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Harvard Pilgrim Behavioral Health


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If you need treatment for substance abuse, addiction, mental health issues, or all of the above, you may be able to get the help you need at little to no cost to you thanks to your Harvard Pilgrim behavioral health insurance plan.

Casco Bay Recovery is proud to work as an in-network provider with Harvard Pilgrim. This means that with your Harvard Pilgrim Health Care plan you will have access to all of our services and treatment options including:

  • Outpatient Treatment
  • Intensive Outpatient Treatment
  • Partial Hospitalization
  • Dual Diagnosis Treatment
  • Medication-Assisted Treatment
  • Sober Living
  • Aftercare Programs
  • Therapy

Keep reading to learn more about your Harvard Pilgrim insurance plan regarding addiction and mental health treatment.

What Is Harvard Pilgrim Insurance and How Does It Work?

harvard pilgrim behavioral health

For over 50 years, Harvard Pilgrim and its family of companies have been providing health benefits to more than 3 million people in and around New England. As is the case with many private insurance companies, most Harvard Pilgrim Insurance plans cover some form of addiction and mental health treatment.

If you have an insurance plan with Harvard Pilgrim though, you will likely need pre-authorization from the insurance company before beginning treatment. Pre-authorization means that your insurance representatives will determine if they feel that treatment is medically necessary before signing off on any sort of insurance coverage.

If you receive pre-authorization, the amount of your treatment that the insurance company will cover will be determined based on the plan that you have. If you have not met your deductible yet for the year, you will likely be expected to pay the balance of your deductible out of pocket. Once you have met the deductible, you still might incur additional out-of-pocket expenses based on what your insurance premium covers as well as any co-pays you may be responsible for.

What Substances of Abuse Does Harvard Pilgrim Cover?

harvard pilgrim insurancePeople suffer from addiction and mental health issues differently. Even if they have the same or similar conditions, what might work for one person might not necessarily work for another person. That’s why Harvard Pilgrim offers addiction treatment for a wide variety of substances of abuse.

Some of the substances of abuse and mental health conditions that we treat at Casco Bay Recovery that may be covered by your Harvard Pilgrim insurance plan include:

Based on your Harvard Pilgrim plan, your addiction treatment might be covered with little out-of-pocket expenses required. If you are unsure about what is and isn’t covered with your Harvard Pilgrim plan you can reach out to your insurance representative, or you can even reach out to us at Casco Bay. We will look over your insurance policy and see what it does and does not cover. Then, we will go over your policy with you before starting treatment and let you know of any out-of-pocket expenses that you might be responsible for.

What Addiction Treatment Services Does Harvard Pilgrim Cover?

When the time comes to get help for your substance abuse or addiction, there are many different treatment options available to fit you and your needs. Based on your Harvard Pilgrim insurance plan, your treatment may be covered either in full or with very little out-of-pocket expenses on your end.

The first step in the overall recovery process is detox. Detoxing is done to rid the body of all the harmful substances in it so that the body and the brain can begin to heal.

Due to the nature of detoxing and its symptoms, detoxing should be done under the care and supervision of trained medical professionals. Detoxing can be done at a local medical facility, a dedicated detox center, or a treatment center that also offers detox services. Attempting to self-detox can be incredibly dangerous and can increase the chances of a relapse.

Once detox has been completed, the next step is to enter into a treatment program. One of the more highly recommended treatment programs is inpatient or residential treatment. With inpatient treatment, you live at the facility for the duration of treatment. This allows you to go through treatment in a very structured setting where you go to your counseling and therapy sessions and avoid any and all temptations. Inpatient treatment also typically provides access to services that other treatment options don’t, including access to medical care and services.

For those who are looking for another treatment option that doesn’t involve living at the facility, outpatient treatment program is likely the best option for them. Some people are unwilling or unable to commit to attending inpatient treatment. There are also unique situations where a person’s addiction is not deemed severe enough to warrant inpatient treatment. No matter what the reason, for those who are looking for an alternative to inpatient treatment, outpatient treatment may be the option for them.

If you choose the outpatient treatment route, you still attend the same therapy and counseling sessions that those who are in inpatient treatment do. The main difference is that you come to the facility for your treatment and then return home at the end of the day. For those attending outpatient treatment, it is important to have a safe and supportive home environment to return to each day to limit the temptations of relapse.

Not everyone that needs treatment falls into the outpatient or inpatient categories. There are those who might be suffering from a mental health issue or even those who suffer from a mental health issue AND a substance abuse issue, also known as a co-occurring disorder. For those people, a partial hospitalization program might be best for them.

Partial hospitalization provides more access to medical care and treatment but still allows the person to go home at the end of the day. It’s a middle ground between inpatient and outpatient treatment.

Outpatient and partial hospitalization treatment is also a much more affordable treatment option as well since it does not require housing. As a result, many insurance providers are more likely to cover a greater amount of outpatient and partial hospitalization treatment.

If you are considering one of the Casco Bay outpatient treatment programs and are curious to know how much of it will be covered by your Harvard Pilgrim insurance plan, you can reach out to your insurance representative or you can visit our insurance verification page. We will quickly verify your insurance and take a look at what is and isn’t covered. Should you incur any out-of-pocket expenses, we will let you know before you start treatment.

Does Harvard Pilgrim Cover Mental Health Services As Well?

Under the Affordable Care Act (ACT), Harvard Pilgrim, like all health insurance companies are required to provide coverage for not just substance abuse and addiction, but mental health disorders as well.

At Casco Bay, we also offer a wide variety of mental health and therapy services in addition to addiction treatment, all of which might be available to you at little to no out-of-pocket expense.

Some of these treatments and therapies include:

Is Harvard Pilgrim Considered In-Network?

At Casco Bay Recovery, we are proud to work with Harvard Pilgrim Health Care as an in-network provider. What this means for you is that, as an in-network provider, we can offer our treatment services at little to no cost to you. Since Harvard Pilgrim is in-network, they will cover a greater chunk of your treatment, leaving you more time and energy to focus on getting the help that you need.

In fact, with many Harvard Pilgrim plans, all you will be responsible for is any deductible that you haven’t hit for the year yet and the copay.

Looking To Get the Help You Need With Your Harvard Pilgrim Behavioral Health Insurance Plan?

harvard pilgrim behavioral health insuranceRecognizing that it is time to get help for your substance abuse and mental health issues is a major decision that will affect the rest of your life. While there are many moving parts when it comes to starting addiction treatment, one of the things you should not have to worry about is how you are going to have to pay for treatment.

That’s why, at Casco Bay Recovery we will handle all the financials for you, allowing you more time and energy to focus on the important things, like getting clean and sober and starting your new sober life.

If you or a loved one is in need of treatment for substance abuse and mental health, we want to help. Contact us today to learn more about the treatment services we offer and to find out what will be covered under your Harvard Pilgrim insurance plan. Should you be responsible for any out-of-pocket expenses, we will let you know before you begin treatment.