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.
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
1 month 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
1 month 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. ❤️
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
1 month 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
1 month 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!
Was recently at the provive office and my experience was phenomenal! The office was immaculate and I had a chance to talk with Noel and it was an absolute pleasure. He is extremely passionate about helping anyone that has any substance abuse or mental health issues. Amazing experience overall!
John Ballard
3 days ago
I’ve seen firsthand how much heart and care the team at Provive Wellness puts into their work. The staff is warm, professional, and truly committed to helping people heal. Highly recommend to anyone seeking support for mental health or addiction.
Coming to The Center changed the trajectory of my life. I had a lot of trauma that I had never dealt with that was unknowingly causing unhealthy behavioral patterns. These patters had slowly been building over time and were becoming more and more damaging both to myself and to my loved ones.My time here helped me find a path forward and gave me momentum in my journey toward healing. Where I felt completely hopeless before, I now fully believe that my life is worth living and The Center has given me the tools and the knowledge to pursue that life to the fullest.
joe pennock
2 months ago
The Center A Place of HOPE offers an exceptional level of care and dedication. Their programs helped me regain my confidence and find hope again.
Feye Husen
2 months ago
I am so grateful for my 6 weeks at The Center. It was both shocking and relieving to see the wide range of different kinds of people that come into there, as well as the wide range of issues that bring them in.The days are full and it can feel like a lot, but it truly is what you make of it. Apply yourself and you will get so much great information, as well as inspiration from other clients and genuine care from your individual team. It is incredibly evident how much these people love their jobs.It wasn t my idea to go there, but I m so glad that I did choose to make the leap. I had basically come to accept that I was just stuck due to depression, anxiety, shame, fear, etc, but I was able to build the foundation for reconnecting to my true self. Looking forward to life again. Certainly still work to do, but it was definitely the jump-start I needed.Loved my whole team, and all the therapists who led groups, but special shoutout to my psych, Austin, for being so diligent with my medication changes, and to my lead therapist, Virgil, for being the absolute man and helping me look at myself and life differently.All the love to The Center and anyone who is considering going there
I loved it here. Such a great experience!! They are so nice and very helpful!!
Hailey Pyenta
1 week 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
4 weeks 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.
Tree House is truly an incredible place. My life was changed in so many ways thanks to Tree House and the amazing staff. I love this place with all my heart and the people I got to know during my time there. The structure of the program combined with the camaraderie of the people around you is a match made in heaven. Thank you Tree House for giving me the life I live today.
clint wilson
2 months ago
Hands down the best decision I made for myself to save my life. I had no idea what to do with my life as I was spiraling into a seemingly inescapable abyss until I reached out to Treehouse. I had my reservations about going to a place like Treehouse as a member of the LGBTQ+ community but the amount of support and acceptance I received even before I committed to going was incredible. I gained the knowledge and tools that I use on a daily basis that help me live life to the fullest potential. I discovered new things about myself while going through the program by living outside of my comfort zone and allowing myself to try things I never thought I would be interested in. Treehouse was able to create a space where I could explore these new things and create strong bonds with guys that impacted my recovery in the best way possible and gave me a stronger foundation to move forward with my life. The therapy was life changing, shoutout to Chuck and Ryan, they saw something in me that I could not see for myself and helped me bring that out. The coaches were incredible as well, shoutout to Dylan, he taught me so much that went above and beyond physical fitness and weight training. Vechi and Brandon were instrumental in working with me to get me the help that I needed and incredible human beings. Words cannot express how grateful and honored I feel to have gone through and graduated from this program. If you're looking for a place that'll give you the best chance at success in recovery, this is it. You are worth it.
