Alcohol And Drug Rehabs That Accept Harvard Pilgrim Health Care

Medically reviewed by

Isaac Alexis, M.D., AAMA, AMP-BC

April 10, 2019

Addiction was not always viewed as a medical condition. Fortunately, this has changed in recent years — and it’s now easier than ever to get help paying for addiction treatment. Insurance providers like Harvard Pilgrim Health Care can help people cover the cost of rehab programs.

Harvard Pilgrim offers medical coverage across Massachusetts, Maine, and New Hampshire. This company provides quality behavioral health coverage for a range of addiction treatment services.

Finding a treatment center that meets your medical and financial needs can be an overwhelming process. However, knowing the details of your Harvard Pilgrim Health Care plan can reduce the stress of finding a rehab center.

Does Harvard Pilgrim Health Care Cover Addiction Treatment?

For the last 50 years, Harvard Pilgrim Health Care has provided health coverage for New England residents. Harvard Pilgrim was founded by doctors, and places a high value on maintaining affordable health care.

Because of the Mental Health Parity and Addiction Equity Act, insurance providers are now required to provide behavioral health coverage at the same level they would cover physical conditions. This law has made it much easier for Americans to pay for addiction treatment.

Harvard Pilgrim Health Care provides coverage for several different addiction treatment services. Coverage details will vary, based on their state and individual health plan.

Alcohol And Drug Rehab Services Covered By Harvard Pilgrim Health Care

There are multiple approaches to addiction treatment, and no one approach to treatment is best. To gain the most from your health care, it’s important to familiarize yourself with the different alcohol and drug rehab services covered by Harvard Pilgrim.

Addiction treatment services covered by Harvard Pilgrim Health Care may include:

• crisis intervention
• medical detox services
• inpatient rehab centers
• outpatient treatment programs
• mental health counseling
• sober living homes
• recovery coaching sessions

In addition, some Harvard Pilgrim Health Care plans may offer coverage for family therapy sessions and aftercare support. Medication-assisted treatment may also be covered, even after a person has successfully detoxed.

Depending on your specific Harvard Pilgrim Health Care plan, these services may require pre-authorization. This means a doctor may need to provide a referral in order for you to use your benefits. Check with a Harvard Pilgrim representative to verify your plan’s requirements.

Inpatient Treatment Programs

Inpatient rehab centers are the most intensive level of addiction treatment. These residential treatment programs offer clients a chance to focus on their recovery, away from the everyday stressors of life.

Daily structure may include individual and group counseling sessions, as well as recreational therapies like creative arts and wellness groups.

Harvard Pilgrim Health Care also covers alternative medicine support, including acupuncture and chiropractic care. These holistic services are offered at certain inpatient treatment centers.

Inpatient treatment may be a good fit for Harvard Pilgrim Health Care members who:

• have a dual diagnosis, such as substance use disorder and bipolar disorder
• have a home life that makes it difficult to stay away from drugs or alcohol
• do not live close to any other treatment programs
• have tried other forms of treatment that did not work

Some Harvard Pilgrim plans may require members to pay a copay, which is a portion of the inpatient treatment costs. A Harvard Pilgrim Health Care representative will be able to explain the specific coverage details of your plan.

Outpatient Treatment Programs

In an outpatient treatment program, patients are provided alcohol and drug treatment services on a flexible schedule. These programs often work best for those who have already completed a higher level of treatment, and are looking for continued support.

Outpatient rehab programs can be beneficial for those who have scheduling commitments, like a full-time job. Sessions can be scheduled in evening or weekend time slots, and are usually offered in a central location (like a local medical office).

Outpatient treatment may work well for Harvard Pilgrim Health Care members who:

• can’t or don’t want to take a leave of absence from work
• have personal or family scheduling conflicts
• have already completed an inpatient treatment program
• could benefit from ongoing accountability, including drug screening and individual therapy

There are several types of outpatient treatment programs. Intensive outpatient programs (IOPs) offer treatment on a “part-time” schedule, with sessions three times per week. Partial hospitalization programs (PHPs) operate on a more rigorous schedule, with five sessions per week.

Both IOPs and PHPs may include treatment services such as group counseling, individual therapy, and medication-assisted treatment. Additionally, regular contact with other group members helps people build a recovery support system.

Medication-Assisted Treatment (MAT)

For those who have a history of relapse, medication-assisted treatment (MAT) can be a life-saving treatment tool. MAT allows medical staff to prescribe certain medications that help to reduce withdrawal symptoms, curb drug cravings, and reduce the chance of relapse.

Medication-assisted treatment can be used for a short period, or as a long-term treatment plan. Thanks to the Mental Health Parity and Addiction Equity act, insurance providers like Harvard Pilgrim Health Care are required to help cover the cost of MAT.

Using Your Harvard Pilgrim Health Care Plan To Cover Drug And Alcohol Rehab

Each person who struggles with alcohol and drug addiction will have unique treatment needs. It’s important to understand your coverage details, in order to get the most customized and affordable treatment with your Harvard Pilgrim Health Care plan.

The first step in securing your treatment plan is to connect with a Harvard Pilgrim representative. This person will help verify your plan’s benefits, and answer questions about the specific treatment services you are interested in.

Next, check in with several rehab centers and verify that they accept Harvard Pilgrim Health Care plans. Rehab center admissions specialists will be able to advise on personalized treatment services and answer questions about insurance.

Finding the right treatment center can take time, but familiarizing yourself with your Harvard Pilgrim Health Care plan will help you feel more confident during the research and enrollment process.

Frequently Asked Questions About Harvard Pilgrim Health Care Treatment Coverage

Many people have questions and concerns about how to pay for alcohol and drug rehab programs. To ensure you have a clear understanding of your benefits, it may be helpful to have a list of frequently asked questions on hand.

Common questions about Harvard Pilgrim Health Care coverage may include:

• Does my plan cover medical detox services?
• Do my benefits cover all necessary medications?
• Do my benefits include inpatient treatment? For what lengths of stay?
• Does my Harvard Pilgrim Health Care plan cover outpatient treatment options?
• What are my estimated out-of-pocket costs (including copays and coinsurance)?
• Do I need any medical referrals before I am covered for treatment?
• Are there any Harvard Pilgrim Health Care forms I need to fill out before I enter treatment?

How To Find A Rehab Center That Accepts Harvard Pilgrim Health Care

Finding a rehab center that accepts your insurance can greatly reduce the cost of addiction treatment — and knowing the details of your coverage can help you feel more empowered as you search for the right treatment center to meet your needs.

Allow one of our treatment specialists to assist you in this process. To learn more about alcohol and drug rehabs that accept Harvard Pilgrim Health Care, reach out to one of our team members today.