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.
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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 ProgramYoung Adult ProgramProgram For MenProgram For Women
Private InsuranceSelf-Pay Options
I will recommend this facility to anyone who is in need of a care especially an addict. The staff here has excellent knowledge.
Shea
2 months ago
All in Solutions changed my life. The staff here is very friendly and heart warming. Jason my counselor guided me down a healthier, sober lifestyle. Silva is an angel and helped me along the way with my marriage. HepZ is an A++++++ and my buddy Conner helped me find my higher power. I would recommend All in Solutions to anyone seeking a healthier lifestyle and sobriety. Debbie and Anthony are Rockstars and run a wonderful facility.
Eric Boyer
2 months ago
This facility is awesome. The staff is so caring about everyone. I would definitely recommend All in solutions.
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
I absolutely love this facility!!! It has been life changing for me. I appreciate all the staff and their efforts to help the clients. Zee is amazing and got me back here for the help I needed. The PM shift at Honey Pine has been such a great support system for me. Nancy, Margret, Barbie and Keisha have been absolutely wonderful. Nancy and Keisha have always been great to talk to and keep me motivated. Even if it’s just someone to vent to. Their words are genuine and powerful for my recovery. Anthony and Debbie have been life saving for me. They have gone above and beyond to keep my recovery and my safety strong. I am forever grateful to have been a client here twice. Thank you AIS for all that you have done for me. I’m forever grateful!!
Sydney Catlett
4 weeks ago
The curriculum here, recovery, relapse prevention, addiction and self love has truly changed my life and given me the tools I'll Cary forward. From the bottom of my heart, thank you to all of the staff for your care and support. A special.Thank you to my counselor, Hepzi, along with Tracy the EMDR therapist and Connor, the sober coach, along with all the other counselors. You've all made a lasting impact on my recovery. Debbie and Anthony are also amazing and truly care about the clients and their healing. I'm incredibly grateful for this experience and would highly recommend this program to anyone seeking help. Thank you all so much.
R P
1 month ago
The staff care about your treatment and recovery. They are respectful and knowledgeable. Everything here is designed to help you succeed.
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
All staff extremely hospitable and helpful, Good food made for for lunch and dinner on weekend days nursing was very attentive and knowledgeable
Ryan Abram
1 month ago
They are really awesome and nice
demetria
1 month ago
The facility was clean, the staff is helpful and friendly. The facility offers groups all day where they have activities and open discussions. They have a real life chef during the week and take out on the weekends. The facility also has snacks, ice cream, multiple breakfast foods, and more. A therapist is appointed to assist that clients see at least once a week. This was my first time in treatment, but several other clients told me that this was one of the best treatment centers they had been too. I highly recommend.
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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.
Indiana Center for Recovery is an amazing facility that helped me rediscover myself. Transitions between levels of care are a bit rough but the group facilitators are all excellent and if you stay the course and complete the full treatment you won't regret it.
Karah Schutz
5 days ago
The staff at ICFR are all very kind and helpful throughout the entire process of being at the recovery center. The facilities are very well maintained and clean. There does seem to be a lack of communication between staff members as there was often confusion when questions were answered. Overall I had a fantastic experience at IFCR and would recommend to anyone seeking treatment.
Ry
5 days ago
Place is great. I was in a pretty bad way coming in, and have been for a while, because t feel like I have a new outlook and perspective on sobriety. Staff are caring and helpful. Coursework is current and applicable and the accommodations are comfortable. If you come with an open mind and some willingness you can get what you need.
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
The Haven was a great facility for detox and the residential portion of my rehab process. The entire staff was extremely kind. The nursing staff was very thorough. The techs were so cool and caring. The administration team was extremely helpful seeing me through the process. And in my opinion,, the food was great which is always a bonus. I would recommend the Haven to a friend in need with no hesitation.
