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Highmark Rehab Coverage

For many Americans who suffer from mental health and addiction issues, the idea of going to rehab is just an idea. Many roadblocks prevent those who need help from seeking treatment, but one of the most common factors is the cost. Rehab is often expensive, and many people who suffer from addiction cannot afford the expense. Between paying the full amount and taking leave from work to recover, the financial burden of rehab is too much for many individuals to handle.

With coverage from health insurance, those who would not normally afford quality addiction treatment can finally receive the help they need. By covering a portion or the full amount of rehab, insurance companies are helping Americans recover from addiction or substance abuse and go on to live happy sober lives.

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More About Highmark
Insurance & Rehab Coverage

Individuals covered by Highmark health insurance are in luck when it comes to coverage for addiction treatment. As an independent licensee of Blue Cross Blue Shield, Highmark alcohol rehab coverage includes detox, inpatient, and outpatient services in the mental health and substance abuse treatment section. Since each person may require a different type of treatment depending on their personality and substance issues, several types of rehab facilities are covered in Highmark’s plan, ensuring that all members receive treatment that is right for them.


Verifying Highmark Rehab
Coverage Details

Besides receiving individualized service by professionals who care, Highmark has several features that make it the ideal insurance carrier for those who require rehab treatment. Highmark classifies alcohol addiction as a medical condition and therefore recommends treatment based on this. The coverage is dependent on the unique plan you are enrolled in. However, many plans include a total cost coverage option if all your out-of-pocket or deductible expenses have reached their maximum for the year.

With Highmark, all medically necessary treatments, such as detox, are covered, except treatments that are considered experimental. If you choose a treatment that is considered experimental or interested in entering a facility that Highmark does not cover, you are provided the option to pay above what the insurance will provide or make payment plans to afford the treatment.

Top-down view of Florida rehab facility featuring pool and sports court.

The History of Highmark

Serving 5.3 million members in Delaware, Pennsylvania, and West Virginia, Highmark is one of the largest healthcare providers in the country. Opening in 1977 as part of a merger between two Blue Cross Blue Shield licensees, Highmark has since worked to innovate the industry with high-quality, affordable care. With policies that are easy to understand and employees who care about the experiences of their clients, Highmark delivers on its promise of accessible care. For more information on your coverage and plans, call 877-284-0353 today.


The Benefits of Highmark

Why is Highmark Rehab Coverage Important?

The Substance Abuse and Mental Health Services Administration (SAMHSA) estimates that roughly 23.5 million Americans suffer from substance abuse. They also estimate that out of that figure, only 11 percent receives treatment. If these numbers seem shocking to you, it’s because they are.

Despite numerous studies that show how addiction is more like a chronic disease rather than a moral failing, there is still a stigma attached to seeking help for substance abuse problems. With the passing of the Affordable Care Act, it became a requirement for insurance companies to provide coverage for rehab. This small step reduces the negative stigma associated with addiction, helping millions of Americans get their help.

In addition to the personal damage and trauma that addiction and substance abuse can cause, there is also a national side effect damaging our economy. The National Institute on Drug Abuse (NIDA) estimates that $700 billion per year is spent on costs associated with addiction. By making treatment more readily available, the benefits will trickle down and help the economy.

When a person enters a rehab facility for substance abuse, it’s important to focus on recovery and working towards sobriety. Worrying about paying the full amount for treatment is detrimental to recovery. Addressing the uncomfortable causes of personal addiction is stressful. Adding the financial stress of treatment increases the chances of relapse. By providing coverage for mental health and addiction issues, patients can recover in peace without the burden of paying the full amount.

Does Highmark Rehab Coverage
Include Aftercare?

Aftercare is the treatment that occurs after the initial stay at a rehab facility. All reputable facilities will have strong aftercare programs in place to ensure the success of their clients. Some examples of aftercare programs include access to group therapy, placement in a sober living environment, participation in group activities, and enrollment in support groups. Highmark drug rehab coverage typically covers aftercare costs, although it’s best to confirm the details of your specific plan.

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What is Detox?

Arguably, the most important part of treatment is detox. Detoxing is also referred to as the detoxification process. During this time, complete abstention from drugs or alcohol allows the body to rid itself of the physical dependencies on substances. Almost all rehab coverage includes detox services since medically assisted detox is the preferred way to detox. By detoxing with the help of a medical professional, the client’s safety is ensured, and any unpleasant withdrawal symptoms can be managed with medication if needed. Depending on the client’s unique needs, detox can take a few days to a few weeks to be complete.

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What are the Differences Between
Inpatient and Outpatient Treatment?

Once you have determined the extent of your Highmark rehab coverage, it’s time to consider treatment. There are two main types of treatments to choose from that insurance will cover. Inpatient and outpatient rehab both have many benefits, and the treatment plan you end up choosing is solely dependent on your specific needs and requirements. The main differences between the two types of treatment include:

    • Inpatient
    • Usually lasts between 30-90 days.
    • Clients must take time off work or school to live at the facility.
    • Daily therapy sessions are included.
    • The cost of accommodations and food is included in the cost.
    • Clients are completely removed from any environment that may trigger a relapse.
    • Clients receive 24-hour medical supervision.
    • The length of the program is usually longer than inpatient rehab.
    • Clients can continue working and living at home.
    • Meetings and therapy sessions occur less frequently, usually on a weekly basis.
    • Clients are held accountable for their actions.
    • This treatment is ideal for patients who can self-regulate their exposure to substances.
    • Beneficial for clients who have already detoxed.

Depending on your coverage, a dollar amount, percentage or amount of time of outpatient and inpatient services are covered by Highmark alcohol rehab coverage.


Signs You May Need Rehab

The most effective way to overcome addiction and recover from substance abuse is with the help of a professional inpatient or outpatient program. Some of the most common signs that indicate rehab is required for you, or a loved one includes:

    • Feeling ashamed about drinking or using drugs.
    • Feeling as if you need to be under the influence of substances to be loved or feel confident.
    • Engaging in risky behavior such as driving while drunk.
    • Experiencing problems at work or trouble in school.
    • Losing touch with loved ones or family members due to drinking.
    • Experiencing legal troubles related to substance use.

If you or a loved one is experiencing any of these symptoms, it may be time to check in with your insurance company and determine the extent of your Highmark drug rehab coverage.

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Get Started on the Path to Recovery Today

Whether it’s for you or a loved one, entering rehab is one of the biggest decisions a person will ever make. Don’t let a poor financial situation keep you from getting help. Call Beachway today and speak with an expert about your Highmark rehab coverage.