Does highmark insurance cover drug rehab in pa

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This can be confusing because there are several different subsidiaries of this insurance company. Highmark is different than some of the others because it is a non-profit organization even though its annual revenue is several billion dollars. Highmark policyholders are fortunate in that the insurance company classifies alcohol and drug addiction as a health condition that requires medical treatment and offers coverage for the cost of addiction treatment.

Since Highmark is affiliated with Blue Cross Blue Shield, the plans that they offer are usually similar to those offered by the main company. Highmark insurance company recently made changes to its tiers to ensure that even more people would be able to afford to purchase their health insurance plans.

Now, their policyholders in Western Pennsylvania will be able to choose from a low-cost plan that has three tiers instead of just selecting from the bronze, silver, gold, and platinum plans. Before this new system was created, the company had two levels that they called their standard-value plan and the enhanced plan. The new third tier that they are offering is the preferred-value plan.

It is the least expensive option of all. Highmark insurance plans may cover the cost of inpatient rehab programs , depending on individual plan benefits. When inpatient treatment is covered, you may still be responsible for a copay or covering your deductible. Higher coverage tiers may incur lower copayments, while lower-tier levels may result in higher copayments for residential treatment.

Your total out-of-pocket cost for inpatient treatment for addiction will largely depend on your individual Highmark insurance plan. Outpatient rehab programs are generally covered by Highmark insurance plans, but your level of coverage can be affected by which Highmark plan you have. Because each outpatient program differs greatly from the next, Highmark coverage for outpatient treatment for substance abuse may depend on a few factors.

These factors can include whether the rehab program you choose is in-network with Highmark and whether you need prior authorization for the outpatient rehab program. Partial hospitalization programs PHP are a form of outpatient treatment that may be covered by your Highmark health plan. Commercial health insurance plans like Highmark may have strict eligibility requirements for covering PHPs.

These could require that partial hospitalization takes place for four to five days per week for a minimum of 20 hours and that the recovering individual is not in need of medical supervision. Highmark insurance may cover the cost of intensive outpatient programs IOP at the same rate of partial hospitalization. IOPs are similar in format to these rehab programs, but require less days and hours per week of therapy and counseling.

As with other rehab programs, your copay amount for intensive outpatient programs covered by Highmark may vary according to your individual insurance policy. Medication-assisted treatment MAT with Suboxone helps individuals who are addicted to opioids and is often covered by Highmark health insurance. However, Suboxone is often part of a long-term recovery plan.

Continued coverage for Suboxone therapy through Highmark may require that patients submit regular clinical assessments. Methadone maintenance therapy is usually covered by Highmark insurance plans. Often used as part of an opioid treatment program, methadone helps recovering individuals find relief from opioid withdrawal symptoms. Sober living costs can be covered by Highmark insurance plans if they are part of an outpatient rehab or inpatient rehab program.

Most sober living homes partner with rehab centers to offer a transitional living solution for newly recovering individuals and connect residents with outpatient treatment options. Whether your sober living home costs will be covered by your Highmark plan may depend on the sober living facility you choose and where you live.

Using your Highmark plan to pay for the cost of drug rehabilitation is a fairly simple process because the insurance carrier considers drug and alcohol addiction to be a medical condition.

For example, a person who is addicted to both drugs and alcohol may need to have a longer stay in a rehab program than someone who is addicted to only one substance. For these individuals, their doctor might recommend that they are admitted for at least 90 days to a long-term residential treatment program. If a longer amount of time is needed than this, policyholders just have to get approval from their doctor to make sure that their Highmark plan will cover it.

It is important to mention that using your Highmark plan to pay for rehab still requires that the deductible is covered first. Those who have a plan with a high deductible will have to pay a higher portion of all of their treatment bills. Learn more about Inpatient Rehab. 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. Highmark insurance may also fully or partially cover costs for aftercare services such as care coordination and case management. Learn more about Outpatient Treatment. Our addiction specialists work to make the process of finding affordable treatment as easy and stress-free as possible for individuals and families.

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.

Achieve long-term recovery. Learn more about Detox Programs Highmark Insurance Coverage For Inpatient Rehab Inpatient and residential treatment programs offer the highest level of care for people struggling with addiction. Learn more about Inpatient Rehab 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 addiction services that may be eligible for coverage include: partial hospitalization intensive outpatient treatment outpatient programs medication-assisted treatment e. 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.

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