Highmark Insurance Coverage for Addiction Treatment
Discover how Highmark Insurance covers drug rehab and mental health treatment in the Northeast. Verify your plan for recovery options.
Highmark Insurance Coverage for Addiction Treatment
Discover how Highmark Insurance covers drug rehab and mental health treatment in the Northeast. Verify your plan for recovery options.
Highmark Insurance started in 1996 after two of the oldest health insurance companies in the U.S. merged. The two companies were Blue Cross of Western Pennsylvania and Pennsylvania Blue Shield. Now known as Highmark, they offer plans in four northeastern states.
Where Does Highmark Insurance Operate?
The four states that Highmark Insurance works out of are Pennsylvania, New York, Virginia and Delaware. This means they cover people and companies based in these states, but it doesn’t mean that the services they cover are also limited to these states.
Does Highmark Insurance Cover Drug Rehab?
Most Highmark Insurance plans cover drug rehab and mental health because the 2010 Affordable Care Act (ACA) requires most plans to cover 10 essential health benefits. These benefits include both substance use treatment and mental healthcare.
However, there are exceptions to the law, so be sure to review your insurance coverage before you start treatment. You’ll also want to work with your doctor to create a treatment plan because that will be the guide your Highmark plan uses to determine medically necessary care.
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Staff has a TON of knowledge an truly cares an wants you to be the best version of you. I truly appreciate the Love I felt!!!!
Henry Plonski
1 month ago
This place truly saved my life I never thought of it helping me but the facilitators really care about the people holly really goes to the ends of the earth much love
Kamron Wright
1 month ago
I came to avenues a broken soul. I didn’t love myself or anybody else. I did not want to live anymore. I have been to 5 star rehabs with private chefs and rooms that look like the four seasons and those places have nothing on avenues Cambridge. This place is truly amazing and that’s coming from a dope fien. I’m no longer a slave to my addiction and I will forever love avenues, holly is the alumni cordinatoor and she is amazing I definitely recommend coming here if your struggling
The review of this place lies within in its name! I am very grateful for this facility. The staff are friendly, professional, and efficient. They are very attentive and helpful to your needs. In addition, the environment is clean, orderly, and safe. I would definitely recommend this place to anyone. Thank you for all that you do to make this place wonderful experience!
Danielle Magpantay
2 months ago
I had such a great experience in such a hard time in my life. The staff was so supportive, friendly, and welcoming they knew exactly what I was going through and were so supportive. I would highly recommend Gratitude lodge to anyone who is struggling with substance abuse.
brandon fuentes
2 months ago
My name is Nik Everett, I had an amazing experience here, outstanding staff they are very open to suggestions. I learned a lot from this place and would highly suggest you go here, thank you Gratitude Lodge seriously!
.the only place I will never try to prove wrong….. even though I was right 😘. IP got my head on straight!!!!! Forever grateful 🥲 ikyk
If you are trying to maintain your marriage and finances, I recommend having a solid plan before walking through these doors
Zack Metcalf
1 month ago
I think that Patrick should be the Director of the Facilities. He has a passion for his job. Because he understands what patients are going through. He’s an amazing advocate.
Kristin Chaplin
2 months ago
This place is awesome!! I was skeptical at first but when I got there it was such a beautiful place. The staff are ALL amazing! After 10+ years of being an opiate addict I am now finally free!! Thank you My Time Recovery.
I loved it here. Such a great experience!! They are so nice and very helpful!!
Hailey Pyenta
1 month ago
A wonderful experience, the entire staff attended to all of my needs so I could focus on me while I was here. ❤️🩹 I’m fortunate to have found Spring Hill, they helped guide me in my treatment and getting ready for the next step. Thank you all!!!!!
Ryan O'Connell
2 months ago
This is an excellent residential program where you are not locked onto a unit. There is full access to the absolutely stunning campus. The staff is kind and can relate as most are also in recovery. The food is fantastic with home cooking by Matt, Jon & Eric. I received the best treatment through group therapy, individual therapy, family therapy & case management. The nursing staff is top notch & available 24/7. I highly recommend Spring Hill for the best substance abuse recovery experience out there.
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Life saving program filed with people that actually care. Amenities, good food, and everything you could ask for.
