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.
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.
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.
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.
AlcoholismDrug AddictionOpioid AddictionSubstance AbuseDual DiagnosisMental Health And Substance Abuse
Adult ProgramYoung Adult ProgramProgram For MenProgram For Women
Self-Pay OptionsPrivate insurance
All in was a great program! The staff was amazing. Very helpful in my recovery! They were very attentive.
Mike Garcia
1 week ago
This place helped me when I felt like no one could, 5 stars to the techs, 5 to the therapists, and 5 to case management will love you guys for ever.
kyle Buchmaier
2 weeks ago
My experience at All in Solutions was absolutely the best it could be given the situation. The staff were absolutely amazing. With this course of recovery I've been given the keys for a bright future. It's up to me to put my training to work in in my life.
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 AddictionMental Health
Adult ProgramLGBTQ ProgramYoung Adult ProgramMilitary Program
Self-Pay OptionsMonthlyPrivate Insurance
Good place, great housing
Nicole Rivera
1 month ago
Amazing support network and great staff lovely time with my stay at STR buck
William Perry
1 month ago
My experience at Steps to Recovery has been great for the most part, the people and the environment are very welcoming and comforting. I have had some issues that have come up, but they usually get resolved. My only main gripe is with some of the other clients at the community living house fail to clean up after themselves, and some do not know self control. But, the staff here is very professional and easy to talk to. I find that the opportunities here for my recovery journey are pretty good, although I'd like access to more holistic therapy resources. I've actually personally facilitated a Dharma meeting and will facilitate more in the future. I appreciate my time here at STR and am excited for the future with them.
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
I had a wonderful time! Everyone was very helpful with my recovery journey! Thank y'all so much!
Savannah Banana
2 weeks ago
I can't recommend All-In enough. There's no real way to phrase a review like this that doesn't sound sappy and trite, but I firmly believe I wouldn't be where I am today without them. Love y'all ❤️
Squid Jabine
4 weeks ago
I had a great experience with All In Solutions The staff is nice, knowledgeable and helpful, I would like to give a special shout out to my Therapist KAREN CASTON she is a awesome therapist and an amazing caring, loving women. She really went above and beyond to get me through my obstacles
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 AddictionMental Health And Substance AbuseOpioid AddictionSubstance AbuseDual Diagnosis
Adult ProgramProgram For MenProgram For WomenYoung Adult Program
Private InsuranceSelf-Pay Options
My experience at All In was amazing! I love all the staff. They were definitely wonderful to be around. Jess being one case manager for all the clients is beyond unbelievable and she is truly a God send!!! ❤️ 😍
Michelle Mullen
1 month ago
My experience with All in Solution was life changing. I went through detox and residential to prepare me for on going therapy. I had great nurses techs and patient support through tough days and such support for the family atmosphere I experienced. I am grateful for everyone that helped me there and would recommend to anyone that wants to get sober and learn how to stay sober through their program
Lisa Lunn Green
1 month ago
All in solutions is the best , if you need to get straight , it's the place to go , I highly recommend it 👍
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 AddictionMental Health And Substance AbuseOpioid AddictionSubstance AbuseDual Diagnosis
Adult ProgramProgram For MenProgram For WomenYoung Adult Program
Self-Pay OptionsPrivate insurance
Everyone here was spectacular and professional. Jason was my counselor and he went above and beyond !
Marshall McCormick
3 days ago
All In Solutions truly changed my life in ways I didn’t expect. From the beginning, I felt supported, respected, and genuinely cared for. My counselor, Jason, was amazing! He was patient, knowledgeable, and truly invested in my recovery. He made it easy to be honest and helped me grow in ways I never thought possible. He really related to my struggles and helped me not only want to get sober, but also find lasting recovery.
Debbie, the director, consistently goes above and beyond for clients, even when she doesn’t have to. She truly shows up for people and advocates for them, which says a lot about the heart behind this program.
Anthony was instrumental in ensuring a smooth and supportive transition into sober living. He is genuinely invested in each client’s safety and well-being, and it truly shows.
Zee, the alumni coordinator, is always there - she consistently follows up with former clients and makes herself available in times of need. If you call her, she WILL answer.
The entire staff at AIS is incredible. They don’t treat recovery like a box to check, they treat you like a person. Their support and genuine care made a huge difference in my recovery, and I’m beyond grateful and thankful for EVERYTHING they’ve done.
Jenn
1 week ago
The staff in the facility were amazing my counselor Jason changed my life for the better
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.
What can I say? My stay at Gratitude Lodge was beyond my expectations. This was my first exposure to treatment so I was nervous; nonetheless, I was treated with the utmost respect and compassion. ❤️
From the start, the house was definitely a second home for me having traveled from the Midwest. I was warmly received on the first night and settled in comfortably.
