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.
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.
The staff was amazing, very helpful in recovery, and, and supportive of my personal needs. Vert confidential of my well being, and the mesical staff / nursing,was outstanding the food, incredible, great variety. I would recommend spring hill to anyone neesing tratment.
Derek Moretti
1 month ago
Spring Hill was one of the nicest css programs I have been to. You are treated like a real human, not locked behind doors all day. Being able to be outside made all the difference in the world for me. I finally feel like I made good progress on my recovery.
Sober Motors MA
1 month ago
I had such an amazing experience here. The staff were all so welcoming, the groups were fun, and the people really made it feel like a community. I feel very hopeful about the continuation of my recovery process.
There are moments in life when you feel completely lost, and for me, walking into Starbridge Recovery was one of those moments. I arrived broken, scared, and unsure if I could ever find my way back. What I found there was more than treatment—I found hope.
I spent 30 days in detox at Starbridge, and from the very first day, I was treated with dignity, compassion, and genuine care. The staff didn't just see another patient; they saw a person who was struggling and needed support. Every nurse, counselor, technician, and team member played a role in helping me believe in myself again when I couldn't do it on my own.
Recovery isn't easy, but Starbridge gave me the tools, guidance, and encouragement I needed to take that first step toward a new life. They created an environment where I felt safe, understood, and supported every single day.
As I write this, I am proud to say that I am four months clean. That's something I honestly wasn't sure would be possible before I came here. Starbridge didn't just help me get sober—they helped me rediscover who I am and what my life can be.
If you're reading this and wondering whether recovery is worth it, or whether there's hope for you, please know that there is. Asking for help was one of the hardest things I've ever done, but walking through the doors of Starbridge Recovery was one of the best decisions I've ever made.
To everyone at Starbridge: thank you for helping save my life. I will never forget what you did for me.
Kertis Royster
3 weeks ago
Absolutely loved starbridge from the moment I got here , was supposed to do 30 days and volunteered to do 45 , all the workers took really good care of me and the other clients. We did a lot of outdoor activities including disc golf , pickleball and the golf driving range. Also went to see many movies at AMC topanga. I also want to give a special shoutout to Anna , Evan , Adrianna , Zach , pearl and Leslie for just being awesome staff and really making starbridge what it is. Thank you guys for helping me along this journey of sobriety much love to you all.
Alex Truck
3 weeks ago
went through here and was amazed by everything about it. staff was fantastic and fun. help me start the road to recovery in a new light. zach evan melanie pearl and nick are amazing and highlights of my stay there
AlcoholismDrug AddictionDual DiagnosisMental Health and Substance AbuseOpioid AddictionSubstance Abuse
Adult ProgramYoung Adult Program
MonthlySelf-Pay OptionsPrivate insuranceFinancial Aid
Izzy is the best staff member there along with Clint Linley and Kyle where beyond helpful and I can’t thank them enough <4
Ashley Rae
2 months ago
Peaks will forever hold a place in my heart.
If you are looking for help with depression, addiction, alcoholism, trauma, anxiety, body image issues… you name it. This is the place that will not only help you, they will LOVE you through it!
From the moment I called, I felt loved and cared for. Angela - You are an Angel! Angela kept in contact with me several times a day until I was on a plane to CO. As soon as I got there, Katie picked me up from the airport, she was a doll! She made me feel so comfortable going in. I met with a few staff members, and stayed in “detox” for 2 days.
When I first got to the Women’s house, I met Miss. Pat - She’s the most incredible woman I’ve ever met. I’ll never forget her. EVER.
I went in for Trauma and Depression. Within 7-10 days, I could tell my life was changing. I had never felt this good in my life.
Chris, Bobbie, and his team hired a staff that is like nothing I would have ever imagined. From the Director (Sara), Doctors, Therapists/Counselors (Kate, Madi, Shayna, Sam), PA’s (Alyson), Gym Instructors (Nicole and Dan), my caseworker, Tyler, the chef, Taylor, and the staff (Miss. Pat, Cassie, Leah, Kayla, Mariano, Julie, and Cheyanne), - They are all AMAZING! Everyone has a heart of gold!
