Highmark Insurance Coverage for Drug & Alcohol Rehab

Highmark BCBS Insurance for Drug and Alcohol Rehab Near Me

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.
Yes. Highmark BCBS Of Pennsylvania covers drug and alcohol rehab.
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Does Highmark BCBS of Pennsylvania insurance cover Inpatient Alcohol and Drug Rehab Centers?

With a Highmark Blue Cross Blue Shield of Pennsylvania insurance plan, patients are eligible to receive mental health and substance misuse treatment at a rehab facility.1 Highmark BCBS Pennsylvania works with Bright Heart Health to administer substance use treatment to its members.

Those who are seeking substance misuse treatment can contact one of the BCBS of Pennsylvania rehabilitation centers and ask them to verify their insurance for them. An admissions navigator will take the information and give callers an answer while they wait on the phone. They can also contact the number on the back of their insurance card to obtain more information about the specific plan they have.

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

American Addiction Centers (AAC) is a top-rated drug rehab facility with locations across the U.S. They will verify a member’s Blue Cross Blue Shield Pennsylvania mental health coverage for them. When someone calls the helpline, they can talk to the admissions navigator about their Highmark BCBS plan. Someone will check the benefits while the person waits on the phone.

Additionally, people can find assistance locating a top rehab center in the area when they contact AAC. There is an easy-to-use online treatment center locator that people can access if they prefer online methods.

What is Highmark BCBS Of Pennsylvania?

As the largest health insurer in Pennsylvania, Highmark Blue Shield of PA got its start after Blue Cross of Western Pennsylvania and Pennsylvania Blue Shield consolidated in 1996. As a top insurance company in Pennsylvania, Highmark is a licensee of Blue Cross Blue Shield. They provide a robust healthcare package to its approximately 4.7 million members.

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

When entering a BCBS of Pennsylvania rehab center, the amount of out-of-pocket costs a person may have can vary depending on how long they stay and what type of treatment they receive. A Blue Cross Blue Shield residential treatment plan will be customized for each patient to ensure they get the best care. A case management advisor will discuss the treatment plans with each patient to determine which level of care is appropriate for their needs.

Blue Cross Blue Shield Pennsylvania coverage may pay for some of the following treatment programs:

  • Inpatient treatment program: During an inpatient rehab program, patients begin their journey to sobriety. This type of program is comprehensive and consists of therapeutic care and around-the-clock treatment. Clinicians and medical professionals will monitor patients, check their vitals, and provide medication if needed. They can participate in whatever length of program fits their situation. There are 30-, 60-, and 90-day stays, as well as up to 1-year programs.3(inpatient)
  • Partial hospitalization program (PHP): A PHP provides patients with a high level of care that is personalized for the patient’s situation. It involves a full day of treatment and clinical care, including close monitoring of the patient’s symptoms and needs. Patients receive all-day therapy and treatment but will go to their own homes in the evening, allowing them to take care of some responsibilities at night.4(partial)
  • Intensive outpatient program (IOP): When people participate in an IOP, they will get an intense treatment program. Yet, they are participating on an outpatient basis. Some patients step down to this level of care after completing an inpatient program or PHP. IOP consists of therapy sessions that are diverse and lengthier than a standard outpatient program. Sessions could be for several hours a day and be several days a week.3(outpatient)
  • Outpatient treatment program and therapy: During a standard outpatient treatment program, patients are attending a regular therapy program, but it is targeted at the needs of substance misuse. Outpatient drug rehab in Pennsylvania teaches patients methods for overcoming triggers and temptations. Therefore, it’s useful for relapse prevention. 3(outpatient)

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

Therapy is a foundational part of any substance use treatment rehab program. Through behavioral therapy sessions, people learn methods for sober living. Some of the therapies that may be paid for by your Blue Cross Blue Shield substance abuse coverage include:5

  • Cognitive-behavioral therapy.
  • Contingency management intervention.
  • Motivational enhancement therapy.
  • 12-Step facilitation therapy.
  • Family behavior therapy.

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

Blue Cross & Blue Shield of Pennsylvania benefits provide coverage for mental health benefits too. In 2008, the Mental Health Parity and Addiction Equity Act (MHPAEA) was established. This mandated that all insurers must not turn anyone away from coverage due to mental health or substance misuse.6

Also, the Affordable Care Act (ACA) has additional provisions in its “Essential Health Benefits” that all marketplace health plans must carry. It provides 10 essential benefits, which include substance abuse and mental health services.7 People with Blue Cross Blue Shield of Pennsylvania substance use treatment coverage can count on these mandates to kick in for them when seeking treatment. The amount of coverage they’ll receive or how much in out-of-pocket costs they may have to pay varies, but they can’t be denied outright due to seeking treatment for a substance use disorder.

It’s beneficial to get treatment from a Blue Cross Blue Shield of Pennsylvania drug treatment facility that offers both mental health and substance abuse services. Co-occurring disorder treatment is a better plan for treatment because it targets both issues simultaneously.8(bottom)

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

Pennsylvania drug rehabilitation lasts for different lengths of time depending on where the patient is in the sobriety journey and what type of treatment plan they need. Those interested in rehab can contact one of the Blue Cross Blue Shield of Pennsylvania drug treatment providers and talk to an admissions navigator about a treatment plan. They will check the insurance status and determine how long the plan will cover. There may be some minor out-of-pocket costs, such as copays, coinsurance, and deductibles.

BCBS of Pennsylvania members can look up their plan by looking at the back of the insurance card. Whatever information the person receives, experts recommend that patients stay in an inpatient substance use treatment facility for at least 3 months.9 This gives them time to develop some stability.

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

If a person discovers that their Blue Cross Blue Shield addiction treatment is not fully covered at a Pennsylvania substance abuse treatment center near them, they can always try to work with a Pennsylvania addiction treatment center that accepts Anthem Blue Cross Blue Shield Pennsylvania and can ask about financial aid or payment plan options. Some Blue Cross Blue Shield addiction treatment centers offer scholarships, financial aid, or sliding scale cost reductions. It always is worth asking if there are options available instead of pushing off seeking treatment.

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

As a patient begins the treatment process, it’s vital to work with one of the Blue Cross Blue Shield of Pennsylvania insurance rehab centers that is in the network with the facility. Doing so can save on many out-of-pocket costs.

In-network Blue Cross Blue Shield of Pennsylvania insurance drug treatment programs have a contract with the rehab facility to provide services at a rate that is already agreed upon. So, no matter what occurs, the cost is already negotiated. This allows the insurance company to understand the costs in advance and charge their monthly premiums accordingly. When people use the in-network rehab facilities, they don’t have to worry about additional costs because they are using an approved provider. That’s why people must call the rehab ahead of time to make sure they are an in-network provider. People can do that easily by contacting AAC, who will verify BCBS of PA insurance.

Rehabs That Take Blue Cross Blue Shield 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 Hospital: 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.

Sources

  1. Highmark.(2022). Treatment for substance abuse.
  2. Highmark.(2022). Our story.
  3. National Institute on Drug Abuse. (2019). Treatment approaches for drug addiction DrugFacts.
  4. National Institute on Drug Abuse. (2020). Treatment settings.
  5. National Institute on Drug Abuse. (2020). Behavioral therapies.
  6. FindTreatment.gov. (n.d.). Paying for treatment.
  7. Highmark.gov. (n.d.). What marketplace health insurance plans cover.
  8. National Institute on Drug Abuse. (2018). Comorbidity: Substance use disorders and other mental illnesses DrugFacts.
  9. National Institute on Drug Abuse. (2020). Principles of effective treatment.
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