Matthew Relaxed
1 month ago
This place saved my life, the greatest decision I ever made, can't thank avenues and their great staff enough!!!
fredo milano
2 months ago
Committing to 6 months was a huge decision for me. But it was the best one I have made by far for my recovery. I can’t say enough about Avenues and the staff here. They have helped me to become a better person and find my place in this world. I was able to make lifelong friendships and have found a purpose in life. Thank you Avenues for everything!!!
I'm writing this review to express my sincere appreciation for Chris Vallecillo, a clinician who truly made a difference in my treatment at Relevance. I worked with Chris for a significant period, and his approach to therapy was incredibly effective for me.
Chris has a unique ability to connect with you on a personal level while maintaining a professional and insightful demeanor. He created a comfortable and trusting environment where I felt safe to openly discuss my challenges. His guidance was always practical and actionable, helping me develop coping mechanisms and strategies that genuinely improved my well-being. I particularly valued his ability to listen intently and offer perspectives that I hadn't considered, which was crucial for my progress.
I was genuinely disappointed to learn that Chris is no longer working at Relevance. His departure is a significant loss for the facility, as his expertise and compassionate approach are truly exceptional. For anyone seeking a clinician who is not only highly skilled but also deeply committed to their patients' success, Chris Vallecillo is, in my experience, outstanding. I wish him all the best in his future endeavors and hope that others will have the opportunity to benefit from his incredible support as I did.
Zach
1 week ago
I learned a lot of valuable skills at Relevance. Gracie was a phenomenal counselor who was empathetic with great boundaries. Latifah helped me so much with guidance, med management and life skills. Chelsea was incredible at teaching and explaining DBT. The only pressing issue I had during treatment was difficulty receiving case management needs. Other than that, I have made immense progress, and it was with the helping hands of relevance. Thank you Relevance team for your patience, dual diagnosis care, and laughter. Empowering experience for sure.
Mandy H
2 months ago
I could not have asked to be cared for by a more caring, knowledgeable staff.
Bayside Marin is an excellent treatment center.
At first, I didn't want to go here, mainly because of negative reviews and hearsay from an acquaintance, and corporate ownership.
But I quickly changed my mind. I came here devestated by a very traumatic year of my life, in as much of a mental health crisis as I was in a substance one. Throughout the length of my stay, I was treated with understanding, patience and compassion.
The bulk of their program is cookie cutter evidence based, but high quality.
The employees at Bayside really care about their work, and their clients, and because of this it didn't have a corporate feel, even though they're owned by Acadia.
What made this stay extra special for me was the therapy and one on one conversations I had with staff. I had the honor and privilege of working with the best therapist I've ever seen. When there's a true match with therapy it can be magical, spiritual. I have transformed into a better version of myself because of the one on one work with my therapist, whose intelligence, wit, patience, and compassion helped me to rise above and shine, despite facing some extremely challenging triggers in residential this time. When you can't fully care about yourself, sometimes you can borrow someone else's faith in you until you're able to care about yourself a little more. By the end of my stay, I felt more confident and centered than I had in a long time.
I also wanted to say, the tech supervisor helped guide me psychologically and spiritually as I faced various challenges at Bayside, and helped revive my interest in spirituality, meditation and awakening.
I had the best spiritual and psychological support I could have asked for, which I thought would be impossible after being at Olympia House in 2022. (Both are good rehabs with their unique strengths and weaknesses. I learned a lot at both, but they're not directly comparable, OH is a little more unique in terms of approach and programming. Bayside was extra meaningful because of the particular therapist I worked with, the behavioral technician supervisor I mentioned and the particular clients I bonded with.
They actually listen to client feedback and I watched them make numerous improvements over the three months I was there.
With that said, there is room for further improvement. Clients are shuffled over to the main campus from detox with very little explanation of where to go and when, which leaves freshly detoxed clients confused, angry, and feeling disrespected. I've been told they're working on fixing this problem.
Scheduling glitches do happen, but that's true of any medium or large rehab. They do their best. And also, sometimes communication can be a little complicated between departments. No place is perfect.
Gorgeous campus. Food was great. I was told this was a rehab for rich people who valued aesthetics over content, but that's not what I found here. They have some incredible talent working for them and client socioeconomic backgrounds are mixed.
Last. I would encourage people, strongly, to ask to change their therapist if the initial assignment isn't a match. I did, and it made all the difference in my stay.