Each week in group they discuss a topic. The topics discussed are LIFE CHANGING! There are things in life that you think you know, you don’t. I learned so much in group and I’ll hold onto that info for life.
I also met with my Therapist/Counselor Kate, 2-3x a week. Kate is part of the reason I am who I am today. ❤️
I can’t say enough good things about this place. If you are looking for a place that will truly save your life, Peaks is where you want to go. I promise you. ❤️
Love, hugs, & Prayers for anyone taking the time to read this.
I believe in you! Make the call! Much love!❤️
*****Edit - In the last 3 years I’ve had a few people reach out to me and ask questions. If you are struggling on making a decision and want to speak with someone, please don’t hesitate to reach out to me via facebook messenger. I would love to help you in your journey to getting better. ❤️*****
Angie Glass
3 months ago
Peaks was truly an amazing experience. From the staff, to the groups, to the food, I loved it there. Special shoutouts to Clint and Alyssa for being awesome.
This place and the staff here are amazing, when I was at my lowest casco bay took me in. I followed their program and the steps and am now going on 4 months sober. And many many more to go.
I quickly grew attached to the staff which is wild. Because hated myself at that time. But I found help and happiness and companionship while my time in the program. And then found myself. You may walk in like a lamb. “I did” but I promise you, you will walk out like a lion if you want too. It’s up to you. And it starts with you. And casco bay is there for you. Day and night. I seriously have love for each of the staff members. And will absolutely be visiting and popping in to say hi from time to time. Thank you casco bay for all that you do!
Duane
4 weeks ago
Haven’t been a model patient, despite that they’ve been there time and time again
They truly do care
Shoutout Colleen, Mike B, Noah,, Leslie
Aidan K
2 months ago
This place saved me and I will gladly say if you need help this is the place to be. Shoutout to Colleen for being the best counselor I ever had and thank you to everyone at casco for saving my life
Very supportive ! You get what you put in. Very satisfied with there support! Nate was big support! Proud to have graduated! They saved my life!
Norman White
3 months ago
Granite Recovery Center (specifically Green Mountain Treatment Center) gave me the tools to live a successfully sober life. All the 12 Step Coordinators were fantastic and greatly helped me in my journey!
IZZYRAY08 Raymo
3 months ago
GRC saved my life, they taught me how to manage my emotions in a healthy way without the need for substances. I am forever grateful
I can't get ahold of you all. I tried . I need assistance
Jaimie Borys
4 weeks ago
This by far is the best treatment ive ever been to.The staff was the best in the world and they helped me get back to my real self. I was honestly sad to leave. I highly reccomend this place . Thank you guys !
Corey Geiger
3 months ago
I love the people here they treated me like family and became family I love and appreciate all of y'all !!!! Alisha🫶🫶Brittany 😘🫶❤️💪 Bryan 🎧🧩💪💪Alex🤜🤛Alec💪🎮 Adrian❤️🫶 Molly❤️ Erica🫶❤️ Ms Louise thank you for cooking amazing food for us everyday 🔥❤️ Darius💪🤜🤛 Sandra(mama)🫶❤️ thank you for caring about me when I didn't care about myself
I was angry leaving my initial one star review because I felt lied to and deceived. I was told I’d be lucky to make it back to this place… meaning that I’d be dead and not be able to make it back. I was told I would be dead cause of how “horrible and defiant” I was. I did not like AA was not for me so I was going to die. Many people that worked here told me. My case worker gossiped about me to a whole group of my peers saying “one of you is going down a dark road” really? These are the people to trust? These are the people “getting me better.” Also they said the bill would not need to be paid and I kept getting harassed by AP office I believe in Florida? So I was furious.
So my initial review was one star and I left out words because I wrote a nasty review and had to erase them.
