Expert Insights
When I lived in Pennsylvania, I remember seeing memorials pop up all throughout my town and the towns I traveled to, with pictures and candles for people who never made it to 30. And witnessing Kensington Avenue in real life, it is a soul crushing experience.
You’d even hear about a car accident and find out later it had been someone who had nodded off from heroin or pills. It just continues to hammer home how addiction doesn’t care where you live or how you grew up.
Pennsylvania has started expanding harm reduction efforts, like increasing access to naloxone and offering syringe exchange programs.
According to the PA General Assembly, Pennsylvania lost one person to a drug overdose every two hours in 2023, with many of these drug overdoses coming from substances laced with fentanyl. From what I witnessed, it’s clear that saving lives has to come first.
~ Alizabeth Swain
How Much Does Drug Rehab Cost in Pennsylvania?
Pennsylvania is ranked 26th nationwide in terms of addiction treatment affordability, with an average cost of drug and alcohol rehab of $56,708 (without insurance).
- Medical detox is the most expensive, with an average cost of $139,806
- Long-term inpatient drug rehab in Pennsylvania costs an average of $50,041
- Outpatient addiction treatment in Pennsylvania costs an average of $8,315
- Outpatient methadone treatment is the most affordable, with an average cost of $7,388
Keep in mind these costs are averages for all types of addiction treatment, including medically supervised detox and residential inpatient rehab, both of which drive up the average. These numbers also reflect the full cost of drug rehab without any insurance coverage. Most individuals can expect to pay far less than these prices for more typical outpatient drug treatment, MAT, and addiction therapy.
Cost of Drug Rehab in Pennsylvania Compared to Nearby States
Here is how much addiction treatment costs in Pennsylvania vs nearby states like New York, Ohio, and New Jersey.
How to Pay for Drug Rehab in Pennsylvania
As of 2024, there were over 640 drug rehab facilities across the state of Pennsylvania. These facilities accept several payment methods. Of those treatment facilities, the following numbers reflect how many accept their respective payment methods:
555 accept self-payment or cash
287 offer sliding-scale fees for those without insurance
513 accept Medicaid insurance coverage
313 accept state funded insurance coverage
453 accept private health insurance
213 offer free or low-cost treatment
5 offer free treatment for all clients
5 accept tribal funding
Private Pay and Insurance
There are many major commercial health insurance carriers in the state of Pennsylvania. As of 2024 there were 14 insurance companies offering plans on the Insurance Marketplace. Commercial insurance providers include:
Highmark Blue Cross Blue Shield
Highmark works with Bright Heart Health to provide members with alcohol and substance use disorders options for treatment. These include in-network individual and group therapy, Medication Assisted Treatment (MAT) and 24/7 virtual support options. Inpatient treatment may be included, participants need to check with Highmark to determine if this is a covered service and what the cost will be.
Cigna
Cigna of Pennsylvania offers members many choices when it comes to alcohol and substance use disorder treatment. After an evaluation and assessment by Cigna health professionals, they work with clients to determine which level of care is most appropriate and which treatment option is best to meet their individual needs.
These could include inpatient and outpatient hospitalization, inpatient and outpatient detox, Intensive Outpatient Programs, and individual and family therapy. The amount of out-of-pocket costs depend on the individual’s plan coverage. Participants will need to contact Cigna to find out what out-of-pocket costs will be.
Aetna
Aetna insurance of Pennsylvania covers many treatment options. They offer members virtual counseling with licensed clinicians through Elenorhealth.com, Medication Assisted Treatment( MAT), some inpatient rehabilitation and outpatient alcohol and substance use disorder counseling. Participants will need to check with their insurance provider for coverage information and out-of-pocket costs.
UPMC Health Plan
UPMC Health Plan of Pennsylvania covers a number of treatment options for those experiencing alcohol and substance use disorders. Additionally, they offer virtual counseling services for those with co-occuring mental health concerns such as anxiety and depression.
UPMC Health Plan is affiliated with the University of Pittsburgh Medical Center and offers their UPMC Western Behavioral Health Addiction Medicine Services which provides in-patient and out-patient options including medication assisted treatment and detox, intensive outpatient programs, substance abuse education and prevention, and case management.