Gabriel Green
7 months ago
This facility saved my life in 2017! They treated me as an individual while helping me process my trauma and grief. I was able to create new habits, build self esteem and stop
self medicating through life. My children & I are forever grateful to Bayside for showing me a new way to live!
Hello im Ashley and im an addict. My whole life has been filled with chaos and trauma. Some from my own doing and some that wasnt my fault. There is not a single bad word i can say abouy my experience at Beachway Therapy Center. My time there was cut short thanks to my own self-sabotaging behavior. Even then Beachway still treated me with compassion and the desire to help me. My situation was a unusual one. I came into the trauma program with a clean date of April 16th 2014. So at 11 years clean i was dealing with bipolar disorder, intense anxiety, a very unhealthy toxic relationship and an intense desire to break generational curses for my children. My history is one that involves homelessness, street drugs and a street mentality. Beachway took on the challenge of helping me work thru that trauma. I opened up to the program and other woman like never before. I had an amazing counselor, amazing case manager, and amazing staff that were there anytime i had moments of high anxiety or worry. I am so disappointed i ruined my chances of having a chance at going thru a trauma program with Beachway. Just in the short time i was there i did gain a small sense of self back. If you were like me and worry about making friends with the other clients because they wont understand you or like you, that is not even close to true. I found a sense of community that i couldnt find anywhere else in my life. If i manage to find a magic lamp, one of my wishes would definitely be used on looking young forever after that id wish to feel the peace and serenity i felt at Beachway. Thanks to them i had just enough courage to get me and my kids out of my bad situation. Now my goal is to continue with trauma therapy. Do not be me and let your past dictate your future. No matter how clean you are from drugs that trauma will creep up on you and when it does use tools like Beachway to seek help instead of the alternative, and please for the love of your higher power get out of your own way and accept their help before you get kicked out like i did. I am forever grateful. Thanks for letting me share my expierence, strength and hope.
Ashley Wilburn
2 months ago
My experience at Banyan was very good. The staff was very helpful, the therapy was extremely beneficial , and the food was great! Like with all rehabs, it is what you make of it. If you go there thinking everything is perfect, you’ll be disappointed, it’s not. If you go for simply a social experience, it’s not a resort. If you go because you’re serious about your recovery, it’s a great place to take the first step !
Brian Koppen
2 months ago
Loved Beachway. I was extremely anxious with everyday panic attacks, and the medicine was no longer working. At Beachway I found a way to control my attacks and anxiety. It is not easy and sometimes I felt like it wasn’t going to work.
We worked through my childhood traumas and I learned techniques on how to defuse my anxiety.
Loved Dina’s honest and hardcore classes and also Gigi’s trauma class.
From the intake department, to the counselors, security, kitchen staff, Directors, Nurses and everyone that worked there I thank you. ❤️
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I want to give Avenues a huge Shout out! Sarah was my counselor. She was amazing! Saw me at my worst! I give them my my life!
Max Sonnino
2 months ago
The best recovery center hands down staff and counselors genuinely care about you and your sobriety and it's a very comfortable place to be for your recovery I know a lot of people say that but I truly do mean it from the bottom of my heart thank you 🙏🏾 so much avenues for the tools you have given me for success
Korey Willis
3 months ago
I had a great time at avenues I stayed 60 days and graduated it was well needed
I just left Profound and I couldn’t wait to leave, but when it was time, I wanted to stay. I created a new family that I could communicate without being judged. Maybe not everything pertained to me, but I did get a lot of tools and coping mechanisms for my addiction. I was fortunate to be in the new Oxnard house and it was a resort. Everyone was great there, so many people to name, but let’s do it! Doug, Katie, Camille, Rob, Jessie, David, Dalton, Kyle, Mike, Michelle, Lindsey, Chloe, Tez, Rodney, Sheryl, Irma, overnight Mike and most of all our amazing Chef Kayla! I will miss all of you and especially all of my house mates! I’m proud I stuck it out and received my 30 day coin! Love you all and thank you🙏
Jason Moore
1 month ago
A Love Letter to the Place That Saved My Life
There are no words big enough, no thank-yous deep enough, to fully express what this place has given me. Walking through the doors of this rehab, I was not just broken—I was gone. A shell. An echo of the person I used to be. I didn’t come in with hope; I came in with desperation. I had burned bridges, lost myself, and forgotten what it meant to truly live. But this place… this place gave me everything back—and more.
