Highmark Insurance Coverage for Drug and Alcohol Rehab 

Drug and alcohol addiction is a serious, life-threatening condition that impacts all aspects of the user’s life, as well as their loved ones. If you’re ready to put alcohol and drugs behind you, seeking professional help from a reputable provider will be one of the best decisions you will ever make.

Highmark understands the importance of providing coverage for detox and treatment programs to help their members cover the costs to get the help they need.

Keep reading to learn more about Highmark BCBS and some related topics of interest. 

Overview of Highmark Blue Cross Blue Shield Insurance Provider

Highmark Inc. is a health insurance company based in Pittsburgh, Pennsylvania, and is one of the largest in the US. They were founded in 1977 and operate in Pennsylvania, West Virginia and Delaware.

Highmark offers a variety of health insurance products to individuals, families and businesses, including traditional health insurance, Medicare Advantage plans and Medicaid plans.

The company also operates a network of hospitals and medical facilities called Allegheny Health Network, which includes over 12 hospitals, more than 300 outpatient clinics and physician offices and over 2,500 affiliated physicians.

Highmark also offers a range of wellness programs and services to promote healthy living and preventive care.

Highmark has received recognition for their commitment to quality and customer satisfaction, including being rated among the top health plans in the country by the National Committee for Quality Assurance (NCQA) and receiving high ratings from J.D.

Power for customer satisfaction. They are also involved in various community initiatives and philanthropic efforts, supporting local charities and providing grants for health-related research and education.

The Importance of Rehab Coverage for Addiction Treatment

Deciding to seek help for your drug or alcohol addiction will be life-changing in so many ways. Sadly, many people are deterred due to the cost of treatment programs.

Fortunately, there are many insurance companies, including Highmark, that provide coverage for substance abuse issues and mental health treatment.

Having insurance for drug and alcohol rehab is incredibly important for a number of reasons. Addiction is a complex and chronic disease that requires long-term treatment and support.

Without adequate coverage for treatment, people struggling with substance use and mental health issues will face barriers in accessing the care they need to achieve and maintain sobriety.

Here are some reasons why coverage for drug and alcohol treatment at a reputable rehab center is so crucial:

  • Treatment can be expensive: drug or alcohol addiction treatment can be costly, especially when you need to stay in treatment for an extended period of time. 
  • Access to a wide range of treatment options: having insurance for addiction treatment can help ensure that you have access to a range of treatment options.
  • Legal requirements: under the Affordable Care Act, health insurance providers are now required to offer coverage for mental health and substance use disorder treatment. 

Does Highmark Cover Rehab for Addiction and Mental health Treatment Services?

Highmark BCBS insurance for drug, alcohol and mental health will depend on the specific plan you have, but in general, they offer coverage for the following:

  • Inpatient and outpatient rehab: short to long-term inpatient, detox, hospitalization, partial hospitalization and intensive outpatient programs for drug and alcohol addiction.
  • Behavioral health therapy: covers a range of mental health services including individual, group and family therapy.
  • Medication management: offers coverage for medication costs.
  • Mental health screenings and assessments: to help identify and diagnose substance use and mental health disorders.

You can also seek the help of the treatment center you wish to go to. Luxe Recovery accepts Highmark and will liaise with them to verify your benefits and determine what coverage you have and advocate on your behalf to maximize your benefits.

If you are considering treatment for alcohol or drug abuse, go ahead and contact the team at Luxe Recovery.

Understand Your Highmark BCBS Coverage for Drug or Alcohol

Understanding your plan and what coverage you have will give you some peace of mind so you can focus on your treatment and sobriety without having the extra financial worries. To check your coverage options you can follow these simple steps:

  1. Contact Highmark: call the customer service number on the back of your insurance card or visit the Highmark website determine what is covered by your insurance plan as well as any co-payments or deductibles that you may be responsible for. Make sure to ask about your alcohol and drug addiction coverage and check on any treatment centers you have in mind. You should check on inpatient and outpatient treatment options.
  2. Verify providers: Highmark has a network of approved providers for drug and alcohol rehab that they can share with you. 
  3. Get pre-authorization: in most cases, you will require pre-authorization so be sure to ask how to go about getting this approved.

Remember to keep notes of your conversations, such as names of reps you spoke with, dates of calls and reference numbers. This is going to be helpful in case there are any issues or discrepancies with your coverage later on.

Out-of-pocket Costs and Deductibles at Drug and Alcohol Rehab  Centers

Many Highmark plans have deductibles that must be met before coverage begins. The amount can vary and once you meet your deductible, you may still be responsible for a copayment or coinsurance.

Your out-of-pocket costs will depend on the type of program you attend. For example, attending a rehab program at an inpatient facility is going to have higher out-of-pocket costs than outpatient. 

Prior-Authorization Requirements for Substance Abuse Treatment

Prior-authorization requirements will depend on your plan and the type of addiction rehab treatment being sought but in general, you are likely going to need prior-auth for most services.

In-network vs. Out-of-network Coverage for Alcohol and Drug Rehab

In most cases, you will need to go to a rehab facility that is in-network to receive full benefits. Sometimes even if you choose an in-network treatment center, you may still have to pay for some of the costs. If you choose an out-of-network center, you will be responsible for more and sometimes all of the costs. 

Although out-of-network benefits tend to be less than in-network providers, Highmark will often pay up to 50% of the co-insurance fees for out-of-network providers.

Not all providers accept Highmark BCBS but Luxe Recovery does and can help you navigate through all of these things and determine what coverage you have and what fees you may be responsible for. If you are considering rehab, go ahead and reach out to Luxe Recovery.

In-network coverage refers to services at treatment centers that are contracted with Highmark and have agreed to accept negotiated rates, which are typically lower than what they would charge out-of-network patients.

Out-of-network coverage refers to services by providers that are not contracted with Highmark and do not have negotiated rates. As a result, they may charge higher fees leaving policyholders having to pay higher out-of-pocket costs. Out-of-network coverage may be necessary when a member needs to see a specialist who is not available in-network or when emergency care is required.

Highmark Insurance Accepted at Luxe Recovery for Drug and Alcohol Treatment 

Luxe Recovery is pleased to accept Highmark insurance for their drug and alcohol addiction treatment. If you or a loved one are dealing with substance abuse and mental health issues, Luxe Recovery can support you every step of the way.

To have the best chance of success, you need to choose a facility that offers individualized and tailored treatment plans because one size does not fit all.

Luxe Recovery’s addiction treatment program is robust and will support you from the first call you make through to being back home. The amazing team will work hard to ensure you get the most out of treatment.

The serene environment at Luxe Recovery makes it the perfect place to recover, far away from your daily life, a time for you to focus on healing.

Luxe Recovery will verify your insurance to determine your level of coverage and maintain communication with Highmark throughout your stay. You can contact the friendly admissions team to learn more and have them check your coverage.

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