Highmark Insurance Coverage for Drug & Alcohol Rehab Centers Near Me

Does Highmark BCBS of Pennsylvania insurance cover Inpatient Alcohol and Drug Rehab Centers?

Do you struggle with substance use in Pennsylvania? If so, you’re not alone. In fact, between 2017 and 2019, over 1.5 million Pennsylvania residents over the age of 12 admitted to using marijuana in the last year, and 384,000 admitted to misusing prescription pain medications in the last year.^{1, p. 25 and 28, second paragraph on each}

Unfortunately, substance use can lead to significant long-term health and legal problems. If you’re ready to break free, you’re making a great choice. The question is, how can you get the help you need?

If you have Highmark Blue Cross Blue Shield, your health insurance coverage may help you afford the treatment you need to break free of substance use.

Each plan has different levels of coverage, so it’s important to verify your insurance before you commit to a treatment program. You can learn more about your plan by calling the Blue Cross Blue Shield of Pennsylvania phone number on the back of the insurance card or by reaching out to American Addiction Centers (AAC) by phone, chat, or using the verification form below. You’ll get the information you need in just a few minutes.

This guide will help you understand how to use Highmark BCBS to access substance use treatment and how to maximize your coverage. Breaking free is worth it.

How to find Highmark BCBS Of Pennsylvania covered Inpatient drug treatment centers in PA?

Verifying your insurance coverage will help you connect to high-quality treatment centers. You’re not limited to Pennsylvania, either—AAC has a variety of excellent rehab facilities around the country.

Whether you think you’d do best at a holistic rehab in Florida or a specialized rehab facility in Nevada, you can find the treatment you need and ensure your health insurance will help you pay for it.

You deserve a life that’s happy, healthy, and free of substance use. We’re here to help you take the first steps.

What is Highmark BCBS Of Pennsylvania?

The name “Blue Cross and Blue Shield” sounds like a single company, but BCBS is actually an organization made up of 34 independently owned and locally operated companies.^{2, top paragraph} Through these companies, BCBS is able to offer health coverage in all 50 states, D.C., and Puerto Rico.^{2, top paragraph}

The BCBS company that operates in Pennsylvania is known as Highmark BCBS and covers the insurance needs of more than 6 million Americans in three states.^{3, Highmark’s Corporate Profile} Highmark was founded during the Great Depression to help Pennsylvania residents pay for health care, and eventually, a variety of smaller organizations were merged into one company.^{3, Highmark’s History}

Does Blue Cross Blue Shield of Pennsylvania cover addiction treatment therapies?

In the past, many people were concerned that their health insurance plan wouldn’t cover the substance use treatment they need. However, the Affordable Care Act (ACA) changed that. The ACA requires that long-term health insurance plans cover 10 essential health benefits, which include mental health and substance use treatment.^{4, fifth bullet}

With the ACA, you can be assured that your health insurance plan covers at least some of the costs of the substance use treatment you need. The specifics will depend on your individual plan, which is why it’s important to verify your insurance before you commit to a program.

How Much Does BCBS Of Pennsylvania Cover (Addiction Treatment)?

There are a variety of ways to address substance use issues, and as a result, there are many addiction treatment options. Your Highmark BCBS Pennsylvania plan can help you pay some or all of the costs of medically-necessary treatment.

The specific treatment plan that’s right for you will be determined by working with your doctor, who will look at the substances you use, how long you’ve been using them, and environmental factors.

Some of the common treatment approaches include:^{5, 6}

• Inpatient/residential rehab: Inpatient rehab provides around-the-clock care and support, as well as medication and therapy, to help people overcome their addiction. It’s an intense program that can be challenging, but it allows you to live outside your normal environment so you can form new habits and overcome old triggers through group and individual therapy.
• Outpatient rehab: Outpatient rehab is a type of addiction treatment that doesn’t require you to live at a rehab facility. Instead, you attend group and individual therapy sessions, as well as classes on self-care and relapse prevention, while living at home. Outpatient rehab is a good option for those who can’t take time off from work or school, or who have a strong support system at home. It can also be used after inpatient treatment.
• Intensive outpatient programs (IOP): Intensive outpatient programs (IOP) are a form of substance abuse treatment that provide comprehensive care in a less restrictive setting than inpatient treatment. IOPs offer multiple group therapy sessions per week, as well as individual counseling and other services such as medication management, case management, and education.
• Partial hospitalization programs (PHP): PHP is a type of treatment program that offers a level of care between outpatient and inpatient treatment. It provides treatment during the day, five days a week, and allows patients to return home at night. PHP typically includes group therapy, individual therapy, and other activities such as recreation and skill development.

With the right treatment, you’ll be setting yourself up for success as you move forward into a new life.

Does Blue Cross Blue Shield of Pennsylvania provides coverage for Inpatient mental health treatment facilities?

Mental health treatment is an important aspect of substance use treatment. In fact, around 50% of those with substance use issues also have a mental health diagnosis, such as anxiety, depression, ADHD, PTSD, personality disorders, and more.^{7, second paragraph} Both diagnoses at the same time is known as co-occurring disorders, or a dual diagnosis.