From day one, the staff treated me not as a case or a number, but as a soul worth saving. They didn’t judge my past. They held space for my pain, gently guiding me out of the shadows I’d been lost in for so long. They reminded me that I wasn’t just addicted—I was hurting, I was human, and I was still worthy of love.
The counselors weren’t just professionals—they were warriors, walking with us every step, sometimes carrying us when we couldn’t carry ourselves. They challenged us. Believed in us. Cried with us. Laughed with us. Celebrated every tiny victory like it was the Super Bowl. Because in recovery, those victories are everything.
I learned how to feel again. How to breathe. How to forgive myself. I learned that recovery isn’t just about saying no to a substance—it’s about saying yes to life. Yes to family. Yes to morning sunlight and belly laughs and long talks and second chances. I got my smile back here. I got my future back.
I will never forget the people I met here—the late-night talks in the common room, the moments of raw, unscripted honesty, the way complete strangers became family. We cheered each other on. We picked each other up. We healed together. That kind of bond doesn’t fade.
Today, I am sober. I am strong. I am healing. But most importantly—I am here. And I owe that to this sacred place that saw light in me when I could only see darkness.
If you are wondering if this is the place for you, let me say this from the deepest part of my heart: it is. Let this be the start of your miracle, like it was mine.
Thank you, from the bottom of my soul. You didn’t just save my life—you gave me a reason to live it.
Forever grateful,
Cynthia Madison
1 month ago
🌟 A Love Letter to the Place That Helped Me Begin Again 🌟
I don’t know if words will ever fully express what this place means to me — but I’ll try.
When I walked through those doors, I was exhausted. Not just tired — spiritually winded. I was carrying the weight of choices, shame, fear, and the echo of my own voice asking, “Will I ever be whole again?”
And then something happened.
A team of the most compassionate, professional, beautifully human beings I’ve ever met welcomed me — not like a patient, but like a person. Like someone worth fighting for. From the nurses to the counselors, the kitchen staff to the therapists, the front desk to the housekeeping — each one of them carried light into my darkest moments.
They didn’t judge. They didn’t push. They walked with me — step by step — back into myself.
Every group, every one-on-one, every conversation over coffee, every morning reflection… it rebuilt me. They didn’t just treat addiction here — they treated the person beneath it. They reminded me I was still in there, still breathing, still capable of joy, laughter, strength, and purpose.
And yes, I laughed. I cried. I healed. I grew.
If you’re reading this and you’re afraid — please come. If you think it won’t work for you — come anyway. If you believe you’re too broken — you’re not. I promise. I thought that too. And now, by the grace of this place and the hearts that run it, I have hope again.
To the staff: I will never forget you. You saved my life — not just my body, but my soul. I carry your voices with me, your strength, your faith in me even when I didn’t have it myself.
You gave me more than sobriety. You gave me myself back.
Thank you. Forever.
— With all my heart,
[A Grateful Human Being]
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Frequently Asked Questions
What Are Highmark Plans?
If you have a chance to choose your plan, there’s a lot to consider. Certain types of plans give you more flexibility to get care outside the provider network. These plans also have more flexibility in how you access specialist care, such as a psychiatrist or addiction counselor. However, those plans tend to have higher monthly premiums.
Here are the types of individual and family plans available from either your employer or the Insurance Marketplace in your state.
Health Maintenance Organization plans (HMOs)usually have the cheapest monthly premiums but also the least flexibility. You’ll need to choose a doctor to be your primary care provider and you’ll need to stay in network with your care.
A Preferred Provider Organization (PPO) planusually has a higher premium than an HMO plan but you don’t need a primary care provider and you can go to any in network provider without a referral. A PPO generally offers some coverage out of network but you’ll pay more out of pocket for the care.
A Point of Service (POS) plan provides in network care without a deductible and will let you go out of network as long as you have a referral from your primary care provider.
Highmark also offers a variety of Medicare plans. You can get Medicare Part D to help with prescription drugs on Original Medicare, or you can get a Medicare Advantage plan to replace Original Medicare and give you additional benefits such as vision and dental care. However a Medicare Advantage plan will likely have a limited provider network.
How to Verify Coverage With Highmark Insurance
Before you get started with treatment, it’s important to know the details of your insurance. To verify your coverage, you can call the insurance company directly or login to your online Highmark account to see what coverage is available.
