Explore UPMC Health Plan’s coverage for addiction treatment, including inpatient and outpatient options, plus mental health support.
UPMC Health Plan Coverage for Addiction Treatment
Explore UPMC Health Plan’s coverage for addiction treatment, including inpatient and outpatient options, plus mental health support.
UPMC Health Plan is the insurance arm of the UPMC (University of Pittsburgh Medical Center) health company that provides integrated health care and insurance coverage to residents of western and central Pennsylvania plus parts of Maryland and Ohio and West Virginia. They are headquartered in Pittsburgh Pennsylvania.
UPMC has their own network of hospitals and doctors and they also contract with other providers including the Cigna PPO network to serve members who live or travel outside of their main service locations. UPMC actively supports Pennsylvania community arts and education groups such as the Pittsburgh Promise, an educational scholarship fund to which they donated $10 million in 2023.
By Rita Milios
Rita Milios, The Mind Mentor, is a recently retired psychotherapist, freelance author (recovery, mental health, spiritual growth), seminar leader, and podcaster from Kissimmee, FL. She provided counseling in rehab facilities in Ohio and Florida, as well as in her private practice. Rita also served as a DOT Substance Abuse Professional (SAP) consultant.
Medically Reviewed by Danielle Letenyei
Danielle Letenyei is a freelance writer living in Madison, Wisconsin. She specializes in personal finance and insurance topics, including medical insurance and Medicare. Her work has appeared in FinanceBuzz, Market Realist, U.S. News & World Report, and more.
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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
This is a Great place to detox. Staff is so friendly and helpful. Most have come through this program and have stayed sober. There is food to food to eat and great speakers that help you learn about yourself and your addiction alcohol or drugs. Make the choice and take over your life again!!
Morris Herbert
6 days ago
I’m so happy I choose to come here. I’ve learned so much being here about my addiction and myself in general. The staff, the nurses the group therapy were all amazing. I’m going to miss the people in here I met. Thank you Kristina, KERMIT, Kate thank you Carlos, Theresa, LACEY, RICKY, CiCI, SAM, JESS nurses Chris Ashley ALL OF THEM! God bless yall!! Love you all I’ll miss you
Nisha Lacondrata
1 month ago
I had a great experience at All In Solutions Treatment Center. The staff was incredibly caring, supportive, and genuinely invested in my recovery. I learned a lot about myself and gained tools I can carry with me moving forward.
The facility was comfortable, the care was excellent, and the overall environment made it easy to focus on getting better. I also have to give a huge shoutout to the chef—the food was outstanding.
I’m very grateful for my time at All In Solutions and would absolutely recommend it to anyone looking for compassionate, high-quality treatment.
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 AddictionMental Health And Substance AbuseOpioid AddictionSubstance AbuseDual Diagnosis
Adult ProgramProgram For MenProgram For WomenYoung Adult Program
Self-Pay OptionsPrivate insurance
This place absolutely changed my life. The staff are all wonderful especially Sarah the Case manager, Bethany And Debbie are absolutely exceptional. I feel like a new person and they have allowed me to become a better version of myself. I will be forever grateful for this place and look forward to my future endeavors. Thank you so much All In Solutions for everything you have down.
Brandon Matthews
6 days ago
AIS. Is a very good program I learned a lot here to cope with life the staff and counselor are amazing and do really care about your sobriety and mental health
Jerry Martinez
3 weeks ago
I absolutely love All in Solutions. They've played a large role in developing me into the person I am today. The staff is great! Especially the counselor, Mrs. Hepzibeth!! She's been the sweetest, and I've created an unbreakable bond with her. She will always hold a special place in my heart. l love y'all and am forever grateful for everything!!
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.
Jaylen was an amazing case manager.
Ezett really helped me as well.
Great experience, thanks to all
Chase McGill
4 days ago
Had a positive experience during my 3 week stay inpatient!
Ian Julian
5 days ago
If you are looking to truly stop your addiction and do it safely with medical attention and care this place is perfect. They will make sure you are safe and comfortable while you go through your withdrawals which can be life threatening. You do not have to do it on your own. The staff is very kind and care about where you are at physically and mentally while you go through the program. The house keeping is well maintained and the team is non stop working to keep the facility clean and comfortable. Please get help if you need it and choosing ICFR is a great choice!
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.
Silver Pines saved my life. While you might read that & think how cliche… but to me, it’s genuinely the best thing that has ever happened to me. I felt love, care, safety, freedom, comfort & so much more for the very first time in my life. Every staff member genuinely cares, every nurse loves on you till your better, the nutritionist fills your belly with good food, the maintenance man makes sure everything is working in a timely manner, the drivers ensure you get there safely & home after you’ve completed… It’s the little things that matter. Thank you Silver Pines & everyone there.
Jazeah Gray
1 week ago
Silver Pines 🪨!
Cameron Casey
1 week ago
I have been to silver pines a few times. I was scared the first time i went there,but that quickly went away. Everyone is so nice from the clients to the staff. You are treated like an actual person, not just another junkie. I would highly recommend this place to anyone seeking help. Everyone is treated with respect and dignity.
