Services received through your Highmark Behavioral Health benefit may require pre-authorization, a co-payment and/or co-insurance, and may be subject to a deductible. If your Highmark Healthcare plan is a Health Maintenance Organization plan (HMO), such as Direct Blue HMO, a referral may be necessary. Pine Tree recovery can assist you with the referrals you may need.
The quickest and easiest way to find out how your particular plan may ease the financial burden of your recovery, is to call a Pine Tree Treatment Advisor at (888) 693-1751. We’re here for you 24 hours a day, 7 days a week.
Will Highmark Health Insurance Cover the Entirety of My Treatment?
The limits of your coverage are affected by several factors, including a past history of treatment for substance abuse; the details of your comprehensive, individualized treatment plan; and your policy’s deductible and co-pay requirements. Highmark offers a wide range of both HMO and PPO health insurance plans. Depending on your specific policy, substance abuse recovery services may require pre-authorization. You may also be required to provide documentation that includes referrals from your primary care provider, and/or your history of past substance abuse treatment and mental health care.
No one should ever undergo detoxification outside of the supervision of a health professional, and your Highmark plan understands that. Recent laws have required health insurance plans in many states to reduce pre-authorization requirements in order to quicken access to medically necessary care. Highmark may cover a greater percentage of the cost of a medically necessary detox, regardless of the coverage limits of your individual plan.