Addiction Treatment
Highmark Health Insurance
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Pine Tree Recovery Center is a world-class, substance-specific, medical detox center located in Portland, Maine. As a premier detox facility on the front lines of the opioid crisis, it’s our mission to help members of the Portland community heal physically, emotionally and spiritually. This includes ensuring that anyone who wishes to use insurance to participate in treatment with us can do so. After reviewing the frequently asked questions about your Highmark Health plan below, call us at any time for more information, or to begin the admissions and assessment process.
Have Insurance Coverage with
Highmark Health ?
coverage and take the first step toward recovery.
Does Pine Tree Recovery Center Accept Highmark Health Insurance?
Yes. Although the limits of each individual’s coverage will vary, thanks to the federal Mental Health Parity and Addiction Equity Act of 2008, no individual health insurance plan that provides mental health or substance abuse coverage can place benefit limits on that coverage that are less favorable than limits for medical or surgical benefits. In addition, substance abuse treatment is considered an Essential Health Benefit, meaning that Highmark is to treat your addiction not as a choice, but as a disease worthy of medical treatment on par with any other ailment you may face.
Highmark insures over 4.5 million Americans through its BlueCard program. Members of this program have access to the Blue Cross Blue Shield network of care providers. Your Highmark insurance may include Highmark Behavioral Health coverage, which provides confidential support for a wide range of mental health and substance abuse concerns. The Highmark Behavioral Health benefit covers both substance abuse treatment and counseling for a wide variety of co-occurring disorders including depression, anxiety and stress. Alcohol abuse and drug abuse treatment services are covered, as is medication management.
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.
Coverage Options Made Simple
Typically, bronze level health insurance plans meet the Affordable Care Act’s Minimum Value Standard of 60% coverage with a high deductible, meaning the patient is responsible for covering the cost of the deductible before health insurance coverage kicks in. At the opposite end of the spectrum, Platinum plans normally cover up to 90% of medical costs, often with no deductible. Monthly premiums, however, are much higher for platinum level plans.
An additional benefit of the Affordable Care Act’s recent classification of addiction as a disease is that it is no longer appropriate for health insurance providers to put lifetime dollar limits on substance abuse treatment. This ensures that your Highmark insurance plan is there for you regardless of past treatment for substance abuse and will cover any pre-existing conditions.
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.
How Can I Find Out if My Individualized Treatment Plan is Covered?
Your Highmark policy may cover some or all of the costs associated with detoxification treatment and related medications, as well as some or all of the cost of therapeutic services as an inpatient or outpatient client. These services may include group and personal therapy, family therapy, and other aftercare programs. The Highmark Behavioral Health Network includes certified professionals such as counselors, social workers, psychiatrists and psychologists.
Each Highmark plan varies based on several factors. Your plan may be employer-based, an individual plan from the Health Insurance Marketplace, or tied to Medicare or Medicaid. If your plan is an HMO, your benefits may be maximized when you use an in-network provider. Your plan may cover not only the cost of a medically necessary detox, but ongoing therapy or aftercare services as well.
Regardless of the details of your particular Highmark plan, rest assured that Pine Tree Recovery Center will work closely with you to verify your benefits. We believe in the efficacy of our services and will fight to ensure that anyone who wishes to use insurance to participate in treatment with us can do so.
Questions About Insurance?
Find out exactly what your plan covers. We make insurance verification fast, easy, and private.
I Have Highmark Health Insurance, How Should I Begin?
Contact a Pine Tree Treatment Advisor today to help ease your concerns and understand your insurance benefits. Contact us 24 hours a day, 7 days a week at (888) 693-1751 to answer questions about your policy and your coverage. All phone calls are completely confidential.
Entering detox is a time of promise and hope, but it can also be a time of stress and uncertainty. Wondering how you’re going to afford your treatment can add to your worries – allow a Pine Tree Treatment Advisor to ease your concerns.
