Provider Overview

Highmark Blue Shield provides affordable, quality healthcare plans for members in Pennsylvania and other East Coast states.¹ If you have Highmark Blue Shield and are looking for treatment for a substance use disorder, some or all of your care may be covered by your insurance plan.² Read on to learn more about Highmark Blue Shield coverage for rehab in Pennsylvania and how to get started on your recovery journey.

This page is intended to be a general overview of how Highmark Blue Shield covers addiction and mental health services, not a comprehensive guide on the subject. For specific questions about your Highmark Blue Shield policy and coverage for addiction treatment at American Addiction Centers’ facilities, call a Highmark Blue Shield representative directly and learn more about paying for rehab.

Does Highmark Blue Shield Cover Drug & Alcohol Addiction Treatment?

Yes, Highmark Blue Shield offers coverage for drug and alcohol treatment, as the Affordable Care Act (ACA) requires all marketplace plans to cover addiction and mental health services to some extent.^2,3 Discussing your policy details with your insurance provider is essential to learn more about your specific plan and the amount of coverage you may receive for these services. Understanding your benefits and limitations, potential out-of-pocket costs, and in-network options can simplify finding the best care for you.

American Addiction Centers (AAC) can verify your benefits within minutes and help you get the most out of your Highmark Blue Shield coverage for addiction treatment. Contact our team at to speak with an admissions navigator who can help you find a rehab covered by Highmark Blue Shield.

Which Types of Addiction Treatment Does Highmark Blue Shield Cover?

Highmark Blue Shield may partially or fully cover multiple types of addiction treatment, as your coverage level can vary based on your policy.³ Since recovery is a unique journey for everyone, several levels of care are available to meet you at any stage.⁴ Here are some common types of addiction treatment a rehab covered by Highmark Blue Shield might offer:

Medical detox. Often the first treatment step, patients safely withdraw from substances and reach stabilization under medical supervision in detox.⁴
Inpatient addiction treatment. Inpatient programs offer a safe, highly structured living environment with 24/7 care. You’ll typically participate in evidence-based interventions, including cognitive-behavioral therapy (CBT), psychoeducation, and motivational interviewing (MI) during your stay, which can last anywhere from a few weeks to several months.⁵
Partial hospitalization programs for addiction. Partial hospitalization programs (PHPs) are the highest level of outpatient treatment, providing about 6 hours of daily, immersive care.⁶Patients can continue to live at home while participating in a PHP.
Intensive outpatient programs for drug and alcohol addiction. The next step down from a PHP, intensive outpatient programs (IOPs) often require patients to attend their program for a minimum of 9 hours of treatment per week.⁷
Outpatient addiction treatment programs. Standard outpatient programs, which require less attendance frequency than other types of programs, are the least intensive type of outpatient care.⁴
Aftercare programs. Participating in aftercare programs can help promote sustained recovery. Common forms of aftercare include ongoing counseling, sober living, and 12-Step programs.⁴

How to Use Highmark Blue Shield for Addiction Treatment & Rehab

Learning more about your policy is the first step in using Highmark Blue Shield to cover SUD treatment. Highmark Blue Shield offers many ways to check your coverage and the specifics of your plan. Consider the following:

Highmark Blue Shield Member Portal. Log into your patient portal online to learn more about your plan, find in-network providers, view your family’s coverage, and more.
My Highmark App. Download the mobile app and sign in with your member portal info to check your benefits from your phone.
Speak with a representative. Call the number on the back of your insurance card to speak with a representative who can explain your benefits and coverage for SUD services. You can also reach a representative through Facebook, X, and Instagram between 8 a.m. and 5 p.m. EST Monday-Friday.

Our team can also help you through the process. When you contact AAC, our admissions navigators can instantly verify your insurance and help you explore your treatment options at AAC facilities.

Highmark Blue Shield Coverage for Co-Occurring Disorder Treatment

Many struggle with mental health conditions, like anxiety, depression, and post-traumatic stress disorder (PTSD), along with addiction.⁴ Mental health experts recommend treating all conditions simultaneously to promote long-term recovery.⁴ Highmark Blue Shield may cover co-occurring disorder treatment to some extent.

AAC facilities treat co-occurring disorders with a personalized, integrated approach. Our empathetic team uses evidence-based therapeutic interventions, including cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT), and specialized care to fit your personal needs. We’re ready to verify your insurance and help you embark on your recovery journey today.

Sources

Highmark Blue Shield. (2024). Our story.
Highmark Blue Shield. (2024). Treatment for substance use.
Healthcare.gov. (n.d.). Health benefits & coverage.
Substance Abuse and Mental Health Services Administration. (2015). Detoxification and substance abuse treatment.
National Institute on Drug Abuse. (2018, January). Principles of drug addiction treatment: A research-based guide (third edition).
Substance Abuse and Mental Health Services Administration. (2021). Clinical issues in intensive outpatient treatment for substance use disorders.
Substance Abuse and Mental Health Services Administration. (2006). TIP 47: Substance abuse: Clinical issues in intensive outpatient treatment.

Drug & Alcohol Rehab Covered by Highmark Blue Shield