Highmark Insurance Coverage for Drug & Alcohol Rehab Centers Near Me

If you’re looking for a quality rehab center but don’t know where to start, don’t worry. Click here to use Project Know’s treatment facility locator, which will help you easily find top-notch American Addiction Centers facilities around the nation. Once you’ve found a facility that interests you, you can call that facility to ask whether they accept your Highmark BCBS of Pennsylvania insurance plan. If the facility is an American Addiction Centers facility, you will be able to speak to a person who can check your benefits right while you’re on the phone if you call the helpline.

It’s never been easier than now to find a Highmark BCBS of Pennsylvania-covered inpatient drug treatment center in PA. Plus, because Blue Cross Blue Shield is a nationwide insurer, it may be relatively easy to find a covered facility in Pennsylvania, thanks to BCBS’s massive provider network. Although there’s not a number available, it’s safe to assume that a large number of people go into rehab every year financed through BCBS of Pennsylvania.

Highmark has been helping Pennsylvania residents get quality, affordable coverage since the 1930s.^{1, 2nd setion} Flash-forward to the present day, Highmark is a leading health insurance company and one of the nation’s top independent licensees of the Blue Cross Blue Shield Association. In fact, it’s the fourth-largest Blue Cross Blue Shield-affiliated company.^{1, last sentence} Across Pennsylvania, Delaware, and West Virginia, Highmark covers approximately 6 million Americans.^{1, last sentence} In Pennsylvania alone, 4.7 million members are covered by a Highmark BCBS plan.^{1, leading the way section, 2nd par}

This large affiliation works with the BCBS’s massive provider network to help provide access to a variety of providers, including drug rehab centers, within the Pennsylvania network. There are at least 120 AAC-affiliated drug rehab centers in network in Pennsylvania. But it’s always a good idea to check with the rehab center and your BCBS plan representative to ensure that you’re covered.²

How much BCBS of Pennsylvania will cover in terms of addiction treatment will vary greatly upon the plan that you’ve selected. The treatment facility you attend may also impact the levels of coverage you receive. It’s also important to note that the treatment you receive will vary depending on your personal situation—no two paths to recovery are the same.

Despite this, the following are common treatment methods for addiction:³

• Inpatient and/or residential treatment. This is perhaps the most well-known form of addiction treatment. This type of treatment often involves the patient staying at a facility short-term (e.g., a few days or weeks), which is known as inpatient care, or long-term (e.g., a few months), which is known as residential care. The type of care received here generally includes detox and/or withdrawal support, therapy, medication, and other treatments as well.³
• Standard outpatient treatment. This care often involves a patient going to a facility to receive care (e.g., therapy) for an hour or a few hours and then returning home.³
• Partial hospitalization programs (PHPs). These combine elements on inpatient and outpatient care, where the patient goes to a facility for a few hours of treatment a few days a week. However, they’re allowed to return home at the end of the day.
• Intensive outpatient programs (IOP). These also combine elements of inpatient and outpatient care. IOPs typically involve a patient receiving outpatient services at a facility a few days a week, but then they return home. Unlike typical outpatient programs, IOPs have more structure.

Please remember that your provider will ultimately determine the best course of action for you on your recovery journey. To find out what your insurance plan will cover, call the number on the back of your insurance card to speak with a BCBS of Pennsylvania representative.

Does Blue Cross Blue Shield of Pennsylvania Provide Coverage for Mental Health Facilities?

Although every health plan is different, they are all mandated by the Affordable Care Act, a federal health-care reform law intended to provide some level of care for a variety of health-care services referred to as essential health benefits.⁴ Mental and behavioral health services include inpatient care for behavioral and mental health disorders, behavioral health treatment, and treatment for substance use disorders.⁴

This mandate ensures that whether you need standalone heroin rehab or drug rehab, or if you need treatment for both a mental or behavioral health disorder and drug or alcohol rehab treatment. If you are struggling with both substance use and a mental health condition, you may have a co-occurring disorder, and you may not be able to fully recover until you receive treatment for both conditions. That’s why the ACA’s coverage mandate is so beneficial: Your insurance plan should cover treatment for each condition in some capacity, enabling you to get the care you need.

Every person’s path to recovery is different, which means no two treatments will look the same. Despite this, it’s commonly accepted that longer treatment times yield the most effective treatment. According to research, treatment for substance use disorders should last at least 3 months to reduce the risk of negative outcomes and be as effective as possible.^{5, point 5}

How long your Highmark BCBS of Pennsylvania plan covers alcohol and drug rehab programs will largely depend on your specific plan. There are many types of policies and tiers of coverage included in all the different plans BCBS of Pennsylvania provides, which makes it impossible for there to be a clear-cut answer to this question. The length of time covered by your plan may also be subject to deductible limits and other cost-sharing requirements. It’s best to check with your insurance company to verify your benefits and coverage. You can do so by calling the number on the back of your insurance card or by calling an AAC helpline to speak to a representative who can help you.

What If My BCBS of Pennsylvania Policy Does Not Cover an Inpatient Drug Rehab Program?

In some cases, your insurance may not fully or partially cover the cost of inpatient drug rehab programs. If this is the case, you may be responsible for paying for the costs out of pocket. However, depending on the rehab center you choose, you may be able to ask whether the facility has financing or scholarship options available to offset the cost.

It’s important to not put off getting the help you need now because of the cost of rehab. The longer you wait, the longer you may need to be in treatment, which can increase the costs of rehab. Please contact the staff at your nearest AAC facility to talk to an admissions navigator and see what can be done to help you afford rehab.

Keeping your health-care costs low hinges on your understanding of in- vs. out-of-network providers. In-network providers are ones that have entered into agreements with your insurance company to provide discounted care in exchange for the company filtering care to those facilities. Often, this results in cost savings for you, as your plan will likely cover the in-network provider at a higher percentage than they would cover an out-of-network provider—if your plan even provides coverage for out-of-network providers.

To find out whether a rehab facility is an in-network provider, you have a few options. You can call the number on the back of your insurance card and talk to a representative from BCBS. You can also log on to your online member portal and search for a facility there. Or you can contact the AAC phone helpline or use the online form to have a staff member help you see if their facility is covered under your insurance. Finally, you can fill out the form at the bottom of this page to check network coverage as well.

Don’t wait any longer to get the care you need, especially if you have a BCBS of Pennsylvania plan. Let us help you get the care you need at a price you can afford.

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.
• River Oaks Treatment Center: Located in Riverview, Florida just outside of Tampa, River Oaks Treatment Center has advanced accreditations and professional staff who provide the highest level of individualized care to each person who attends a treatment program at the facility.
• 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 local rehab near you 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.

Local Alcohol Rehab Near Me

Local Opioid Rehab Near Me

Local BCBS Rehab Coverage Guide

1. (n.d.). Our story.
2. American Addiction Centers. (n.d.). National rehabs directory.
3. National Institute on Drug Abuse. (2018, August 15). Comorbidity: substance use and other mental dsorders.
4. gov. (n.d.). Mental health & substance abuse coverage.
5. National Institute on Drug Abuse. (2018 January). Principles of drug addiction treatment: A research-based guide (third edition), principles of effective treatment.