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One of the most daunting aspects of beginning treatment for substance abuse is figuring out how you’re going to pay for it. But if you’ve got insurance through Harvard Pilgrim, you may not have to pay for it all out-of-pocket.

In this article, we’ll tell you everything you need to know about your Harvard Pilgrim insurance plan and substance abuse treatment. Keep reading to learn more.

What is Harvard Pilgrim?

Harvard Pilgrim is an insurance company that’s based out of Massachusetts. It’s the insurance provider for more than 3 million Americans spread throughout New England and the rest of the country.

The company offers a wide variety of HMOs, PPOs, and POS plans for its members to choose from.

Does Harvard Pilgrim cover rehab?

Most plans from Harvard Pilgrim include coverage for both substance abuse treatment and mental health care associated with it. That means you could have coverage for treatment plans like:

  • Inpatient rehab
  • Outpatient care
  • Co-occurring disorders
  • Partial hospitalization and intensive outpatient programs
  • Medication-assisted treatment (MAT)
  • And more

That being said, the specifics of this coverage can vary quite a bit from plan to plan. So your out-of-pocket costs for each type of treatment could be high or low depending on the type of plan that you have.

How does my Harvard Pilgrim coverage work for substance abuse treatment?

When you use insurance to pay for substance abuse treatment, you usually need to get something called pre-authorization. This essentially just means contacting your insurance company and getting their approval for the facility and treatment that you want.

You need to have pre-authorization in order to get coverage. In other words, you can’t just start pursuing treatment at a facility and expect Harvard Pilgrim to cover the bill afterward. They may still end up doing that. But there’s no guarantee if you don’t get pre-authorization first.

Can I go out of network with Harvard Pilgrim?

Most insurance plans give you a list of pre-approved doctors and treatment centers that they describe as being “in-network”. But the treatment center that you want to go to may not end up being on this pre-approved list.

You can still go to an out-of-network provider. But your coverage level typically won’t be as high if you do. That means you will almost definitely end up having to pay higher out-of-pocket costs for choosing a provider who isn’t in Harvard Pilgrim’s network.

That may end up being worth it to you. But you should check the language of your plan to see how much more you’re going to have to pay out of pocket before you decide to do this.

How to learn more about your Harvard Pilgrim coverage

Harvard Pilgrim’s coverage for substance abuse treatment is highly dependent on the specific plan that you have. That’s why it’s important to reach out to the company before you pursue treatment. They can let you know the general percentages that you should expect to pay.

That being said, you won’t be able to get a dollar amount from Harvard Pilgrim until you pick a specific treatment center and plan. That’s why your next step should be to reach out to a facility like The House of the Rising Son.

We can verify your insurance plan from Harvard Pilgrim for you so that you know exactly how much you’re going to have to pay out-of-pocket for your substance abuse treatment. Our addiction specialists can even recommend a plan that fits into your budget.

Ready to get started? You can do so by reaching out to The House of the Rising Son today.