Roberto Vidal
1 week ago
Anthony and Nick made my stay at Haven Detox Center genuinely comfortable. Their professionalism, kindness, and attention to detail helped ease a stressful time. Grateful for the care and support they provided.
Super nice facility, very nice staff and great community. Have both Mental health and substance abuse groups with great facilitator’s. Many amenities for your down time and great food. Definitely recommend!
JP Keipp
2 weeks ago
Beachside was very good for me. I went there not understanding how to cope with anxiety. All the primary therapist helped me in different ways, even if they weren’t my main therapist. The techs and nurses are top notch, administration is very good and helpful. Shout out to Chris F, Chris B, Bryan, Eloise, Sarah, and Ashley therapists. Nesha, Monice, Drew, Brandon, More nurse Karen, nurse Victoria, nurse Jerry for getting me through my journey. I left a week ago and feel great using the tools provided!
Dillon Gary
2 weeks ago
Beachside is a supportive place that has done wonders for my recovery. My therapist was and is extraordinary. The nursing staff, technicians, and therapists care deeply about helping their clients, and it shows. The holistic approach allowed me to explore new therapeutic activities and practices, and the activities director is simply the best. I highly recommend Beachside for those seeking help in recovery.
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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.
Very friendly, both peer ran and counselors, in beautiful nature area, trails are gorgeous so is the chapel!! I give thanks to the staff here! All the RAs and counselors oh and don’t forget the nurses! They are all super friendly and supportive
Jade Viglione
8 months ago
St. Joes is an absolute paradise! Such a beautiful place to go and work on yourself. The staff are amazing and the treatment is so productive. They're pulling strings you may not realize to help you!! Thanks to St. Joes I've found me again. He was lost for a long time in the fog of a deep depression, masking that with substance use, I thought he was gone forever. Thank you guys so much for an opportunity to live again, not just exist. If you are struggling and need help, give them a call. They will pick you up and mark will call you everyday until they do to ask how you are doing! I've never been to a more beautiful place that helps you as a whole being, mind, body, and soul!
Chuck Rose
damon rose
8 months ago
Absolutely amazing place if you are in jeed of recovery from substance abuse. Amazing staff. Great place to go to get yourself back on the right track. I would recommend this to anyone who is in need of help. They also offer an iop for those that could benefit from it as well
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 is amazing! From the community to the staff and the nurses! If anyone needs help with addiction Swift River is the place to be ! Thank you !
Much love
Thomas McMaster
Thomas McMaster
8 months ago
Great place great community, great staff, all around great experience
I didn't know what to expect when I showed up at Restore. I was scared and hating life. I ended up having a great adventure. Did everything run smoothly, no. But you show me a place that does and I will still call you a liar. I met empathetic, warm hearted and determined people who wanted to help me and see me get better. I have been through TX before so I had expectations, but after looking back at my time there, it was exactly what I needed. I am forever grateful that Restore answered the call when I needed help and hope the most. Thank you :)
Renae Dougherty
5 months ago
Restore taught me that relapse isnt failure its data about what needs to change next time.
Blanca Vaughn
5 months ago
My counselor saw my potential when I was at my absolute worst thats real love right there
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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.
As a mental health provider, I feel confident referring patients with substance use challenges to Never Alone. Feedback from former residents consistently highlights the quality of the staff, clinical care, and overall environment. The facility offers a well-rounded program that combines a variety of therapeutic groups with meaningful recreational activities, supporting both recovery and personal growth.
I highly recommend Never Alone, both personally and professionally, to anyone supporting a teen struggling with substance use.
Alexis Lima
3 weeks ago
I highly recommend Never Alone for young adults navigating substance/mental health issues. The staff were attentive, caring and knowledgeable of the issues that affect the youth and their families.
Mary Shea
3 weeks ago
Very good place and very supportive with the youngest one. We need more places like this one.
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Frequently Asked Questions
Does UPMC Health Plan Cover Addiction Treatment?
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.
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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