United Health Care
For those with United Health Care, coverage differs from plan to plan. The company suggests you check your benefits summary to determine what services and at what cost are covered for Alcohol and Substance Abuse.
According to the Affordable Care Act, signed into law in 2010. Substance Use Disorders must be a covered benefit at the same parity of medical and surgical coverage for most insurance providers.
Medicaid
Medicaid in Pennsylvania, also referred to as Medical Assistance, is a government funded health insurance for those who financially qualify or meet other guidelines such as disability status and age. Alcohol and substance use disorder treatment is a covered benefit. Participants will have to check with their provider to find out what type of treatment plans are available under their benefits summary.
Medicare
Alcohol and Substance Use Disorder are covered under Medicare plans. These treatment plans could include inpatient and outpatient treatment, medication assisted treatment, and in person and virtual counseling services.
The type of Medicare a participant has will determine what services are covered as well as how much a person is expected to pay out of pocket. Moreover, participants are required to use in- network providers for their treatment plans.
Military Insurance
TRICARE and VA benefits are accepted at participating providers throughout the state of Pennsylvania . For those with alcohol and substance use disorders, the Veterans Administration offers inpatient and outpatient services at their clinics and hospitals at no cost.
Tribal Funding Programs
All individuals of Native American or Alaska Native descent are eligible for health care and Medicaid through the Indian Health Service (IHS). Alcohol and substance use disorder treatment are covered services.
Other Low Cost Treatment Options
For those individuals without commercial insurance, government sponsored insurance, or insurance through military service, some providers will accept sliding scale payment options, no fee for service, or financial aid. Clients will need to speak with service providers to find out what options are available to them.
Free Addiction Treatment Resources in Pennsylvania
Department of Health and Human Services
The Department of Health and Human Services in Pennsylvania provides free resources for those with alcohol and substance use disorders. Under the Office of Behavioral Health, individuals and families in Allegheny County can get connected to the help they need. They offer a 24/7 telephone help-line that provides callers with information on treatment services, education, crisis intervention and peer support.
Prevention Point
Through the non-profit organization, Prevention Point Pittsburgh and Prevention Point Philadelphia, residents in these metropolitan areas can obtain free services such as Narcan distribution and education for individuals and their families, emergency housing programs, alcohol and substance use disorder evaluation and treatment planning, and case management services using a harm reduction approach to help those in their recovery journey.
Medical services are also available for those with co-existing conditions such as Hepatitis and HIV/AIDS.
Dept. of Drug and Alcohol Programs (DDAP)
The state of Pennsylvania’s Department of Drug and Alcohol Programs is committed to providing PA residents with addiction and prevention education, support for those seeking alcohol and substance use disorder treatment programs and harm reduction services, such as Narcan distribution and training and needle buy back services.
Additionally, DDAP is a resource for individuals and families looking to find treatment options in their local area.
Savage Sisters
Savage Sisters is a non-profit 501(C) (3) organization in the Philadelphia area that offers free services for those with substance use disorders.
One is their recovery housing programs where they currently operate six houses in the Philadelphia area, offering men and women a safe and trauma-informed place to live during their recovery journey.
In addition, they offer community outreach programs where hot meals, clothing and bedding needs, and harm reduction items including Narcan, are distributed to high risk individuals in the community.
Addiction Recovery Mobile Outreach Team (ARMOT)
Addiction Recovery Mobile Outreach Team (ARMOT) provides case management and recovery support services to adults and adolescents with substance use disorders in Armstrong-Indiana-Clarion Counties in Pennsylvania.
Members of the Outreach team work with individuals experiencing crisis, their families, and hospital staff to determine the best treatment options for recovery.
They currently operate with cooperation from Armstrong Center for Medicine and Health, Clarion Hospital, and Indiana Regional Medical Center through a grant from the Federal Office of Rural Health Policy.
Pennsylvania Alcohol and Drug Use Statistics
In 2019, roughly 316,000 people in Pennsylvania were known to have a drug use disorder.
Approximately every 2 hours, someone in the state of Pennsylvania dies from a drug overdose.
Chronic alcohol consumption among Pennsylvania adults is at its highest rate since 2011.
On a single day in March 2019, 66,969 people in the state were enrolled in a treatment program.
In 2019, a total of 23,351 residents received methadone in an outpatient treatment program.