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.
Asana Recovery has helped me get my life on track again. Before I came in, I didn't know what direction I was going in life. With their help, I have transformed in to a productive member of society. The entire team has been so helpful and supportive. If you are looking for a top notch treatment program that treats you like a human being instead of a dollar sign, come to Asana Recovery.
Evan Beecher
4 months ago
We’ve had a great experience working alongside this treatment center. Their team consistently provides excellent client care, strong communication, and a genuine commitment to supporting individuals through recovery. Their outpatient program is well-structured, supportive, and clearly focused on long-term success for clients. We truly value the partnership and would highly recommend them to anyone seeking quality care and professional support.
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.
Great place with staff that really care about you. They went above and beyond to make sure I was completely taken care of. Very professional, great food, excellent therapy groups, and special activities that were a lot of fun! 5 out of 5 stars!
John B
5 days ago
Great staff! Beautiful facility! 🥰
Kelsey Sides
1 week ago
The facility is fantastic! Very clean and organized. The staff is wonderful, esp: Ms. Janell, Desmond and Meachi. Honestly the staff was always helpful and chipper when you are at your worst. I would definitely go back again and recommend it to anyone. I appreciate all the help I received. <3
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.
My experience at Silvermist was truly transformational and one of the best things I’ve ever done for myself. The staff created an environment where I felt supported, challenged, and genuinely cared for throughout my stay. I’m leaving with a much better understanding of myself, practical tools for moving forward, and real confidence about the life I’m returning to. I’m incredibly grateful for the people I met here and the care I received. Five stars without hesitation.
John Phebus
1 month ago
Fantastic staff. Definitely cares about quality of service and its clients
Nicholas Clemens
2 months ago
The Staff Was Great, The Clients Great! A Life Changing Experience!
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.
This place has completely changed my life and for the better I came in high as a j bird and I hated my life and when I got here I really just wanted to do the detox portion but here I am 26 days later and I’m still here the classes they we do are amazing dbt classes helped me out a lot and I learned I can live a life that does not involve using drugs like meth or fentanyl and that I can honest be happy done the staff are wonderful very helpful and they really are here to help change lives there not after a paycheck heck they even take you to your appointments and they also make sure your safe when you leave and they find after care for you so you can continue to stay sober and live the life of a sober person and the best part is when you wake up in the morning you can go out side with your coffee and a smoke and watch the sun rise over the lake and sunset as well I’m truly going to miss this place and if I ever relapse again I know where I will come back to
Thank you to all the staff at HAVEN DETOX
Nathan Schibline
4 weeks ago
The haven has been one of the greatest experiences I’ve ever had the pleasure of going to. From the staff to the clients I’ve been here since September and I coin out on Thursday. Every step of the way I have learned something new. I wouldn’t trade my experience for anything. I highly recommend the haven detox for detoxing or residential treatment.
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.
First and foremost I would like to take the time and thank all of the staff at the West Palm Beach phacility for being so kind, caring and understanding of my needs during my time in detox and residential. From clinical to the therapist, chefs, nursing and senior staff, my time did not go unattended or unnoticed. If you're in need of help and looking for a treatment center that truly cares, please don't hesitate and give The Haven Detox a call.
Sincerely...Thomas F.
Thomas Fallis
1 week ago
Learned so much about myself. It was a blessing. And David is the best!!!
William Grappy
1 week ago
Treatment and continued support here was very helpful
As required by the 2010 Affordable Care Act (ACA) most UPMC Health Plan insurance plans offer mental health and substance abuse treatment along with other medical care. However there are exceptions to the law and every insurance plan is different, so be sure to check with your insurance provider to find out which addiction treatments are covered by your specific plan.
Most UPMC in network substance abuse rehabs are in Pittsburgh, but there are some UPMC covered rehabs in Maryland and New York.
If you have a Cigna PPO plan or other out of network plan that has a partnership with UPMC Health Plan, you may have other rehabs available to you as well. Check with your insurance provider to find out which addiction treatments are covered by your specific plan.
What UPMC Health Plans Are Available?
UPMC offers individual and family plans through the state Insurance Marketplace and through employers. If you qualify you can also get Medicare or Medicaid plans through UMPC.
The individual and family plans have several different options. They have Exclusive Provider Organization (EPO) plans, which require you to get care in the provider network but you don’t need a referral to see a specialist such as an addiction counselor.
They also have Health Maintenance Organization (HMO) plans, which require you to stay in network and to get a referral for specialist care. However, HMOs are often the least expensive on a monthly basis. Finally, a Preferred Provider Organization (PPO) gives you the most flexibility with some out of network coverage and no referrals required. However these plans tend to cost the most each month.
UPMC Health Plan offers Medicare Advantage (“Medicare part C”) HMO and PPO plans. Medicare plans by UPMC healthcare are called UPMC for Life. These plans provide the same services as regular Medicare, including coverage for addiction care, but they generally offer extra benefits like prescription coverage and vision and dental care.