Salvatore Bonilla
3 months ago
When I first walked through the doors at Treehouse, I was lost, broken, and trapped in a cycle of addiction that I never thought I could escape, Never! I had become a prisoner to alcohol and drugs, and my life was spiraling out of control. The guys at Treehouse, there programs, and there unwavering support, helped me find my way back to the person I was meant to be!At my lowest point, I felt like there was no hope But within the walls of Treehouse, I found Compassion, Understanding, and the TOOLS I needed to fight for my sobriety. Through counseling, support groups, and the kindness of those who had walked this path before me, I learned that I was NOT alone. I discovered strength within myself that I never knew existed, and for the first time in a long time, I believed in the possibility of change. I learned to take Responsibility for my Actions, to heal from the pain I had caused myself and others, and to embrace a FUTURE filled with HOPE. TREEHOUSE gave me the courage to rebuild relationships, to Chase Dreams I had long abandoned, and to live a life of PURPOSE and CLARITY.Today, I am proud to say that I am sober. Every morning, I wake up with a sense of Gratitude instead of dread. I have regained my health, my relationships, and most importantly, my sense of self-worth. NONE of this would have been possible without the GUIDANCE and SUPPORT that Treehouse provided me during my darkest days.I just want to say Thank You for being the place where I found healing, hope, and a second chance at life. I have and will carry the lessons I have learned within me ALWAYS, and I hope to one day give back to others who are fighting the same battle. Because of you, I am no longer just surviving, I am truly living!Much Love..
Prosperity Haven/ Wellbrook Recovery is such a wonderful place that helped me get sober. From the moment you walk in, everyone is so warm and welcome. When looking for a facility, WRC covered all the bases with being male only with fewer patients than a traditional set-up.The group instructors are diverse and will push you to be vulnerable and work outside of your comfort zone. There are all different types of therapies that are used to help you heal.The entire place/ program is about fellowship. Seeing the alumni come through the doors and support the guys in the house was huge for me.10/10 would recommend this facility to anyone seeking sobriety!
Brock Spurling
2 months ago
Prosperity is an excellent facility. They have an amazing and knowledgeable staff there to support clients throughout their stay that show a genuine Interest in client long term success. They do a fantastic job of making sure needs are met, including helping with coordination of any after care. I highly recommend this facility to anyone seeking to improve their situation.
Brandon Epp
2 months ago
I worked at Prosperity Haven for two years. Working here was a truly transformative experience, both personally and professionally. The leadership at Prosperity Haven was exceptional supportive, open to feedback, and always striving to provide the best care possible. The culture of compassion and respect that permeates the facility is remarkable, and it s evident (in everything they do) that the staff is fully committed to the mission of helping individuals heal and thrive. If you're looking for a place where you can start or pick up your recovery journey in a supportive and compassionate environment, I cannot recommend Prosperity Haven Treatment Center highly enough. The success stories I got to witness were genuinely life changing and my time there was an experience I will always cherish.
This Rehab facility was absolutely life-changing for me. There are so many great things I could list about this place. The staff were knowledgeable, compassionate, friendly and MOST of all: EXTREMELY accommodating and understanding with requests. The house was located in a quiet and peaceful residential neighborhood with absolute stunning views overlooking the ocean. The fun activities and experiences/outings were extremely helpful coping skills for my mental health and cravings.At Laguna View Detox it is evident that the staff care about you from the time you walk in the front door.I would like to point out that while this experience was amazing, there are a couple of things I would like to point out as areas for growth and improvement.1. Food - the food was sub-par in my humble opinion. While they do cater to dietary restrictions and allergies, there were many occasions that felt like the same food was repetitive, less-healthy, and lacked the right amount to serve everyone to their satisfaction.It would have been nice to maybe have the option for meal prep or an activity cooking course to teach people the skill and value in cooking together as well as considering a part-time chef position to develop those skills in staff and clients alike.2. Staff/clients - While 90% of the staff/clients were absolutely amazing, there were a couple that maybe could ve brought more value to the table or fulfilled their duties so others wouldn t have to suffer the consequences. It s not fair nor realistic to expect perfection from everyone but it is possible to differentiate those that are there to just collect a paycheck or take advantage of the care the system provides.These problems will undoubtedly always arise in every work environment and company alike thus should be expected time to time. The higher management can hopefully take more proactive measures to prevent the house becoming a toxic environment as well as addressing the problems at the core of the individuals.Once again I would highly recommend this place to anyone seriously committed to attaining a peaceful and healthy life of sobriety. I am forever indebted and grateful to LVD for my experience. I am also proud of myself for making the best of this opportunity and utilizing all the tools, skills and knowledge taught from the wise and relatable staff.I have made life-long friends, relationships, coping skills and knowledge that I will carry throughput my lifetime toward sobriety. I just wanted to thank you all for everything.Much love,Joe
Joseph Mancuso
1 year ago
I would give 10 stars if I could. I called the number on their webpage in the early morning on a Sunday and their director of intake, T.J. answered . He listened to me try to explain the nightmare I m living in with my son and he made me feel so much more calm and I felt as if I was talking to a friend or family. It was amazing. He found my son a place in their facility right away and explained the process and what to expect, even sharing his own experiences. I have never dealt with this before so I had a lot of catching up to do and I was literally in the midst of a serious crisis with my son which is already enough. I don t think I could ve handled this situation without the patience and support everyone at Laguna Detox but especially T.J. offered me. Unfortunately our insurance declined us in the 11th hour which was petrifying, but TJ called me himself and gave me a handful of alternative places and helped me call them and check for availability. What a difference that made. TJ ended up finding the best alternative in our area and hours later I had my son in their care and he s getting the attention and care he deserves and I can finally take a deep sigh of relief. TJ reached out throughout the entire process giving us his support and care and even checked in a couple days into my sons treatment to see how we were doing. TJ is one of those humans you pray for when you or anyone you love is in a crisis. Just a gem! Thank you TJ and Laguna Detox, I appreciate you and would recommend you to anyone.
