Members of Highmark Health should contact their provider for specific information on coverage, which varies depending upon several factors, including the type of addiction being treated, the length of stay in the rehab facility, the length of outpatient or aftercare services, and the individual’s deductible and co-pay.
If the patient’s plan is a Managed Healthcare plan (HMO), Highmark coverage is maximized when patients stay within the preferred network of doctors and rehab centers. If the patient’s plan is a Preferred Provider plan (PPO), there may be fewer restrictions on the choice of treatment provider.
Highmark offers individual and family plans through employers, Medicare and Medicaid, and the Health Insurance Marketplace. You may also be eligible for short term insurance of up to 360 days if you need coverage during a transition period in your life. While employer plans may differ, all Health Insurance Marketplace plans cover substance abuse treatment as an essential health benefit. This means that pre-existing conditions are covered, and spending limits are not allowed.