So many staff members impacted my experience...from the start, Ryan, meeting my at the airport and providing sound advice for tlnext steps in my recovery, Peter for his fantastic music therapy sessions, James for his sincere commitment to my casework, Mario always for his listening skills, Trinity, Justin, Andrew...and everyone beyond.
Jesse Emswiller
1 month ago
Best experience of my sober life. I want to personally thank, Trinity, Justin, Mario, Ryan, Eli, Megan, Andrew, Lee, Kyle, James and Peter for everything and that they do. The best staff at any program I’ve ever been to (and I’ve been to a bit over my fair share). They actually care, they love you and they truly want to see you succeed. A special shout out to James, for always and I mean ALWAYS being in my corner. A shoutout to Trinity for being my confidant when I felt alone in the beginning. To Peter, who listened to all my bullshit with a smile on his face and some music in the background. The best place to get sober and the best people to ever be around. Truly a sober environment, where you learn how to be sober. Not just get sober but BE sober. I’ll forever remember my time here with love, respect and of course plenty of GRATITUDE!!!!!!!
Vivi
1 month ago
I had such a great experience here. I've been to alot of rehabs and I cant say the same for most of those. I didn't know if I wanted to come in or even be sober and James and Megan stayed out front with me for a long while, patiently helping me to make the right decision to come in and I am so glad I did. They have such a great team of people and I couldn't thank you guys enough. Shout out to James for always staying late and convincing me to not AMA lol i even decides to stay longer, you can tell he really pours his heart into his job and wants to help. Same goes for Megan and Ryan you guys are really the best.
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.
staff is friendly, stayed long enough to get the help that I needed
Richard Hauser
4 days ago
My experience at ICFR was great. The facility was nice. My therapist was excellent. The only thing negative keeping the from 5-stars was the lack of communication. I gained more about the place and where I needed to be from my peers rather than receiving instruction from faculty.
David Carpenter
1 week ago
I have been to this place twice and would highly recommend to anyone struggling with mental health or substance abuse. Staff is great and so is the brother and sisterhood you will build.
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 honestly can’t thank this place enough, it honestly saved my life. When I came to the haven I had literally gave up on life. I had overdosed when I got here and they got me to the hospital fast enough to save my life. The next 3 days were pure hell. The staff truly does care. Roni is amazing(has great style to) always had a smile on her face. Anthony and Shawn were my go to if I needed something done, they always made it happen. Ashley and Lauren were great always running around like crazy getting things done for people. Most of the BHT were cool. The night BHT’s were more down to earth. Shaggy is definitely one of my favorites when I wanted to give up he told me to keep pushing. I could keep ranting on and on about how good the place is but we would be here for hours. Thank you to the Haven for giving me my life back!
Kaila Clark
5 days ago
The Haven is a great place very helpful and attentive. Roni helped out a lot and Anthony. And my therapist Robert is amazing. And Lynn helped me so much for my medical needs. I appreciate u guys so much. Y'all have helped me more than you all would ever know.
Shayna Becker
6 days ago
I had a great experience at The Haven Detox center. All of the staff were very friendly,helpful and I was treated like I was the best person there, The nurse practitioner Jessica Percites was very helpful,Roni, the Administrator was so helpful. Kerry, Nesha, Lauren, Stephanie, Harriet, Jose, we’re always helping me with anything I needed. Anthony, the client Care Coordinator was amazing, Shawn, another Client Care Coordinator was extremely supportive and helpful withe all of my needs.
If I ever needed to come to a treatment center again, I would definitely come back here.
I made many friends and will keep in touch with all of them.
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.
Drug AddictionAlcoholismOpioid AddictionDual DiagnosisMental Health and Substance AbuseSubstance Abuse
Adult ProgramYoung Adult ProgramSeniors ProgramProgram For MenProgram For WomenLGBTQ Program
Private InsuranceSelf-Pay OptionsMilitary InsuranceFinancial Aid
Exceptional staff and facility. Definitely one of a kind tailored treatment for people struggling with substance abuse!!
Charlie Hite
1 month ago
The staff and clients at boca are incredible. Joe leads the most incredible meetings; I wish I could virtually sit in on them. Bri was such a strong supporter. If you have an opportunity to go here, give it a chance and go!! It works!
Krista Calabrese
1 month ago
This place was amazing! The staff has also walked in shoes similar to my own so it made relating to them much easier! I was able to get a good head start in sobriety here! The residents were also amazing! If I had to refer anyone needing help I would definitely refer them here! It’s a great place to start your sober journey!
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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.
Calls to any general helpline will be answered or returned by a paid advertiser.
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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