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.
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.
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
4 weeks 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
4 weeks ago
All in solutions is the best , if you need to get straight , it's the place to go , I highly recommend it 👍
AlcoholismDrug AddictionMental Health And Substance AbuseOpioid AddictionSubstance AbuseDual Diagnosis
Adult ProgramProgram For MenProgram For WomenYoung Adult Program
Self-Pay OptionsPrivate insurance
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
6 days ago
The staff in the facility were amazing my counselor Jason changed my life for the better
Slow Poke
1 week ago
All In solution’s was the best decision I’ve ever made they helped me get my life back together. And got me back on the right track again. My counselor Jason was very helpful and was very supportive of my recovery. Even though I’ve completed the program ASI Still reaches out to me. Brandon my case manager was very helpful in getting all my paperwork done. I’m forever grateful to AIS and all the staff and techs.
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
3 days 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.
Shauna Wolfe
6 days ago
Good people... Both the other clients and staff were supportive and caring...the food was terrible...and communication between departments could be improved. I feel my needs were met adequately and I was giving the tools and resources to continue in my recovery
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.
Jean Jordan
1 day ago
Such a awesome rehab I love it learned a lot Anthony is amazing sweet and very helpful and very humble Lauren was amazing and sweet and Ashley was great getting me into where I need to go and she Always made me feel welcome and omg Jason was the best therapist ever he made my heart warm and he's funny and sweet I loved all the staff and Shantel and Henny are amazing and shaggy and also jose was great always has a amazing love you all and thank you xoxo 😘
Corinne Nelson
5 days ago
I had an excellent stay at Haven !
The facility was very clean and the staff there
Was very Professional and Concerned about our needs !
⭐️⭐️⭐️⭐️⭐️ Exceptional Care, Life-Changing Experience at Asana Recovery
My journey with Asana Recovery has been nothing short of transformational. Walking through their doors, I wasn’t just another patient entering a treatment center—I was a person in need of compassion, structure, and genuine guidance. From the very beginning, the team at Asana made me feel seen, heard, and supported in a way that very few treatment centers truly deliver.
After just two months in recovery, I was given the incredible opportunity to become a house manager, which was a breathtaking experience. Not only did it deepen my recovery, but it allowed me to support others walking the same path. That chance to step into responsibility and service was life-changing, and it’s something I will always carry with me.
What sets Asana apart is the people. Jonathan and Linda, in particular, are shining examples of what makes this place extraordinary. Jonathan’s ability to connect with individuals on a deeply human level created a sense of trust that allowed me to open up and truly engage in the process. His wisdom, steadiness, and encouragement gave me tools that I will carry for the rest of my life. Linda’s presence is like a beacon—warm, nurturing, and absolutely unshakable. Her kindness and dedication went far beyond a “job”; it was clear she cares about every single person who comes through Asana’s program as if they were family.
And it isn’t just them—the entire Asana team embodies that same commitment. Whether it was the counselors guiding me through difficult conversations, the medical staff ensuring I was safe and cared for, or the support staff who brought positivity into every interaction, each person played an important role in making recovery feel possible. They created an environment that blended professionalism with heart, where structure and accountability were balanced with compassion and encouragement.
I’ve been to other facilities and spoken with countless people who have gone through recovery in different settings, and I can say without hesitation that Asana stands in a class of its own. Their approach is holistic, their community is genuine, and their impact is lasting.
To anyone considering Asana Recovery—whether for yourself or a loved one—know this: you will not just find treatment here; you will find hope, healing, and a family that will walk alongside you every step of the way. I am deeply grateful to Jonathan, Linda, and the entire Asana Recovery team for helping me reclaim my life.
Brad Barton
3 months ago
Amazing residential home! Or at least the one I was at in Huntington beach. Love the food, staff, nd they also helped me get a job towards the end of my treatment!!
This place is special. It saved my life and set me on the road for a long and fulfilling future.
Alex Brooks
1 month ago
Prosperity Haven (Now Wellbrook Recovery) saved the life of one of my loved ones and I (as well as my family) will forever be grateful for it!!! We were able to visit every week and the staff and other men staying at the house were always so kind and welcoming to us. The house and property are so nice and well taken care of. The counseling and therapy as well as the friendships that my family member was able to find through this program was so unique and special, I truly believe it saved his life and allowed him to live a life he's really never been able to live before. He is now an alumni and still continues to participate in AA meetings and alumni events. Every week he is excited to reconnect with the men he met at the house and at alumni events since then. His experience at Prosperity Haven has allowed him to fully understand his substance abuse behaviors and how to find the right tools to handle his urges and temptations. It has saved his marriage and relationships with friends and family. I would definitely recommend this facility to anyone who is seeking a place that focuses on both mental health and addiction in a supportive, welcoming environment!!
Kelly H
1 month ago
Great place to be.. Not like any other place I've been..The staff is amazing and they truly care about you... Wellbrook has helped me change my life..
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
3 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
3 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
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
3 months ago
Great place great community, great staff, all around great experience
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Frequently Asked Questions
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
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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