Drug And Alcohol Rehabs That Accept Highmark Insurance

Medically reviewed by

Dr. Gerardo Sison

April 12, 2019

Making the decision to pursue drug or alcohol addiction treatment can be life-changing in more ways than one. Unfortunately, many people who would otherwise seek treatment are deterred when they discover the cost of rehab programs. Luckily, several insurance companies – including Highmark Insurance – offer coverage options for addiction treatment.

Highmark Insurance is an independent licensee of the Blue Cross Blue Shield Association. Highmark is one of the largest health insurers in the nation and is the fourth-largest Blue Cross Blue Shield affiliate. Highmark Insurance offers several options for its members pursuing addiction treatment.

Does Highmark Cover Addiction Treatment?

Based in Pennsylvania, Highmark serves residents of Delaware, West Virginia, and Pennsylvania. They have more than 5.2 million members and have a variety of insurance plans to select from. These plans include PPO, EPO, HMO, and Medicare plans.

As part of the Blue Cross Blue Shield network, Highmark is able to offer a wide network of healthcare providers. In fact, according to their website, they offer access to 93 percent of the nation’s physicians and 96 percent of all hospitals throughout the United States.

Highmark’s vast network gives its members access to a variety of healthcare services. These services include drug and alcohol addiction treatment programs. Whether you receive insurance coverage as an individual or through your employer as well as the state you live in will determine the amount of coverage you are eligible for.

Drug And Alcohol Addiction Services Covered By Highmark Insurance

There are a variety of addiction treatment options available to choose from. These range from weekly therapy sessions to inpatient programs. The addiction services you are eligible to receive coverage on will depend on the plan you have with Highmark.

Common substance abuse services often covered by Highmark include:

• detoxification programs
• drug testing
• mental health and dual diagnosis treatment
• individual and family counseling
• intervention programs

Other addiction services that may be covered under your Highmark Insurance plan include outpatient and inpatient treatment. These programs are more intensive and require daily or weekly attendance.

Outpatient Addiction Programs

Outpatient programs are less intensive than inpatient programs. There are several different types of outpatient addiction programs. These include partial hospitalization programs (PHP), standard outpatient treatment, and intensive outpatient programs (IOP).

Partial hospitalization programs are the most intensive form of outpatient treatment and consist of daily therapy. Sessions typically last four to eight hours and are often held Monday through Friday. Unlike inpatient treatment, patients can return home at the end of the PHP treatment each day.

Intensive outpatient programs provide similar structure to PHPs but are less intensive. People often attend an IOP two to four times weekly for several hours each day.

Standard outpatient programs are the least intensive and typically consist of therapy and other types of addiction treatment for a few hours each week. Sessions are usually held in the evenings, allowing patients to continue work or school during the day.

Outpatient treatment is often much less expensive than inpatient treatment, making it attractive to people seeking help for an addiction. Highmark Insurance will typically cover at least some portion of the cost of outpatient treatment. Exact coverage will vary from plan to plan.

Inpatient Treatment Programs

Inpatient treatment provides 24-hour care and monitoring in a residential treatment facility. Patients live at the facility for the length of treatment. Standard lengths of stay are often 30 to 60 days but will vary from person to person.

The full-time care and removal from a person’s typical environment allows patients to focus their full attention on recovery. People receive daily treatment in inpatient programs that is often catered to their specific needs and condition.

Highmark offers a wide range of coverage for inpatient treatment. Coverage varies from partial to full and will depend on the specific Highmark plan you have.

Using Your Highmark Insurance Plan To Cover Addiction Treatment

There are several factors of your insurance plan that you should become familiar with before seeking treatment. One of these factors is making sure that the treatment facility you plan to attend accepts Highmark Insurance.

Additionally, understanding your coverage and the amount of treatment that Highmark will cover is also important. Some plans will cover partial costs, whereas other plans may cover 100 percent of the cost of treatment. Knowing which plan you have and what it covers can help you make an educated decision on the treatment you pursue.

There are a number of questions you can ask a Highmark representative to better understand your insurance plan. These include:

• Does my plan cover outpatient treatment? Which forms of outpatient treatment are covered?
• Does my plan cover inpatient treatment? If so, how many days or weeks are covered by my plan?
• Do I need prior authorization for any addiction treatment programs or services?
• Is medication covered under my plan? Are there any medications that aren’t covered?
• What will my out-of-pocket costs be?
• Is a detoxification program covered under my Highmark plan?
• What addiction services aren’t covered by my insurance?

Finding A Rehab Program That Accepts Highmark Insurance

Using your Highmark insurance to pursue addiction treatment can drastically reduce the overall cost. This can be incredibly relieving and allow you to focus solely on getting better as opposed to worrying about how you’ll pay for treatment.

Speaking with a treatment specialist or Highmark representative can help you better understand your plan. These individuals can also help you find a treatment center that suits your needs and is covered under your Highmark plan.

To learn more about your treatment options and the facilities that accept Highmark Insurance, contact us today.