Highmark Insurance Coverage For Drug & Alcohol Rehab

Medically Reviewed by Johnelle Smith, M.D. on November 30, 2023

People with Highmark health insurance can get at least some of their addiction treatment covered by their healthcare plans. Covered services may include detox, behavioral therapies, counseling, and more.

Highmark Insurance Coverage For Addiction Treatment

Due to the high cost of addiction recovery services, many people without adequate health insurance will not seek the care they need.

Highmark insurance coverage offers affordable options for people in West Virginia, Delaware, and Pennsylvania looking for drug and alcohol treatment.

Does Highmark Insurance Cover Rehab?

Yes, Highmark insurance covers a range of behavioral health services and multiple levels of care. The level of coverage will depend on the plan and other variables.

Highmark insures over 4.5 million Americans through the BlueCard program. Mental health and substance abuse treatment coverage is offered through Highmark Behavioral Health.

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Substance Abuse Treatment Services Covered By Highmark Insurance

Highmark insurance recognizes the importance of substance abuse treatment and provides coverage for many treatment services.

These services are designed to address the unique needs of people facing addiction.

Treatment Type Covered Not Covered
Long-Term Residential ✔️
Residential ✔️
Inpatient ✔️
Inpatient Detox ✔️
PHP ✔️
IOP ✔️
Outpatient MAT ✔️
Dual Diagnosis ✔️

Highmark Insurance Coverage By Treatment Type

Understanding which types of treatment are covered by Highmark insurance will be helpful for people preparing for their recovery journey.

Highmark Insurance Plan Types

All of Highmark’s health insurance plans are exclusive provider organizations, or EPOs. An EPO plan combines elements of both PPO and HMO plans.

Highmark offers a network of preferred providers, and while clients don’t need a referral to see a specialist, they’ll generally only receive full coverage for in-network services.

How To Use Highmark Insurance Coverage For Substance Abuse Treatment

Policyholders will need to go through a few steps to utilize their insurance for addiction treatment.

First, members should contact Highmark or visit its website to gather information about the healthcare plan. Inquiring about the details of coverage will minimize the chance that unforeseen expenses will pop up.

Next, clients will need to identify in-network facilities, therapists, and other healthcare providers that specialize in addiction care.

Once a treatment center is found, members can contact the admissions staff at the rehab center and give them their Highmark insurance information.

Communication with the rehabilitation center and Highmark insurance is important in maximizing coverage for treatment.

Highmark Insurance Co-Pays And Deductibles For Addiction Treatment

People searching for Highmark insurance plans will have several options available to them. The cost of co-pays and deductibles will differ based on the type of plan.

Types of plans include:

  • EPO Bronze — an annual deductible of $3,800 with a $60 co-pay per visit
  • EPO Silver — an annual deductible of $3,450 with a $70 co-pay per visit
  • EPO Platinum — no deductible and a $5 co-pay per visit

Monthly premiums for Highmark insurance plans typically range between $383 to $669 per month. Plans with a higher premium will usually feature lower deductibles and co-pays.

What Addictions Does Highmark Insurance Cover?

Addictions to the following substances may be covered by Highmark insurance plans.

These substances include:

Some people may be facing a co-occurring mental health disorder such as depression, an anxiety disorder, bipolar disorder, or post-traumatic stress disorder (PTSD).

Highmark will cover mental health services as well as co-occurring disorders.

What If My Insurance Plan Doesn’t Cover The Treatment Program I Need?

If your insurance coverage is inadequate, there are several other ways to pay for addiction care. Below are some of the other options available to you or your loved ones.

Other ways to pay for treatment programs include:

  • scholarships for addiction treatment
  • Medicare or Medicaid insurance
  • payment assistance plans
  • sliding fee scales based on income and family size
  • faith-based or non-profit organizations
  • free rehab facilities

You may also access affordable treatment by attending a program that offers grant funds from the Substance Use Prevention, Treatment, and Recovery Services Block Grant (SUBG).

This grant is designed to help people with limited income, pregnant women, people who use IV drugs, and people with HIV/AIDS get the care they need.

Finding A Rehab Center That Accepts Highmark Insurance

The easiest way to find a drug rehab facility that accepts Highmark insurance is by calling the customer support line and asking for help in locating an in-network facility.

In-network providers can also be found in the member portal on the Highmark website.

Members can also use the search tool on the Substance Abuse and Mental Health Services Administration (SAMHSA) website to find a facility in their area.

Find Drug And Alcohol Treatment Today

Reach out to AddictionResource.net today for more information about addiction recovery programs for you or your loved one.

This page does not provide medical advice. See more

Addiction Resource aims to provide only the most current, accurate information in regards to addiction and addiction treatment, which means we only reference the most credible sources available.

These include peer-reviewed journals, government entities and academic institutions, and leaders in addiction healthcare and advocacy. Learn more about how we safeguard our content by viewing our editorial policy.

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Medically Reviewed by
Johnelle Smith, M.D. on November 30, 2023
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