UnitedHealthcare Insurance Coverage for Rehab

If you are searching for an alcohol and drug rehab center, you may be concerned about the cost. However, the good news is that many substance abuse treatment programs are covered by UnitedHealthcare insurance.

There is a law in the United States called “The Affordable Care Act (ACA),” which has made health insurance available to people who may not have had the opportunity to get it before. Some of the services covered by the ACA include drug screening and addiction treatment.

To learn more about UnitedHealthcare (UHC) Insurance, or if you are curious about the types of treatment covered by your insurance, the types of addiction that can be treated, or how to find treatment facilities covered by your insurance, keep reading below!

The Mental Health Parity and Addiction Equity Act of 2008 requires insurance companies to provide the same amount of coverage for mental health treatment as they would for another type of medical treatment.

This means that, yes, UnitedHealthcare insurance does cover drug rehab due to the fact that substance use disorders fall under the mental health category. The amount of coverage you will receive for treatment will depend on the type of plan you have signed up for.

If you or a loved one are interested in seeking treatment for drug or alcohol addiction, it is helpful first to know what types of treatment will be covered by your insurance provider.

When it comes to treating substance abuse, there are several evidence-based treatment programs available, including inpatient and outpatient programs. The following treatment services are at least partially covered by UnitedHealthcare insurance.

The first step in any treatment program is medical detoxification. This is the period of time when your body gets rid of the substance, and it can be debilitating without the assistance of medicine.

Most of the insurance plans at UnitedHealthcare will cover at least a partial amount of the total cost of treatment, especially if a medical practitioner has deemed it necessary. In emergency situations, such as at a hospital, medical detox will be at least partially covered.

Medication-assisted treatment (MAT) is a very beneficial and effective part of substance use disorder treatment. These medications help lessen feelings of withdrawal and cravings and are a part of many addiction treatment plans.

The following medications are commonly used in medication-assisted treatment and are covered, at least in part, by UnitedHealthcare:

• Acamprosate
• Bunavail/Zubsolv (buprenorphine/naloxone)
• Disulfiram
• Methadone
• Suboxone (buprenorphine)
• Vivitrol (naltrexone)

Most of the UnitedHealthcare insurance plans will cover at least a portion of MAT treatment. However, they usually require prior authorization before releasing the funds.

Inpatient rehab, also known as residential treatment, is for patients who need frequent assistance and a higher level of care than they would get in an outpatient program. It can be in the form of short-term and long-term treatment options.

Inpatient treatment involves frequent monitoring by a medical professional, individual and group therapy, and other evidence-based treatments.

Most, if not all, of UnitedHealthcare policies, cover some portion of inpatient treatment.

Below is the general plan coverage information for two different policies at UHC:

1. UnitedHealthcare PPO: With this type of insurance plan, you may receive up to 50% coverage of inpatient treatment services. This amount of coverage usually depends on being pre-authorized; without prior authorization, you may be required to pay an out-of-pocket expense. This could be between 20-100% of the cost of inpatient treatment, depending on your specific copay.
2. UnitedHealthcare HMO: This insurance plan usually insists on a higher copay for inpatient treatment and a physician’s fee of 10-30% on top of the copay. You also will likely not receive coverage for out-of-network inpatient care.

Dual diagnosis treatment is an integral part of substance abuse treatment. Most people who have an alcohol and drug addiction also have underlying mental health issues called co-occurring disorders.

Treating any mental illnesses will assist in long-term recovery from addiction. There are also instances of patients developing situational anxiety, for instance, in treatment. UnitedHealthcare plans typically cover medications prescribed during the course of addiction treatment.

For those who have graduated from inpatient programs or who do not require a higher level of care for their addiction treatment, outpatient treatment programs are an ideal option.

Outpatient programs work in a step-down method, with the level of care lessening with each program. These programs include partial hospitalization programs (PHP), intensive outpatient programs (IOP), and general outpatient programs.

Most UnitedHealthcare plans offer partial to full coverage for outpatient programs. Outpatient services usually require copayments each time you go rather than a total lump sum at the beginning of treatment.

