Drug addiction is a serious illness that affects millions of individuals and families across the United States. To help individuals access professional treatment, many rehab centers across the country work with private insurers to expand affordable treatment options.
Highmark is a leading insurance provider that offers a range of individual, group, and employee-sponsored health insurance plans. Depending on the type of insurance plan you have and included plan benefits, you may be eligible to use your Highmark insurance to cover some of all of your treatment costs.
At Recovering Champions, we understand how stressful it can be to navigate the insurance and payment process. Here, you can find information about using Highmark insurance to pay for rehab, and how we can help you verify your insurance coverage.
About Highmark Health
Highmark Health is one of the largest health insurance companies in the United States. As an insurance company affiliated with Blue Cross Blue Shield (BCBS), Highmark serves 5.6 million individuals across West Virginia, Delaware, and Pennsylvania.
Highmark insurance plans, which vary by state, include:
- HMO plans
- PPO plans
- Medicare plans
- CHIP insurance coverage (Pennsylvania)
The amount of health care coverage you’re eligible for—including coverage for mental health and substance abuse services—will depend on your individual insurance policy. This applies to individual and family plans, employer-sponsored plans, and Medicare plans.
The type of insurance plan you have will also affect your monthly premium costs, deductible requirements, copay requirements, and out-of-pocket costs for medical and behavioral health care services.
Does Highmark Insurance Cover Drug And Alcohol Rehab?
Highmark offers rehab coverage for members who have substance abuse benefits included in their individual plans. The type of plan you have may affect which types of treatment programs are covered, eligibility requirements, and where you can seek treatment.
Under the Affordable Care Act, all plans purchased through the healthcare marketplace are required to offer coverage for mental health and substance abuse services. This ensures that individuals and loved ones can access life-saving care for drug and alcohol addiction without bearing the full responsibility of paying for treatment.
If you have Highmark health insurance, you’ll need to check your insurance policy or speak to one of our addiction specialists to verify your plan’s covered treatment services.
Treatment Programs Eligible For Highmark Health Insurance Coverage
Having health insurance with Highmark doesn’t guarantee that your insurance will cover all drug addiction treatment services. While Highmark insurance covers many services, your coverage will depend on the type of treatment service, your individual policy, and the treatment provider.
Highmark may cover the following addiction treatments, in part or in full:
- detoxification services/programs
- inpatient rehab
- short-term residential rehab
- outpatient drug rehab programs
- outpatient counseling and psychiatric services
- prescription drug coverage
- virtual medicine services
Highmark Insurance Coverage For Detox
Detoxification services are covered by some Highmark insurance plans. Your eligibility for detox coverage, and other eligibility requirements may apply. Highmark may only cover a percentage of detox costs. Copayment and out-of-pocket costs may apply.
Highmark Insurance Coverage For Inpatient Rehab
Inpatient and residential treatment programs offer the highest level of care for people struggling with addiction. These programs are generally short-term, lasting 30 to 90 days on average.
Highmark insurance may provide full or partial coverage for inpatient rehab, depending on your individual plan benefits. Your plan may require that you get precertification for inpatient care prior to beginning treatment. Copayment and deductible requirements may apply.
Highmark Insurance Coverage For Outpatient Treatment
Highmark insurance plans may offer coverage for a range of outpatient treatment programs for ongoing support in addiction recovery. Outpatient treatment is generally recommended for people in early-to-mid recovery who are medically stable and have a steady support system.
Outpatient addiction services that may be eligible for coverage include:
- partial hospitalization
- intensive outpatient treatment
- outpatient programs
- medication-assisted treatment (e.g. buprenorphine therapy, methadone maintenance therapy)
- outpatient counseling
- prescription drugs
- primary care
Highmark insurance may also fully or partially cover costs for aftercare services such as care coordination and case management.
What To Know Before Using Highmark Insurance To Pay For Drug Rehab
If you’re planning to use your health insurance to pay for addiction rehab, there are a few important things you should know to expedite the process and prevent unexpected costs.
What to know before planning to use Highmark insurance to pay for treatment:
- your responsibility for meeting a deductible prior to seeking coverage
- which types of treatment services are eligible for coverage under your policy
- whether precertification is required for certain treatment services
- your responsibility for copays, coinsurance, or out-of-pocket costs
- whether your plan requires that you seek treatment from in-network health care providers
Finding Treatment Centers That Accept Highmark Health Insurance
If you’re looking for an addiction treatment facility in the New England region that accepts your insurance, Recovering Champions can help. Our addiction specialists work to make the process of finding affordable treatment as easy and stress-free as possible for individuals and families.
By contacting us, one of our addiction specialists can:
- verify your insurance
- explain your insurance coverage and treatment options
- find a treatment program best suited to meet your needs
Verify Your Insurance Today With Recovering Champions
Recovering Champions is a top-rated treatment facility in Cape Cod, Massachusetts that offers ongoing support for people in early recovery from substance abuse and addiction. We provide a range of treatment programs, including treatment for dual diagnosis.
To verify your insurance and learn more about our rehab facility, call us today to speak to one of our specialists.