You can also use the Highmark Find-A-Doctor Website to find an addiction treatment provider that’s within your plan’s network. You can start by clicking on the “Medical” link. Set the network to your specific plan, and enter your zip code in the location field. From there, browse by category: Behavioral Health and then select Addictions Medicine. To find more providers, expand the search radius.
Does Highmark Insurance Cover Other Mental Healthcare?
In 2010, the Affordable Care Act went into law. As a part of this legislation, mental health care was considered essential health care and must be a part of most health insurance plans.
There are exceptions to the law and every plan is different so be sure to check with your insurance provider to determine what services are covered. Some treatment may need a referral or preauthorization. Also treatment will need to be within the Highmark network for the greatest coverage and lowest out of pocket expenses.
For many with addiction, there is a co occuring mental health condition such as depression, anxiety, PTSD, and bi-polar disorder. Highmark recognizes that successful recovery not only means sobriety but that underlying conditions are also addressed. Most Highmark plans will cover the integrated care you need to address your mental health and substance use at the same time.
Mental healthcare can include both inpatient and outpatient care and you will get therapy and medication management along with other evidence based care.
What Inpatient Addiction Treatment Does Highmark Insurance Cover?
Highmark offers inpatient addiction treatment. These services include inpatient detox and residential rehab services. You will need to work with your primary care provider to determine what care you need and create a treatment plan that will guide you in the recovery process.
Inpatient medical detox is often the first step in the recovery journey. During inpatient detox individuals receive close medical observation and care that may include the use of FDA approved medications to ease withdrawal symptoms and reduce cravings. Medication assisted treatment (MAT) also helps to normalize brain chemistry and body functions. For some MAT is needed only during the detox period and for others long term use of medications such as methadone, buprenorphine, and naltrexone is necessary for successful long term recovery.
Inpatient or residential rehab centers include individual and group therapy in a structured setting with 24/7 support. In some programs you can continue with longer term MAT depending on your unique needs. Many inpatient programs also use other therapy methods such as music and art therapy along with holistic treatment options such as massage and yoga.
What Outpatient Rehab Does Highmark Insurance Cover?
Outpatient alcohol and substance use disorder treatment is covered by most Highmark plans. Outpatient care allows you to live at home or in sober living while attending treatment during the day.
Some outpatient care is more intensive and other programs are less so. A Partial Hospitalization Program (PHP) is a full day program that’s similar to residential care except you don’t live at the facility.
An Intensive Outpatient Program (IOP) is often the next step in recovery once residential or PHP treatment is completed. Understanding that early recovery can be difficult IOP offers individuals intensive treatment including nine or more hours of treatment per week and a structured plan for recovery. You might also be able to receive MAT during treatment.
General outpatient care only meets once or twice a week and is focused on reinforcing your new mindsets and habits as you continue long term recovery. Aftercare can give you additional support and treatment options to help you establish your substance free lifestyle. You may get help with job training and housing along with other social services. Aftercare is unique to each person because it recognizes that individuals’ needs differ.
Does Highmark Cover Methadone & Suboxone (MAT)?
The use of Methadone and Suboxone as a part of medication assisted treatment (MAT) is covered by most Highmark plans if it’s an appropriate part of your care. You may need to get a referral or preauthorization. You’ll also want to look for a treatment center within your plan’s network.
Medication Assisted Treatment is used along with evidence based treatment to help you manage cravings and stay focused on your treatment program. This allows you to avoid relapse and the danger of overdose while you lay a solid foundation for your recovery. Over time you’ll taper off the medication support and live a truly substance free life.
Can I Travel Out of State For Treatment With Highmark Insurance?
Whether you can travel out of state for treatment depends on your plan. Many plans require you to stay within the defined provider network unless you need emergency help. That means you can’t travel out of state and still use your Highmark insurance to get addiction care.
Some Highmark plans do have coverage for out of network care but you’ll pay far more in terms of your deductible and copayments. So in that case you may be able to go out of state but it will cost you a lot more.
It is important for you to speak with care representatives or check your insurance benefits online before you start a program. That way you know whether you have out of network coverage and what costs you can expect. You also may need a referral or preauthorization even if you use a non network provider. Get the details in advance to avoid surprises during treatment.
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