Addiction Treatment Coverage
Highmark Covers Detox?
Are you wondering if Highmark covers detox and drug treatment services?
Highmark Health Insurance is a non-profit healthcare company and subsidiary of Blue Cross Blue Shield. Highmark is based in Pittsburgh, Pennsylvania, and it serves as one of the largest individual not-for-profit health insurers throughout the US while operating several for-profit subsidiaries itself. The company serves men, women and families throughout Delaware, Pennsylvania and West Virginia. According to the official Highmark website, “Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania. Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia plus Washington County. Highmark Blue Cross Blue Shield Delaware serves the state of Delaware. Each of these companies is an independent licensee of the Blue Cross Blue Shield Association. Blue Cross, Blue Shield and the Blue Cross and Blue Shield symbols are registered marks of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield companies.” At Guardian Recovery we work closely with major regional health insurance providers like Highmark in order to make our comprehensive detox services as accessible as possible to those in need. If you or your loved one is currently insured it is likely you plan at Highmark covers detox and addiction treatment services.
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Covered by Insurance?
It is Likely Highmark Covers Detox
Highmark Health Insurance takes a comprehensive approach to medical coverage, focusing on all essential health-related services – including medically monitored detox and inpatient addiction treatment. In 2020, Highmark announced in a press release that it intended to make effective substance abuse treatment more accessible. According to the press release, “Data analytics will help guide the health plan’s coordinated care approach by using the platform to identify at-risk members, support treatment enrollment, and manage care costs.” The press release also suggested that since Highmark began its initiative to make substance abuse treatment more accessible and to prevent new cases from occurring, opioid over-prescription from more than one in-network provider dropped by 15 percent, and naloxone prescriptions increased by over 100 percent. Additionally, it was determined that opioid prescription overdose deaths among Highmark members were less than half that of the national average, which is significant considering the states the beneficiary serves have some of the highest overdose rates throughout the country to begin with. Clearly, substance abuse treatment is a priority for Highmark Health Insurance. If you or your loved one is currently insured through this regional provider there is a good chance that some or all of our detox services are covered either partially or in full.
Medical Detox and Addiction Recovery
Medically monitored detox is a necessary first step on every journey of recovery. During medical detox, clients undergo a safe and pain-free drug or alcohol withdrawal in a closely monitored inpatient facility. They have around-the-clock access to medical care and supervision, and all withdrawal symptoms are treated accordingly the moment they develop. The fear that goes hand-in-hand with drug and alcohol withdrawal often prevents men and women from seeking the professional treatment they so desperately need. They are afraid of the severity of associated symptoms – they fear the seemingly inevitable physical and psychological discomfort, and simply avoid detox altogether as a result. The main function of medical detox centers like Guardian Recovery is to effectively treat these symptoms, making the withdrawal process as comfortable as possible.
We utilize a range of proven detox methods, including:
- Medication Assisted Treatment (MAT)
- Tapering
- Over-the-counter medications
- Holistic treatment methods (acupuncture, massage therapy and physical therapy)
- Intensive therapeutic intervention
Once a client has been physically stabilized it is essential that he or she continues on to the next appropriate level of clinical care in order to avoid relapse. While Highmark covers detox, they also ensure that clients have access to the other essential treatment phases.
Coverage Options Made Simple
Our standard continuum of clinical care includes:
- A short-term stay at an inpatient detox facility, which generally lasts for between three days and two full weeks, depending on the severity of the substance abuse disorder.
- A transition into an inpatient rehab center, which provides intensive therapeutic care in a safe and supportive environment. Inpatient treatment typically lasts for between 28 days and three full months, depending on the needs of the client.
- A continuation of treatment in a Partial Hospitalization (PHP) program, an Intensive Outpatient (IOP) program or an Outpatient (OP) program.
- A long-term aftercare program, which often consists of daily 12-step program involvement, a continuation of individual and family therapy and ongoing psychiatric services whenever necessary.
Guardian Recovery Programs Covered by Highmark Health Insurance
At Guardian Recovery we offer a comprehensive and highly individualized medical detox program, which includes the following services (which are covered either partially or in full by Highmark Health Insurance):
- Initial medical and clinical assessment – Upon admission to our detox program each client undergoes a detailed medical and clinical assessment, which helps our staff members determine which course of action is the most appropriate for each unique case. Several assessments are conducted throughout the remainder of the detox process, and treatment plans are adjusted accordingly.
- Medically monitored detox – Our medical detox program utilizes a range of evidence-based methodologies, including tapering, Medication Assisted Treatment (MAT), holistically-based treatment methods (like acupuncture and massage therapy), counseling services and psychiatric intervention.
- Addiction services – We offer numerous addiction services that clients are able to take advantage of if they feel physically up to doing so. These services include 12-step program involvement and education, relapse prevention training, life skills training, a thorough education on the Disease Model of Addiction and more.
- Case management services – Each client is assigned a case manager who walks him or her through the early recovery process, helping develop personalized detox and aftercare plans and serving as the main liaison between Guardian Recovery and the loved ones of the client.
- Individual and group therapy sessions – Individual therapy sessions take place one a week, and group therapy sessions take place on a daily basis and cover a variety of pertinent, recovery-related topics.
- Family therapy – At Guardian Recovery we believe that the family should be involved in every stage of the recovery process from start to finish.
- Individualized aftercare planning – Medical detox is only the first stage on every multi-phased continuum of clinical care. We help clients develop personalized aftercare plans that include a transition into inpatient treatment (or the next appropriate level of clinical care).
Questions About Insurance?
Find out exactly what your plan covers. We make insurance verification fast, easy, and private.
Getting Started on the Road to Recovery
Beginning your journey of comprehensive healing – or helping your loved one begin on his or her journey – is as simple as picking up the phone and calling us today. Many of our highly experienced staff members have either been through the early recovery process themselves or have helped a loved one navigate the process. This allows us a compassionate level of insight that generally cannot be found in any impersonal hospital setting or conventional state-run detox facility. We understand how stress-inducing the early recovery process might seem, and we are available to walk you and your loved one through every required step from start to finish. As soon as you make the decision to contact us we begin developing a viable plan of action, which includes setting a date and a time for intake and arranging reliable plans for transportation. We quickly work through potential coverage options, offering free, no obligation health insurance benefit checks to those who are currently insured through Highmark or any other regional or national provider. At Guardian Recovery we remain dedicated to making our individualized detox services as accessible as possible – we believe that effective clinical care should be readily available to those in need. For more information about our integrated program of drug and alcohol detox or to get started contact us today, we are available to help you 24/7.