If you have both a mental health diagnosis and substance use concerns, it’s important to seek treatment for both, not just one or the other. Research shows that integrated treatment yields far better outcomes than simply treating substance use or mental health alone.^{8, first paragraph}

Will your Highmark Blue Shield insurance cover mental health treatment? Fortunately, the answer is yes. In the list of essential health benefits in the ACA, both mental health and substance use treatment are included.^{4, fifth bullet}

When you choose a BCBS of Pennsylvania treatment center, make sure they offer dual-diagnosis treatment if that’s the kind of help you need.

How Long Does Highmark BCBS Of Pennsylvania Insurance Cover Alcohol and Drug Rehab programs?

Health insurance plans focus on covering medically-necessary care, so it’s important to get a treatment plan from your doctor in order to maximize your insurance coverage. Each insurance plan will also have its own coverage limits and amounts, so the length of time that rehab is covered may vary.

However, studies show that longer treatment programs are better, as patients need at least 90 days of treatment to make substantial changes in their level of substance use.^{9, fifth point}

It’s also important to completely finish your treatment program. It’s easy to start feeling better and decide that you don’t need any more treatment, but that’s not the case. These programs are designed so that you get maximum benefit by completing the entire course.

Investing in yourself isn’t just financial, it’s also about sticking out the treatment until the very end so that you can maximize the amount of change and new habits you’ve created.

What if my BCBS Of Pennsylvania policy does not cover an Inpatient drug rehab program?

Insurance plans will pay some or all of the cost of medically-necessary treatment for rehab centers that are part of the insurance network. However, it’s possible that you’ll still have to pay some of the cost on your own. Or you might want a level of rehab, or a specific facility, that isn’t covered by insurance.

If insurance doesn’t pay the full cost, don’t give up on the idea of getting the treatment you need. There are many other ways to pay for rehab. Some treatment centers offer scholarships, or you might be able to set up a payment plan.

You may also be able to get a loan or borrow money from family and friends. You’ll be in a far better position to pay them back once you’re free of substance use and living a happier, healthier life.

The key is to get the help you need before you’re facing long-term financial, legal, or health consequences from your substance use. You’re worth it!

BCBS Of Pennsylvania In Network vs. Out of Network Inpatient Rehab Centers

Health insurance plans all have a specific network of providers that they work with.^{10, What’s a provider network?} These providers have agreed to provide services to plan members at a lower price, which saves you money and allows you easier access to high-quality care.^{10, What’s a provider network?}

Insurance plans want you to use the provider network because it’s less expensive, so they encourage you to do so by providing lower out-of-pocket costs for in-network care.^{10, Why do some plans cover…} At the same time, they may not offer any insurance coverage at all outside the network.^{10, Why do some plans cover…}

If you want to maximize your health insurance coverage when you look for substance use treatment, it’s important to find treatment centers that are in-network for your Blue Cross Blue Shield Pennsylvania coverage. The good news is that BCBS has a large network, so finding BCBS of Pennsylvania rehabilitation centers will be fairly simple.^{11, Personalized healthcare nationwide}

Getting the treatment you need is the way to create a life that you enjoy and can live freely. We’re here to help connect you to the right resources and care. Take the first step away from substance use and contact us today.

Rehabs That Take Blue Cross Blue Shield of Pennsylvania Insurance 

American Addiction Centers (AAC) has various rehab facilities around the country that provide drug and alcohol addiction treatment. If you have a Blue Cross Blue Shield insurance plan, the following AAC facilities accept Blue Cross Blue Shield for drug and alcohol addiction rehab.

• AdCare Rhode Island: With various facilities located in Rhode Island, AdCare provides innovative, quality, and cost-efficient addiction treatment. Its integrated system of care offers an inpatient treatment center in North Kingstown and a network of outpatient offices throughout Rhode Island. AdCare’s continuum of care includes detox services, residential treatment dual-diagnosis treatment, intensive outpatient services, inpatient and outpatient services, and tele-health.
• Desert Hope Treatment Center: Located in Las Vegas, Nevada, Desert Hope provides individualized care programs as well as offering a full continuum of care including detox services, residential treatment dual-diagnosis treatment, intensive outpatient services, and tele-health.
• Greenhouse Treatment Center: Located in Grand Prairie, Texas, Greenhouse offers individualized treatment plans and many levels of care including detox services, residential treatment, dual-diagnosis treatment, intensive outpatient services, outpatient services, and tele-health, all in a luxurious setting with high-end amenities.
• Laguna Treatment Center: Located in Orange County, California, Laguna is a chemical dependency recovery hospital that focuses on treating people who are medically compromised and need 24/7 oversight. Provided care includes detox services, residential treatment, dual-diagnosis treatment inpatient treatment, and intensive outpatient services.
• Oxford Treatment Center: Located in Etta, Mississippi, Oxford offers gender-specific rehab while offering an opportunity to connect with nature and try new activities. Provided care includes detox, residential treatment, dual-diagnosis treatment, inpatient and outpatient treatment, intensive outpatient services, and tele-health, all with individualized treatment programs.
• Sunrise House Treatment Center: Located in Lafayette Township, New Jersey, Sunrise House provides treatment for people suffering from substance abuse from a medical and holistic standpoint. With various evidence-based therapeutic interventions, personalized care is provided through detox, residential treatment, dual-diagnosis treatment, and outpatient services.

There are various treatment programs for individuals struggling with drug or alcohol addiction, so don’t give up if the first program you check out doesn’t meet your individual needs. There are rehabs near me that can provide the treatment you need. Check out the directory to find a list of facilities and programs. You can search by location and filter by Blue Cross Blue Shield insurance.