yet at that time. I went to about half a dozen treatment programs throughout my addiction, but to this day I tell people "if you have medicaid and you're looking to go to rehab in NH - Granite House the best place to go." It is my first choice for referral out of all the treatment centers in the state!
Its obviously been a while since I was there, 7 years or so, but I have had clients tell me about their recent experiences and they all say the same thing " Its like a big family. " I couldn't agree more!
Thank you Granite House for your continued dedication to those who are in need of a safe, caring and trustworthy treatment center during their most vulnerable days. New Hampshire has lost a lot of good, helpful, and solid places over the past several years but to see you still standing and providing people with treatment is truly deeply appreciated!!!
* If you're reading this - and are trying to figure out if this is the right choice... as someone who statistically was not supposed to and never should have made it out... my advice is ;
Ask yourself what do you have to loose by trying? By showing up and giving yourself the chance? Compared to ... if you stay..? And don't even give it a try? We do recover - It takes time and its not easy - but nothing in life worth having, ever comes easy! You are more than worth it, so take the chance 🫶
Catherine Garand
1 month ago
Really enjoyed my time here, came back for my second time and I’m now at nfa and doing great!
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 staff very understanding and sweet. It's recommend to anyone
Jessica Sullivan
3 months ago
I've been going to many clinics lately now I've made the decision to go to this clinic due to many factors.
I'm happy with this decision I've made Every one is super nice there and I'll continue to keep going until I can get off this medication wish me luck! 💫⚔️
Toni Bowne
8 months ago
I have been on the clinic 2015 & it has helped me on my road to recovery. I am addicted to opiates(pills) & have not abused them since I've been on clinic, I also gave up drinking alcohol when got on clinic. The "dosing" nurses are great nurses,. They're very friendly, care n have lots of patience to deal with addicts everyday. The receptionist(s),doctor & councilors are awesome too. I've had many councilors since been here & always been happy them. The hours are good during the week but during the wknd rhey should stay open longer(some of us come a long way & durning bad weather it hard to get there before 10am)
Sue
1 year ago
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Frequently Asked Questions
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.
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.
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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