Your Medicare Advantage plan will have its own coverage limits and requirements to get addiction treatment, so be sure to work with your doctor and get the referrals and preauthorization you need before you commit to treatment.
Medicaid plans by UPMC healthcare are called UPMC for You. Like regular Medicaid, these plans cover medical treatment and substance abuse treatment. However, they also cover prescriptions and dental and vision care.
If you qualify for both Medicare and Medicaid, UPMC for Life Complete Care offers $0 premium fees and $0 copays on medical care and $0 copays for prescriptions. It also offers dental and vision and hearing benefits. Members can get free transportation to healthcare providers and grocery stores along with fitness centers and adult day care centers. There’s also an allowance you can use to buy over the counter products.
What Inpatient Addiction Treatment Does UPMC Health Cover?
All insurance plans will focus on covering medically necessary care which is often defined by the treatment plan your doctor creates. It’s also important to verify your insurance and make sure you get a referral or preauthorization if necessary.
Some of the inpatient drug rehab treatment options that may be included in UPMC Health Plan’s behavioral health insurance policies are medical detox and residential treatment.
Detoxification is the process of letting substances leave your body. Many times you’ll get medical support to help you move through withdrawal symptoms. This may include medication assisted treatment (MAT). Commonly used MAT medications for treating alcohol or opioid addiction are methadone and buprenorphine along with naltrexone.
Inpatient treatment takes place in a clinic or hospital and residential care takes place in a non hospital facility and offers a more home like setting. Both options provide around the clock support and care.
Residential treatment often lasts 28 to 30 days or more. You’ll get a variety of therapy options which often includes holistic approaches like art or music therapy. Inpatient or residential treatment allows you to fully focus on your recovery without any distractions.
What Outpatient Rehab Does UMPC Health Plan Cover?
Outpatient programs, including intensive outpatient programs and regular outpatient programs, are available through UPMC Health Plan’s mental health benefits. Intensive outpatient programs typically involve up to nine hours of treatment each week, for between three to six weeks.Â
In a general outpatient program, counseling and education sessions may take place at a clinic or rehab facility. Addiction and relapse prevention education are provided, with individual sessions offered as needed.
There are multiple types of outpatient care. The most intensive outpatient treatment is a partial hospitalization program (PHP). This is a full day program that offers more than 20 hours of treatment per week. The treatment options are similar to inpatient or residential care.
At the next level are intensive outpatient programs (IOPs) which typically involve nine to 20 hours of treatment each week, with the hours spread over three to five days. Often 90 days of IOP treatment are recommended. The lowest intensity is general outpatient treatment, where counseling and education sessions may take place at a clinic or rehab facility once or twice a week. Addiction and relapse prevention education are provided, with individual sessions offered as needed.
Do UPMC Health Plans Have Additional Benefits?
Part of what makes UPMC Health stand out is the extra benefits members receive. For example preventive services may be free of charge and members can access virtual (telehealth or video) urgent care services to diagnose illness or prescribe medication.
They also have the MyHealth program that provides free health coaching for weight loss and smoking cessation along with tips on stress management and more. Finally, members can get six sessions of free counseling with a trained counselor through the Life Solutions program.
Does UMPC Health Plan Cover Methadone & Suboxone (MAT)?
MAT is covered by most UMPC plans. This treatment uses FDA approved medications to help those with alcohol and substance use disorder during the early recovery period. These medications such as naltrexone and buprenorphine along with methadone and acamprosate ease withdrawal symptoms and help to normalize brain chemistry. This is especially important during medical detox.
Some individuals only need MAT during the detox process while others need it throughout treatment to help manage cravings to reduce the risk of relapse and decrease the risk of overdose. Longer term MAT is combined with inpatient or outpatient treatment to help you establish long term recovery. Once treatment ends you can taper off the medication support and live a fully substance free life.
Does UMPC Cover Other Mental Healthcare?
In 2010 the Affordable Care Act was enacted into law. The ACA requires insurance plans to cover 10 essential health benefits which include mental health and substance use care. As a result most UMPC plans cover mental healthcare such as counseling and crisis intervention. You may get individual or group counseling along with mental health medication.
The extent of coverage differs from plan to plan. It is important to understand the details of your specific plan before starting treatment so you know whether you need a referral or preauthorization. You’ll also learn what out of pocket costs to expect.
Individuals with alcohol and substance use disorder often have co occurring mental health conditions. What’s most important in these cases is that you get treatment that addresses both mental health and addiction. That’s the only way to ensure you get the help you need to reach long term recovery.
Does Addiction Treatment Need to Be In Network?
Many UMPC plans require you to use an in network provider to get coverage. However some allow you to use an out of network provider although you’ll pay a lot more in out of pocket costs. For example your copayment and deductible may both be higher. Or you might have to pay a percentage of the cost instead of a flat copayment.
To maximize your insurance coverage it’s best to use high quality in network providers or facilities. To find out whether your plan allows non network care contact UMPC directly. This can be done by calling the phone number on the back of your ID card or by going online to their webpage at UPMC.com
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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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