I wanted to come back and edit my one star review to a five star. Cause here I am, over 5 years later, still going strong as ever in my recovery, and I have a place that is mine, I have a good steady job, and I’m free of the chains of addiction. Whether I like it or not, my experience here is what lead me to where I am today. There was some amazing staff that was overworked and under paid so if by some grace of god they are still there, god bless. I wanted to give this place the benefit of the doubt and say they were trying reverse psychology on me, the staff talking crap about me to other peers, the staff saying I’d be dead. But they were not that smart, they genuinely were telling me I was hopeless. I won’t name you but I know that you know who you are.
Now I sit here over 5 years later thinking that maybe if you did not spend so much time talking down and being hateful and judgmental to me, maybe all my brothers in program with me that are dead now, would still be alive if you paid them that energy. But it is what it is right? I don’t equate my success to NEATC, hell no. I put my success on my shoulders. I easily could have taken yall saying I’d be dead soon and actually gone and died. But I didn’t. I spit in all your faces and I proved all of you wrong. I did it for me. I did it for my brothers who died due to the lack of care they received wether insurance was poor or you just focused more on me being defiant than their complacent obedience to your AA. What works for some does not work for all. It’s your hate that drove the fight in me to succeed. I see my brothers in the program with me that never will get to share their smiles with the world, I can share the smile they taught me. I can share their message and I will not let them down.
That’s why I have 5 stars. This place did exactly what it needed to. Just like life, drove me insane, judged me, hate on me, gave me a place to live full of rats and mice, financial issues to battle, had to face death, had to hear pain like no other, and was not the smoothest ride. But through the pain and darkness of life there is always light, you can be that light. You can change. Amidst all the bad, there was a handful of AMAZING staff and people that gave me a real life experience I will never ever ever forget. Just like life this place is not perfect, we need to take the challenges and push on. I loved this place. And always will. This place did heal me. Not how I wanted but how I needed. Just like real life. I noticed my growth as I wanted to change my one star review. Even after all the trouble, I pushed through and fought and still see the light. I am still a light that will not be dimmed. And this place is a HUGE part of the reason I am who I am today. An amazing light in a dark dark world. This place put a challenge in front of me, life is not easy, you need to put in the work, and when life punches, you need to punch back harder.
Thank you NEATC and the amazing staff I can’t imagine would still be working here but if you are I love you. Forever I love you, and miss you, and wish you the best. I would love to come speak one day at an event, I don’t live close by anymore but I’d love to make something so please contact. Anyone wondering if they should come here, yes. Yes you should.
Kyle
1 year ago
Coming up on 5 years and I couldn't have done it without this place forever grateful
Williampaul Divenuti
2 years ago
Was in their care for seven weeks. Advanced through various stages at three different facilities. Sober for nearly a year now from both alcohol and benzodiazepines.
AlcoholismDrug AddictionDual DiagnosisMental Health and Substance AbuseOpioid AddictionSubstance Abuse
Adult ProgramYoung Adult ProgramLGBTQ Program
Private InsuranceSelf-Pay Options
I recently stayed at NorthPoint and it was a fantastic experience. The staff and nurses are amazing. They are so kind and are willing to help make it the best stay as possible. I learned so much in the courses, very helpful.
Carly Gammage
3 weeks ago
NPR was a kind and loving space that helped me with my recovery.
Saved my life. Went for a 90 day inpatient 12 years ago and haven't reentered another rehab since. Built great fundamentals to recovery and kept me long enough to get started. If I had only done 30 days I know I likely would have relapsed . I now am healthy and happy and have a trade skill, which is quite dangerous but I'm always clear of mind and haven't been injured for the entire 8 years I've been practicing my trade.
Crystal Kornell
1 month ago
The team at Tranquil Shores is amazing. My clients get great treatment, and their families get consistent communication. The facility is beautiful, clinical staff and programming are legit. As an industry pro for 15 years, I'm happy to share that Tranquil is great.
Darren Hobbs
7 months ago
Excellent program, clinicians and staff are top notch!
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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.
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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.
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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