Highmark Insurance Coverage for Drug & Alcohol Rehab
Drug and alcohol addiction can be a serious, debilitating, and life-threatening condition that can hinder all aspects of a person’s life. Highmark recognizes the importance of detox and rehabilitation programs and provides coverage options to help patients cover the costs they incur during treatment.1
Below are some frequent topics of interest that may help you better understand your Highmark insurance coverage.
Does Highmark Cover Addiction Treatment?
As part of the Affordable Care Act (ACA), Highmark provides marketplace insurance plans that cover some or all the costs of drug and alcohol rehab programs. If you have Highmark health insurance and are searching for a drug and alcohol treatment facility that is covered by your plan, American Addiction Centers (AAC) is here to help.
Highmark typically provides some level of coverage for substance abuse rehabilitation programs since substance abuse is considered an illness. The amount of coverage depends on your plan, so the amounts and types of coverage vary. There may also be coverage available if you have been diagnosed with a co-occurring mental illness that contributed to your drug or alcohol addiction.
Highmark covers a variety of recovery programs, including both inpatient and outpatient treatment facilities. Be sure to carefully review your Summary of Benefits or speak with a Highmark representative to accurately determine your coverage prior to undergoing treatment.
The amount of coverage you have can vary widely based on your state of residence, whether the facility is in- or out-of-network, the length of your stay, and your insurance plan level. The cost of drug and alcohol addiction treatment will vary from person to person and will also depend on the rehab center, the type of program attended, and specific services received.
Check Your Highmark Rehab Coverage
Before choosing the right rehab treatment center for you, check your Highmark policy benefits to determine which costs will be covered by your insurance company and which will be out-of-pocket for you. Call the number on the back of your insurance card or log in to your account on Highmark’s website to learn more about what your specific policy plan covers.
Knowing exactly what your Highmark plan covers can give you peace of mind while you or your loved one is in rehab. You can do the work of getting and staying sober without worrying about unexpected costs or financial struggles. For more information on Highmark insurance plans and to check what your plan covers, call , click here, or fill out the form below.
What Types of Addiction Treatment Does Highmark Cover?
With most Highmark plans covering at least some of the costs of treatment for alcohol addiction or drug addiction, the types of treatment can vary in intensity and frequency. Types of treatment may include:5,6
- Medical Detox: Medical detox helps you withdraw safely from drugs and alcohol. Under 24/7 medical supervision, staff will work closely with you—and may prescribe medications to help ensure that you withdraw safely and that your symptoms are addressed as needed.
- Inpatient or residential treatment: With inpatient treatment, you receive treatment and live at the facility. Inpatient treatment typically involves group and/or individual therapy. It is often recommended for individuals with co-occurring mental health issues, limited outside support, home environments that don’t lend themselves to sobriety, and poor treatment outcomes in the past.
- Partial hospitalization: These programs allow you to live at home throughout treatment and spend your days at the treatment facility. This is sometimes referred to as day treatment.
- Intensive outpatient programs: These programs typically involve attending treatment programs approximately 3 evenings a week. People in these programs can live at home and go to work during the day.
- Outpatient treatment: An outpatient facility lets you meet with doctors and therapists, and you can even attend group sessions and recovery meetings before heading back home at the end of the day. With a residential program, you get the chance to focus solely on your recovery without any daily tasks getting in your way or slowing down your progress.
When you decide to get treatment for a drug or alcohol addiction, you will need to decide what type of treatment is best for you.
Do Rehab Centers Need to Be In-Network To Accept Highmark Insurance?
In most cases, you will need to seek drug and alcohol addiction treatment at a rehab facility that is in-network with Highmark to receive your full benefits. Even if you choose a treatment facility that is in-network, you may still be responsible for some of the treatment costs. If you choose a facility that is out-of-network, you may be responsible for all the costs of your addiction treatment. You may be able to discuss financing options such as a payment plan or scholarships offered by the facility.
Although out-of-network benefits are typically less than coverage for in-network providers, Highmark often pays up to 50% co-insurance for out-of-network providers. However, some providers do not accept Highmark insurance. Confirm coverage with your Highmark representative as well as your admission counselor before you begin treatment.
Rehabs.com strives to provide you with the most updated information on each carrier’s addiction insurance coverage, but policy changes and errors do occur. Please check with your insurance carrier directly to confirm coverage levels.
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