Harvard Pilgrim for Medical Detox

Looking for a detox that accepts Harvard Pilgrim? There’s outpatient and inpatient options. The PPO HSA 5000 Flex plan does cover in-network outpatient treatment including outpatient detoxification and medication management. The plan pays nothing until you reach your deductible, but then it covers everything except a $75 copayment per visit. You pay 20% after your deductible for out-of-network care. Solution Based Treatment offers alcohol detox, heroin detox and benzodiazepine detox programs as well as others that may be covered by Harvard Pilgrim.

Harvard Pilgrim Coverage for Residential Treatment

Harvard Pilgrim does cover inpatient, residential treatment, but you will need to get prior approval for substance use disorder coverage. You can call 1-800-708-4414. On this example plan, inpatient care is provided at a rate of $1,500 per admission after your deductible. You pay 20% after your deductible for out-of-network care.

Harvard Pilgrim Coverage for Outpatient Treatment

Intensive Outpatient Programs (IOP)

Intensive Outpatient Programs are covered following your deductible. You’ll pay $75 per visit as well as $10 for group therapy. However, if you’re going through outpatient methadone maintenance, you’ll pay nothing after your deductible. You pay 20% after the deductible for out-of-network care.

Partial Hospitalization Programs (PHP)

For partial hospitalization programs (PHP), there are no specific mentions in the schedule of benefits. However, inpatient and outpatient treatments are covered. You will need to meet your deductible first. Then, you’ll pay $1,500 per admission for inpatient care or $75 per visit for outpatient care. You pay 20% after the deductible for out-of-network care.

Outpatient Treatment

On this example plan, outpatient group therapy is covered (other than a $10 per visit copay) after you meet your deductible. After meeting your deductible, there is a $75 copayment for all individual therapy, outpatient detox, and medication management. You pay nothing for outpatient methadone maintenance after meeting the deductible.

Harvard Pilgrim Rehab Coverage FAQs

Does Harvard Pilgrim insurance cover drug and alcohol rehab?

Yes. Harvard Pilgrim has coverage options for both inpatient and outpatient substance use treatment. The exact coverage will depend on your plan. 

How can I verify my Harvard Pilgrim insurance benefits?

To verify your Harvard Pilgrim insurance benefits, log into your Harvard Pilgrim account. You can also contact Member Services at (888) 333-4742.

Does Harvard Pilgrim cover outpatient addiction treatment?

Yes, Harvard Pilgrim’s PPO plans will cover outpatient addiction treatment in California. However, it’s important to verify your coverage since all plans are different.

Does Harvard Pilgrim cover inpatient mental health?

Yes. Harvard Pilgrim has insurance plans that cover inpatient mental health care. The cost you’ll pay will depend on if you’re in- or out-of-network and the plan you’ve purchased. Only PPO plans offer nationwide coverage. 

Do treatment centers need to be in-network?

No. With Harvard Pilgrim’s PPO plans, you can see an in- or out-of-network provider. However, how much you pay will change based on your plan. If you choose to go out-of-network, you may pay more in some cases. 

How much does Harvard Pilgrim insurance cover?

The exact amount covered by your Harvard Pilgrim insurance will depend on your plan. Normally, PPO coverage pays nothing until you meet your deductible, and then you pay a co-pay until you reach your out-of-pocket maximum. 

How do I pay for costs not covered by Harvard Pilgrim insurance?

To pay for costs not covered by Harvard Pilgrim insurance, you can use your health savings account, a credit card, a bank account, cash, or check.

How is a Harvard Pilgrim HMO different from a PPO?

As you look for a rehab program that takes Harvard Pilgrim, remember that an HMO is going to require you to see in-network providers. Rehab program Harvard Pilgrim insurance PPO plans cover both in-network and out-of-network care, but the exact amount covered depends on the plan. 

Can you get a single case agreement with Harvard Pilgrim?

Since Harvard Pilgrim’s PPO plan allows you to see out-of-network providers, you should not need a single case agreement. However, if you need to reach out to the company to discuss your options for maintaining care with your current provider, you can reach out to Solution Based Treatment at (833) 999-1941 to verify benefits Member Services at (888) 333-4742 for the correct forms. 

*Solution Based Treatment offers inpatient treatment for substance abuse and mental health disorders for clients all over the U.S. We also offer outpatient and day treatment programs to residents in these cities:

• Temecula, CA
• Murrieta, CA
• Menifee, CA
• Wildomar, CA
• French Valley, CA
• Lake Elsinore, CA
• Canyon Lake, CA
• French Valley, CA
• Corona, CA
• Vista, CA
• Escondido, CA
• San Marcos, CA
• Fallbrook, CA