Harvard Pilgrim Detox & Rehab Benefits Guide - Withdrawal

Harvard Pilgrim Detox & Rehab Benefits Guide

Harvard Pilgrim is a major insurance provider in the U.S which can be utilized to attend detox & rehab. Learn how to use your Harvard Pilgrim plan here.


Takeaways from this article:

  • american addiction centers photo

    Harvard Pilgrim detox & rehab coverage details.

  • american addiction centers photo

    How to check your Harvard Pilgrim rehab benefits.

  • american addiction centers photo

    Finding rehabs near me that accept Harvard Pilgrim.


If you are a resident of Massachusetts, New Hampshire, or Maine, you may have Harvard Pilgrim insurance, and you can be assured that the company offers coverage for rehab and many other medical and behavioral healthcare services.

If you are thinking about getting treatment for addiction and substance abuse, you probably have many questions running through your mind. Does health insurance cover detox? Do I have insurance coverage for rehab? What does drug rehab insurance cost?

This page will help answer some of these questions and explain how Harvard Pilgrim can help with the cost of your detox and rehab treatment for alcohol and drug addiction.

Does Harvard Pilgrim Cover Detox?

For many people struggling with addiction, detoxification (detox) is the first step of their recovery journey. This is because detox—the process by which the body eliminates substances—can help you safely withdrawal from the effects of drug and alcohol use. Factors that determine whether detox is an appropriate first step for you may include the type of substance you use, how long you have been using, the amount you have been using, your physiology, and any underlying health concerns you may have.

The detox process can be uncomfortable and risky for many people. If detox is your first step, be sure to check with both your insurance provider and the treatment facility to ensure that you’re covered for the services you’re likely to need, such as medications, room and board, and addiction specialist interventions.

Harvard Pilgrim offers a comprehensive network of mental health and substance abuse treatment options, so your drug rehab insurance coverage will most likely cover these detox services, whether on an inpatient or outpatient basis. Your plan will also cover psychotherapy and counseling as part of your Core Benefits. 2 You may be reassured to know that your dependents and loved ones may be covered by Harvard Pilgrim rehab insurance as well.

While detox may be your first step toward sobriety, it is certainly not the last. Many other types of treatments and services—including inpatient and outpatient treatment, sober living facilities, and support groups—are available to help you take charge of your addiction. Your substance abuse treatment plan will be tailored to you based on your history, your needs, and yes, your insurance coverage.

Addiction treatment services are very expensive. You’ll want to know how to maximize your coverage and reduce out-of-pocket costs through every step of the process. Again, be sure to verify the specifics of your Harvard Pilgrim drug rehab coverage plan with both the treatment center and your provider. This is especially important if you’re seeking out-of-state treatment.

Types of Harvard Pilgrim plans

Understanding your insurance plan and coverage options is an important part of your journey to sobriety. Harvard Pilgrim Health Care, a private, non-profit insurance company serving more than 3 million members in and around the New England area,1 offers a variety of plans including group, individual, and Medicare options.

What does Harvard Pilgrim cover? It depends on your plan and where you live. All plans offer core benefits that may be related to treatment for addiction. Your plan may cover ambulatory and emergency room visits, hospitalization, mental health and substance abuse services, rehabilitation, labs, prescriptions, and other healthcare services. Coverage will vary from state to state.2

HMOs and PPOs

Harvard Pilgrim offers a variety of health maintenance organization (HMO) and preferred provider organization (PPO) options for you to choose from. Options may vary from state to state. However, there are some basic differences between an HMO and a PPO.

With an HMO, you pay less for your monthly premiums. Your provider must be in-network, and you will most likely need a referral to see a specialist. With a PPO, you can expect to pay more for your premiums. However, you can see any provider you would like; they don’t have to be in-network, and you’ll most likely not need a referral to see a specialist. If you are unsure of whether an HMO or PPO plan is right for you, contact Harvard Pilgrim. They can help you determine the best option for you and your family.

Medicare

Medicare coverage may also assist with the cost of substance abuse treatment services. Medicare is a federally funded insurance program for people who are age 65 and older and for certain adults with disabilities. Harvard Pilgrim has 3 different Medicare plans that you can choose from: Medicare Advantage Stride, which is an HMO; Medicare Supplement; and Medicare Enhance. Medicare Advantage Stride and Medicare Supplement are available in Massachusetts, New Hampshire, and Maine. Medicare Enhance, available through your employer, is offered throughout the United States. To learn more about Harvard Pilgrim’s Medicare options, you can visit their website.

Harvard Pilgrim at American Addiction Centers

 With a nationwide presence, American Addiction Centers (AAC) has developed relationships with many different insurance providers, including Harvard Pilgrim. AAC is constantly working to understand the mechanics of addiction to help make treatment and recovery a success. Exceedingly high medical standards are in place for both their rehab facilities and detox facilities. AAC has received accreditations from The Joint Commission to the National Association for Behavioral Healthcare and many others.

It is normal to have questions about the process of getting into a detox or treatment facility. You may be wondering how to get into detox without insurance. You may even have questions about your Harvard Pilgrim detox coverage. AAC’s caring, compassionate, and knowledgeable specialists are available 24/7 to answer all of your questions about substance abuse treatment and insurance coverage. Most of our admissions navigators have experience with addiction themselves so they understand how difficult it can be to reach out for help.

AAC understands that quitting your addiction is one of the hardest and most important things you can do for yourself. If you or a loved one is struggling with addiction, call the helpline at 1-888-935-1318. You can be sure that your call will remain 100% confidential and that you will be received with compassion and respect.

Check Your Harvard Pilgrim Benefits

 Harvard Pilgrim has made it easy to verify your coverage for substance abuse treatment by logging on to their member page. You can also call their member services representatives at (888) 888-4742. They can answer any questions you may have and help you understand what substance abuse treatment services are covered under your plan.

You can also see if your plan is accepted at any American Addiction Centers location using the form below.

1.Harvard Pilgrim Health Care. (2020). About us.

2.Harvard Pilgrim Health Care. (2020). Plans to keep you and your family healthy.