Highmark Alcohol And Drug Rehab Insurance Coverage

Highmark insurance plans provide treatment coverage for policyholders who are struggling with addiction. Highmark understands that drug and alcohol addiction can negatively affect a person’s life, including their physical and mental health. For this reason, Highmark health plans cover a number of rehab programs.

Highmark insurance company believes in the importance of research-based treatment for people who are struggling with drug and/or alcohol addiction. They provide coverage for both detox and drug rehab, allowing people who are struggling with addiction to go through a full scope of treatment.

Your Highmark insurance coverage for substance abuse treatment may depend on your individual plan. At Spring Hill Recovery, we work with many insurance carrier companies to help our clients get affordable care for addiction treatment.

Highmark Insurance Coverage For Massachusetts Drug And Alcohol Rehab

The amount of coverage Highmark members are offered depends on their individual plans. It’s important to learn more about how much coverage you or your family member have for addiction treatment.

Some of Highmark’s plans offer full coverage for drug and alcohol detox and rehab services, while other plans require a copayment. A copayment means that Highmark will pay a percentage of the cost, and the patient will be responsible for the remaining portion of the cost of treatment.

Highmark typically pays for standard alcohol and drug addiction treatment services and does not usually cover luxury amenities that are options at some rehabilitation centers (such as massage, gourmet meals, private rooms, spa treatments, etc.). Both in-state and out-of-state treatment facilities are usually included in Highmark insurance policies.

Using Highmark Insurance To Pay For Addiction Treatment

If your loved one is suffering from a substance use disorder, using insurance to pay for treatment can be a valuable way to get them the help they need at a cost they can afford. If they choose to go through treatment without insurance, the cost can become extreme and can be prohibitive to completing treatment.

Using Highmark insurance to pay for drug and/or alcohol addiction treatment can partially or completely cover the cost of treatment. The following are some factors you’ll want to consider when choosing how to move forward with substance abuse treatment using Highmark insurance.

Do I Have To Stay In-Network To Use Massachusetts Highmark Insurance For Drug Rehab?

If you choose an in-network treatment center for drug and/or alcohol rehab, it’s likely that your insurance will cover part or all of the cost of treatment.

Preferred provider organizations (PPO) and health maintenance organization (HMO) plans both use networks of treatment providers. If you stay within the network used by your insurance carrier, it’s more likely that some or all of the costs of your treatment will be covered.

Highmark is a widely accepted insurance plan and is accepted by many drug and alcohol treatment centers.

What Will Be My Out-Of-Pocket Costs For Drug And Alcohol Rehab?

Even when using insurance to pay for your rehab program, it’s possible that you may have some out-of-pocket costs that you’ll need to cover. These costs may include copayments, deductibles, and other costs that are not covered by your Highmark insurance plan. Deductibles and copayments are determined by your individual plan.

It’s a good idea to know your deductible amount and whether it has been met before you enter a treatment facility. If you have yet to meet your deductible for the year, you may need to pay a part or all of the cost of treatment before you begin your rehabilitation program.

If you’re struggling to pay for the out-of-pocket costs associated with substance abuse treatment, you may have options to help you afford treatment.

Some rehab centers offer payment plans, sliding-fee scales, and even scholarships to help to cover the cost of your treatment. Other options include paying privately or applying for grants or scholarships from non-profit organizations to help you get the treatment you need.

How Do I Find A Massachusetts Rehab Center That Accepts Highmark?

Highmark is accepted at many treatment centers in the United States, and it will likely not take you long to find a treatment facility that accepts your Highmark insurance. You may want to start by reaching out to a Highmark representative who can recommend a treatment center in your area.

Does Highmark Cover Massachusetts Inpatient Rehab Programs?

All Highmark insurance plans offer full or partial coverage for inpatient treatment programs, also called residential treatment. While the most common inpatient rehab programs last between 28 and 30 days, some programs last 60 days, while others last 90 days or more.