Drug Laws in Pennsylvania
PA Act 139 (David’s Law)
PA Act 139, also known as David’s Law, allows first responders such as law enforcement, firefighters and EMS to administer Narcan for drug-overdoses under the direction of a healthcare provider authorized to prescribe the reversal agent. Moreover, this law provides individuals responding to or reporting drug overdoses immunity from prosecution. This law also allows for family and friends that are in a position to assist someone with opioid use disorder and high risk for overdose, prescriptions for Narcan.
Marijuana Laws
While recreational pot use is illegal in the state of Pennsylvania, there are some circumstances and locations where punishment for possession of certain amounts has been decriminalized and face monetary fines, especially for first time offenders.
In 2016 Pennsylvania’s Medical Marijuana Act was signed into law and allows for individuals to obtain Medical Marijuana Cards from an authorized medical professional. These cards allow for the legal purchase of marijuana from authorized medical marijuana dispensaries in Pennsylvania.
In this case, individuals are permitted to purchase no more than 192 Medical Marijuana Units in a 90 day period. Use must be on private property and not within public view such as in one’s home or backyard. It is illegal for use around minors and in vehicles. Those who rent should consult their lease for guidelines on whether use of medical marijuana is permitted.
The Controlled Substance, Drug, Device and Cosmetic Act
Under the Controlled Substance, Drug, Device, and Cosmetic Act, a small amount of marijuana is considered possession of 30 grams of marijuana or less. Possession of this amount of marijuana is an ungraded misdemeanor with a potential penalty of up to 30 days in jail, a monetary fine or both.
Simple possession (more than 30 grams of marijuana) is an ungraded misdemeanor, and the penalty is more severe than Possession of a Small Amount of Marijuana. The statute also provides for increased penalties for repeat offenders:
Upon conviction for a first offense, an individual may be sentenced to imprisonment for up to one year and a fine not exceeding $5,000 or both.
Upon conviction for a second offense, a person may be sentenced to imprisonment for up to three years and fined up to $25,000 or both.
Under the Motor Vehicle Code, a person convicted of simple possession shall have their driver’s license suspended as follows:
- For a first offense, a period of six months from the date of the suspension
- For a second offense, a period of one year from the date of the suspension
- For a third and any subsequent offense thereafter, a period of two years from the date of the suspension.
Various Municipal Reforms Regarding Marijuana Possession
As far back as 2014, certain areas of Pennsylvania passed local laws and ordinances regarding decriminalization of possessing less than 30 grams of marijuana. These areas include: Philadelphia, Pittsburgh, Allentown, Harrisburg, State College, York, Erie, Bethlehem, Lancaster, Steelton, Delaware County, Carlisle, and Doylestown. Fines start at $25.00 for first offenses.
Resources
- Pennsylvania Office of Drug Surveillance and Misuse Prevention. (2022). Pennsylvania ODSMP – Drug Overdose Surveillance Interactive Data Report.
- Pennsylvania Department of Health. (2020). Alcohol Consumption, Pennsylvania Adults.
- Substance Abuse and Mental Health Services Administration. (2020). Behavioral Health Barometer: Pennsylvania, Volume 6: Indicators as measured through the 2019 National Survey on Drug Use and Health and the National Survey of Substance Abuse Treatment Services. U. S. Department of Health and Human Services (HHS) Publication No. SMA–20–Baro–19–PA. Rockville, MD.
- Mohamed, I. I., Ahmad, H. E. K., Hassaan, S. H., & Hassan, S. M. (2020). Assessment of anxiety and depression among substance use disorder patients: a case-control study. Middle East Current Psychiatry, 27(22).
- Vahratian, A., Blumberg, S. J., Terlizzi, E. P., & Schiller, J. S. (2021). Symptoms of Anxiety or Depressive Disorder and Use of Mental Health Care Among Adults During the COVID-19 Pandemic — United States, August 2020–February 2021. Morbidity and Mortality Weekly Report, 70(13), 490–494.
- National Center for PTSD. (2022). PTSD: National Center for PTSD, Substance Abuse. U. S. Department of Veterans Affairs.
- Center for Substance Abuse Treatment. (2020). Substance Use Disorder Treatment and Family Therapy. Treatment Improvement Protocol (TIP) Series, No. 39. Rockville (MD): Substance Abuse and Mental Health Services Administration (US).
