Find Alcohol & Drug Rehabs that Accept Highmark Insurance

Highmark plans are designed to support members seeking care for addiction and mental health conditions. However, no two plans are exactly alike. Factors like your plan type (HMO, PPO, EPO), your state, and whether the treatment center is in-network all shape what is covered.

Most Highmark plans will support treatment when it is considered medically necessary, meaning a licensed professional has documented that structured care is required for health and safety.

Because coverage varies widely, verifying your specific benefits is essential before choosing a treatment program.

While plan details differ, Highmark may offer benefits for a full spectrum of addiction-related services, including:

• Detoxification Services: Withdrawal from alcohol, opioids, and other substances can be dangerous without medical supervision. Highmark often covers both inpatient and outpatient detox, depending on the severity of symptoms and your provider’s recommendation.
• Residential or Inpatient Programs: These programs provide 24-hour care in a structured, therapeutic environment. Highmark may cover residential treatment when symptoms or safety risks require round-the-clock monitoring and support.
• Partial Hospitalization (PHP): PHP serves as a high-intensity level of care for clients who need daily treatment but do not require full residential accommodation. Many Highmark plans cover PHP when it is part of a clinically recommended treatment plan.
• Intensive Outpatient Care (IOP): This level of care includes several therapy sessions every week. It is commonly approved for clients stepping down from inpatient care or those who need more structured treatment than weekly counseling.
• Standard Outpatient Counseling: Highmark typically includes coverage for individual, group, or family therapy sessions, especially those focused on relapse prevention, behavioral health, or ongoing recovery support.
• Medication-Assisted Treatment (MAT): Treatments such as buprenorphine, methadone, or naltrexone may be covered if they are prescribed by an approved provider. MAT is often included as part of opioid or alcohol dependence treatment plans.
• Dual Diagnosis / Co-Occurring Disorder Treatment: Highmark often extends benefits to individuals who struggle with both addiction and a mental health condition like depression, anxiety, PTSD, or bipolar disorder.

Your eligibility for each service depends on medical necessity, documentation, and network participation.

Highmark uses clinical criteria to decide whether certain levels of treatment are appropriate. This may involve:

• A substance-use assessment by a licensed provider
• Documentation showing symptoms, frequency of use, and functional impact
• Review of safety concerns, relapse history, or withdrawal risks
• An evaluation from a treatment center
• Recommendations for level of care

Some services—especially inpatient or residential programs—may require prior authorization, meaning Highmark must approve the treatment before it begins.

Better Addiction Care can help ensure these steps are handled properly so you don’t face treatment delays.

Treatment costs under Highmark depend on several factors:

Your Deductible

This is the amount you need to pay before your plan begins covering treatment.

Copay or Coinsurance

After your deductible is met, you may be responsible for a percentage of the cost. Copays may apply to certain outpatient visits.

Network Status

• In-network providers: Lower cost, pre-negotiated rates
• Out-of-network providers: Higher cost, depending on your plan type
• PPO plans may allow both, but at different rates

Plan Level

Gold, Silver, Bronze, and other tiers all have different cost-sharing structures.

Because coverage varies significantly, your best first step is verifying your benefits with an expert who can explain your exact out-of-pocket expectations.

Choosing an in-network treatment center often leads to:

• Lower deductibles
• Lower coinsurance
• Faster approval and fewer administrative issues
• Lower overall cost of treatment

Out-of-network treatment may still be affordable depending on your plan, especially if you have a PPO. However, you may need to cover a larger share of costs or pay upfront.

Better Addiction Care can check whether your preferred rehab center is in-network with your Highmark plan.

To ensure care is appropriate and medically necessary, Highmark may require:

• A clinical evaluation or diagnostic assessment
• Prior authorization for certain programs
• Referral from a primary-care provider (varies by plan)
• Use of accredited treatment facilities
• Ongoing documentation from your treatment provider

These steps help Highmark confirm that treatment matches clinical guidelines and is delivered by qualified professionals.

Insurance verification gives you a clear picture of:

• Levels of care your plan covers
• Whether detox, residential, or outpatient services are included
• Your deductible, copay, and coinsurance
• Any pre-authorization requirements
• Whether the rehab center is in-network
• What medications and therapies will your plan support

Better Addiction Care handles this process for you so you can focus on choosing the right program rather than navigating paperwork.

You have several options to verify your benefits:

1. Use the Number on Your Insurance Card

Call Highmark and ask about your behavioral-health and substance-use benefits.

2. Log in to Your Highmark Online Account

You can review coverage, copays, and out-of-pocket costs in the member portal.

3. Let Better Addiction Care Verify Everything for You

We contact Highmark directly to confirm your benefits, check network status, review authorization requirements, and explain your coverage in simple, clear terms.
This option saves time—and avoids paperwork errors that could delay admission.

Highmark provides health coverage in several regions, including:

• Pennsylvania
• Delaware
• West Virginia
• Nationwide BlueCard access for some members

Treatment availability and in-network options will depend on your exact plan and location.
Better Addiction Care can help you explore both local facilities and out-of-state programs that accept Highmark.

If your Highmark plan does not include full coverage for the level of care recommended, you may still have alternatives:

• Choosing an in-network treatment center
• Exploring outpatient or step-down levels of care
• Asking about financing or sliding-scale options
• Reviewing additional facilities that offer similar care at a lower cost
• Considering travel to an in-network program with better benefits

Our team can help you compare each option so you can make the best decision for your recovery and budget.

When you reach out to Better Addiction Care, our team will:

• Verify your Highmark insurance benefits
• Confirm what levels of care your plan will support
• Handle pre-authorizations and required documents
• Match you with accredited rehab centers that accept Highmark
• Explain all financial details clearly before admission

This support helps you avoid coverage surprises and gives you confidence as you enter treatment.