I struggled with drug addiction for 20 years. Could never break the cycle where I lived in Alabama 37 yrs of my life. I was out of options. My insurance found Paramount Recovery Centers in Massachusetts. I got ahold of them and they started the process to get me up here. They was a true blessing. Helped pay for my plane tickets and got me up here. I went thru 6 months of PHP program and then outpatient. Everyone from intake coordinators to councilors and all way up to program directors ALL helped me any way they possibly could. And thru this program I found hope again. I couldn t have done it without their help and am forever grateful for Paramount Recovery Centers. I stayed in their men s sober houses for 2 yrs now and am a manager at another one now. I highly recommend Paramount for anyone struggling with alcohol or drug addiction. Even mental health issues too. They are truly a leader in the recovery community here in Massachusetts.
Patrick Marshall
3 months ago
I attended Paramount recovery program in February of 2023. I found it to be a life-changing experience thanks to all of the amazing clinicians and staff that work there. I would highly recommend this program to anyone that is struggling with addiction.
trevor sand
3 months ago
My cousin has struggled with addiction for most of his adult life. He s been to countless rehabs, tried meditation and even hypnosis to get over his issues with substances. It wasn t until he joined Paramount Recovery Centers PHP that he actually began to embrace sobriety as his new norm. You see, what my cousin never had was a sense of community, and that is exactly what Paramount provided. It was clear from the moment I dropped him off with the clinical staff that he was going to be in good hands. Without Paramount my cousin may be in jail or even worse, deceased. We will always remember Paramount as the place that saved his life.
Maple Mountain Recovery utilizes a unique environment of therapeutic care.The staff are trained, responsible, and show their commitment to provide clients with the best modalities to fit their needs.Clinical and Therapeutic staff encourage clients to process learned techniques, and the application they ll find accessible into the lifelong recovery process.The environment is clean and kept in order. A nutritious diet made easy to integrate through the use of professional chefs. An overwhelmingly positive atmosphere and support of peers and staff create motivation to improve upon the struggles of life.I highly recommend Maple Mountain to those seeking care for their mental wellbeing.
Hunter Reynolds
2 months ago
Maple Mountain has been an absolutely life changing experience for me. I was fortunate to have been assigned Sarah as my therapist. Her support and counselingA.R.T. sessions, thoughtful reflections and her exceptional abilities as a therapist have healed deep and traumatic experiences.Kevin and Vikki have given me a place of compassion, understanding and direction that are invaluable.The food is excellent, fresh and varied. Chefs are talented and accommodating, always going above and beyond.Beds are very comfortable and the facility is impeccably clean and welcoming. Maria in hospitality is warm and friendly offering uplifting conversations and makes you feel at home.And Angel, therapy doggo extradonaire is THE best support dog ever!The wound is the place where the light enters you - RumiWe help you walk through the dark and back to the healing light - the experience of Maple Mountain!
Gigi Crowe
2 months ago
The facility is beautiful and maintained very well. I came here feeling like I had changed into a person I wasn t proud of after experiencing intense traumas throughout life, I am leaving feeling lighter and brighter and much more like the best parts of myself. The chefs are great and accommodating at all times, my therapist Kevin helped me through things I didn t think were things I could work through. The techs Chay, Natalie, Chelsea, and Kailea are full of kindness and will make you feel at home and secure. On the negative side I do think the program lacks consistent communication at times which can be triggering, to be told one thing and it ends up being different.
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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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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.
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