Highmark insurance typically allows patients to choose the length of their inpatient treatment and uses their doctor’s recommendation to help determine what length of treatment is most appropriate.

Effective inpatient programs usually involve several modalities of therapy, including detox, individual counseling, group counseling, trauma-informed therapy, and more.

Many people who are struggling with addiction find that residential drug rehab is a good fit for them, as it allows them to fully focus on their long-term recovery.

Is Medical Detox Covered By Highmark Insurance?

Medical detox is an important first step for many in beginning the road to addiction recovery. In order to effectively begin the recovery process, it’s key for the body to eliminate alcohol and drugs in a safe, healthy way. For many people, this means going through a medically assisted detox program.

In most cases, drug and alcohol detox is covered by Highmark. It’s well-known that supervised detoxification is safer than trying to detox at home. Highmark recognizes that a high-quality, medically supervised detox program can set people who are struggling with addiction up for long-term success after treatment.

Does Highmark Cover Outpatient Treatment Programs?

Some people who are struggling with addiction find that outpatient treatment is a better option than residential treatment. Childcare issues, work issues, and other day-to-day responsibilities can mean that outpatient services make more sense than spending a month in residential treatment.

Highmark covers many types of outpatient treatment. Outpatient rehab programs can be far less expensive than inpatient treatment, meaning it’s also likely to reduce out-of-pocket costs.

Both residential and outpatient treatment share many of the same treatment modalities, such as group therapy, individual counseling, case management, and trauma-informed therapy.

Is Partial Hospitalization Covered Through Highmark?

PHP, or partial hospitalization programs, are sometimes covered by Highmark. A PHP program is an intensive program designed for patients who need specialized care but are unable to go through inpatient treatment.

Is Massachusetts Intensive Outpatient Treatment Covered Through Highmark?

IOP treatment, or intensive outpatient treatment, can be covered through Highmark. This type of treatment (much like PHP treatment) is meant for patients who are unable to enter into a residential rehab program but still need intensive, ongoing counseling and care.

Does Highmark Cover The Cost Of Sober Living Homes?

In some cases, the costs of living in a sober living facility can be covered by Highmark. In order to be eligible for coverage, the sober living facility may need to be paired with a treatment facility.

Does Highmark Cover Medication-Assisted Treatment Programs?

Highmark often covers the cost of medication-assisted treatment (MAT), known as one of the most effective ways to begin the road to recovery for those with opioid abuse or alcohol abuse issues.

Is Methadone Maintenance Therapy Covered By Highmark?

Highmark often covers the cost of methadone when used in conjunction with an opioid addiction recovery program. Methadone coverage through Highmark may be outlined in your plan’s pharmacy benefits information.

Will Massachusetts Highmark Cover Suboxone Costs?

Highmark often covers the cost of Suboxone therapy. For many people, Suboxone is used as a part of a long-term recovery plan. Regular clinical assessments may be necessary for ongoing coverage.

Verifying Your Massachusetts Highmark Insurance Coverage

Verifying your insurance coverage is the first step toward getting treatment. To make this process easier, Spring Hill Recovery Center can help. We can look at your insurance policy and help you understand which forms of drug and alcohol treatment qualify for coverage through your Highmark plan.

We are part of a network of addiction treatment centers in the northeastern United States, and we can help you find the program you need.

Nearby states we serve include:

At Spring Hill Recovery, our inpatient treatment facility, we’re here to help you get well and overcome addiction. Reach out to us to learn more.

  1. Harvard Health Publishing—5 myths about using Suboxone to treat opiate addiction https://www.health.harvard.edu/blog/5-myths-about-using-suboxone-to-treat-opiate-addiction-2018032014496
  2. Highmark http://highmark.com/
  3. Substance Abuse and Mental Health Services Administration (SAMHSA)—Medication-Assisted Treatment (MAT) https://www.samhsa.gov/medication-assisted-treatment

Written by Spring Hill Recovery Editorial Team

© 2024 Spring Hill Recovery | All Rights Reserved

* This page does not provide medical advice.

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