Highmark Insurance Coverage for Drug & Alcohol Rehab 

Highmark Drug and Alcohol Rehab Coverage FAQs

Where Does Highmark Insurance Operate?

Highmark is the 4th largest Blue Cross & Blue Shield associated provider in the US. They have plans in Delaware, Pennsylvania, and West Virginia.

Does Highmark Insurance Cover Rehab?

Highmark usually will cover drug rehab. They consider alcohol rehab a medical necessity. Their coverage varies based on your plan. Highmark is licensed by the Blue Cross and Blue Shield Association.

Highmark doesn’t always offer 100% coverage. You are responsible for any remaining balance. If you have a deductible amount, you must pay it first before your insurance takes over.

Most Highmark plans have coverage for the following:

Inpatient Treatment
Partial Hospitalization
Intensive Outpatient Programs (IOP)
After-Care Program
Mental Health Programs
Behavioral Health Programs

Various mental health and behavioral health programs

To manage your Highmark Health Plan, you can use their online Mycare Navigator.

How Long Does Highmark Cover Addiction Treatment?

Highmark coverage length usually caps at 30 days. They base their coverage on a case-by-case basis.

Out-of-Network providers may not be allowed, or may incur additional costs.

Contact Highmark to confirm your level of coverage, if any, for out-of-network providers.

Does Highmark Allow for Treatment at Luxury Rehab Facilities?

Highmark allows certain, luxury and private rehabilitation centers as long as they are medically recognized. They won’t allow for “alternative” treatments.

Luxury drug rehabs are often where wealthy people and celebrities will go for addiction help. They are often as nice as any hotel or resort you may use for a vacation spot. They usually have massages, acupuncture, hot-tubs, pools, and quality dining, in addition to other exclusive privileges.


Inpatient Addiction Treatment vs. Outpatient Treatment

This is one of the biggest and most important choices that a patient or their family will make when looking for addiction help. Where you go, and what you do from here on matters and can determine your level of success.

Both options are better than not seeking treatment and could save your life. They each have their own strengths and weaknesses.

An outpatient facility is usually a local option. They give you the chance to meet with medical professionals like doctors, alcohol and drug counselors, or therapists, attend group sessions, and go to recovery meetings while being able to head home afterwards. Co-pays may be required for each visit.

Inpatient facilities, also called residential programs, are most often 28 day programs. They provide structure and are typically remote destinations where you stay in the facility for the duration of the program


Do I Need Insurance to go to Rehab?

You are not required to have insurance to get addiction treatment. However, without insurance, the cost of drug rehab facilities is usually very expensive and impractical for most people. You would need to pay out of pocket. You can certainly pay with a credit or debit card, work out a payment plan, or use other methods that each facility accepts.

Typical inpatient rehabs may cost anywhere from $6,000-$20,000 for a 28 day program.

Outpatient Rehab can range from $4,000-$10,000 for 90 days. The cost of outpatient rehab will vary and is mostly based on how many visits are made.

How Does Highmark Decide My Claim?

Highmark makes decisions about their coverage based on your health plan. They comply with all Federal guidelines. Each claim decision is reviewed on a case by case basis. Highmark will look at services you use. They then follow national guidelines and other policies to determine if your claim is covered. Services that may be covered can include drug addiction rehab, blood-tests, surgeries, or hospital stays


What Else does Highmark Provide?

Highmark has a host of health and wellness options and discounts

They serve more than 50 million Americans.

A variety of plans you can customize and the ability to manage and adjust your plan.

Anything that you say is kept confidential, so you don’t have to worry about everyone knowing you may have trouble with alcohol or drugs.

Get Approved for Highmark Drug and Alcohol Rehab Coverage

Verifying what insurance will cover can be a time-consuming process. This hassle usually involves lots of waiting and multi phone calls back and forth. Our knowledgeable staff can verify your coverage for you and take the stress and annoyance out of this already difficult time. You have enough to worry about already. Verifying insurance coverage for rehab shouldn’t be an additional burden.

NOTICE: Step One Rehab works hard to make sure our information is accurate. Due to constant changes in insurance company policies, we suggest you contact your insurance company with your member ID ready to confirm your particular coverage or submit our free verification form to verify benefits.

Instead, give us a call now and let us handle this step, at no cost to you! We are totally confidential. Our number is 877-348-7494