Highmark BCBS Insurance for Drug & Alcohol Rehab (Pennsylvania)
Does Highmark Blue Cross Blue Shield Cover Rehab?
Highmark BlueCross BlueShield may be able to cover all or at least part of the cost of drug or alcohol rehab. This will depend on your plan details and the level of care you need. Even if you have insurance coverage in Pennsylvania, you may still be covered to attend rehab in another state.
From April 2020 to April 2021, there were 5,268 reported drug overdose deaths in Pennsylvania.1 If you or a loved one is struggling with a substance use disorder (SUD), it is vital to seek help from a treatment facility or rehab program. Before you decide which addiction treatment program is right for you, it is important to find out your level of rehab coverage with Highmark Blue Cross Blue Shield. Keep in mind, coverage will always depend on your insurance plan and other variables.
What Addiction Treatment Does Pennsylvania Blue Cross Blue Shield Cover?
Every ACA plan covers mental health and substance use disorder (SUD) services to some extent and refer to them as one of the ten essential health benefits.3 Depending on your plan, Highmark Blue Cross Blue Shield of Pennsylvania may cover at least part of the cost of:
- Detox – A professional drug detoxification program, also known as medically managed withdrawal, uses medications or other therapies to manage any potentially harmful side effects a person may experience as their body rids itself of a substance.
- Inpatient or Residential Rehab – Inpatient or residential treatment is ideal for those with more severe addictions who have been abusing a substance for a long period of time. A patient will receive 24-hour care and work to develop capabilities that allow them to remain in recovery after they have left the treatment center.
- Outpatient Rehab or Therapy – Outpatient rehab allows patients to live at home and carry on with their day-to-day duties. Treatment will take place in different settings and the level of intensity will vary depending on the individual.
- Medication Assisted Treatment (MAT) – Depending on the individual’s unique needs, MAT uses medications and behavioral treatment to treat substance use disorders (SUDs). It is a comprehensive approach to treatment and the duration will vary from person to person.
Before going into an addiction rehab program, always check what your Highmark BCBS of Pennsylvania plan will and will not cover. You may find that you will have to leave Pennsylvania to attend a treatment facility that is right for you. This should not stop you from getting the help you need.
Does Highmark BCBS Cover Mental Health & Co-Occurring Disorder Treatment?
Highmark Blue Cross Blue Shield may cover co-occurring disorder treatment, such as treatment of depression or anxiety as well as addiction treatment under mental or behavioral health services. Depending on your level of coverage, mental health treatments may at least be partially covered.
It is common for those with substance use disorder (SUD) to also have a mental health condition and many rehab facilities offer integrated treatment to ensure an individual’s unique treatment needs are met. If you have Pennsylvania Blue Cross Blue Shield, check the level of coverage you have for a co-occurring or dual diagnosis disorder.
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About Highmark BCBS in Pennsylvania
Blue Cross Blue Shield (BCBS) is a nationwide insurance provider that may cover rehab for drug and alcohol addiction depending on your plan and individual needs. In 1996, Blue Cross of Western Pennsylvania and Pennsylvania Blue Shield consolidated to become Highmark.2 Today, Highmark serves over 4.7 million members and is the largest health insurer in Pennsylvania. Highmark BCBS offers individual, family, CHIP, and Medicare plans, many of which are through the Affordable Care Act (ACA). These may include PPO, EPO, HMO, and POS plans. Plans may vary on the out-of-pocket costs, deductibles, premiums, and other variables.