Here is a breakdown of outpatient coverage guidelines with common UHC plans:

• UnitedHealthcare PPO: Insurance plans may require you to pay a $10-$45 copay for outpatient treatment. However, you may not be required to pay copay or coinsurance payments with some plans. Out-of-network providers may be covered by up to 50%, but without prior authorization, in some cases, you may be penalized.
• UnitedHealthcare HMO: Some of these insurance plans may cover the cost of outpatient treatment entirely. However, most plans will require a copay of $15-$50 per treatment session. Generally, out-of-network treatment providers are not covered by most UnitedHealth HMO plans.

Behavioral health and counseling are very integral parts of drug and alcohol treatment. Both inpatient and outpatient treatment programs use some form of behavioral therapy and counseling as a way to achieve long-lasting sobriety.

Some of the most common forms of therapy include:

• Cognitive behavioral therapy (CBT)
• Dialectical behavior therapy (DBT)
• Motivational Interviewing (MI)
• Group therapy
• Family therapy
• Individual therapy

Most UnitedHealthcare plans will provide partial to full coverage of behavioral therapy and counseling needed for treatment.

Many people who have successfully completed inpatient and outpatient treatment programs do not feel ready to re-enter the same situations they were in before they went to treatment. An essential option in addiction treatment is sober living.

These programs assist people in reintegrating back into their lives outside of treatment. Many UnitedHealthcare plans offer partial to full coverage for sober living and continuing care programs.

UnitedHealthcare offers a wide variety of different insurance benefit plans. These plans cover numerous types of health services at varying coverage amounts. The good news is this means that there is bound to be a plan that fits your specific needs.

When choosing an insurance benefit plan, you should know that there are different factors that will contribute to your insurance coverage.

Factors that can affect your UnitedHealthcare insurance coverage for drug and alcohol rehab:

• Your diagnosis
• The type of medical treatment your will need
• Your plan’s specific copays and deductibles
• Specialist referral requirements
• Your type of treatment provider
• Your insurance benefits

Yes, there are some UnitedHealthcare insurance policies that do cover out-of-network rehab programs. However, they are generally required to have prior authorization before they issue coverage.

In-network means that the doctors and treatment centers work directly with UnitedHealthcare and have agreed to specific rates for UHC clients. This is usually a much cheaper option for people due to the fact that out-of-network programs may require you to pay a lot more.

If you or someone you love are interested in UnitedHealthcare Insurance plans, you have multiple options. Each plan offers a different amount of coverage and out-of-network specifications.

UnitedHealthcare offers:

• Individual insurance plans in 18 states
• Employer-based coverage
• Medicare
• Medicaid
• Short-term health insurance
• Supplemental insurance, including vision, dental, and critical illness insurance

There are currently two distinct types of UnitedHealthcare plans available on the health insurance marketplace:

• Health Maintenance Organization (HMO) — Patients with an HMO plan are typically only covered for in-network treatment. In most cases, you will need a referral for a specialist.
• Exclusive Provider Organization (EPO) — Patients with an EPO plan are only covered if they use physicians, specialists, and hospitals within the plan’s network. No out-of-network coverage is provided. Typically no referral is needed to see a specialist.

It is important to know that different states have different laws regarding insurance coverage and policies. If you have questions about your state’s specific insurance laws, contact a UnitedHealthcare representative today.

If you or a loved one are searching for treatment options for a drug or alcohol addiction, you may be curious about what types of addiction your health insurance plan will cover. Substance use disorders fall under the mental health category; therefore, many addictions are covered.

The following are some of the addictions covered by UnitedHealthcare:

• Alcohol
• Opioids
• Marijuana
• Methamphetamines
• Cocaine
• Prescription drugs
• Heroin
• Benzodiazepines

If you have questions regarding your health insurance provider’s addiction coverage, contact us today! Our addiction specialist would be happy to assist you with any questions.

Generally, finding alcohol and drug addiction centers that accept UnitedHealthcare can be a significant factor in determining which rehab facility you will attend. There are ways that you can determine which facilities will accept your insurance.

The first way is by taking your insurance card and flipping it to the back, and finding the number. This number connects you with a representative who can help you find a treatment facility near you that accepts UnitedHealthcare insurance.

The second option when looking for a treatment facility with UnitedHealthcare treatment coverage is logging onto your member account online. You will find an option for locating an in-network alcohol and drug abuse treatment center.

Disclaimer: Because some of UnitedHealthcare’s plans require prior authorization and referrals to see a specialist and attend a drug and alcohol treatment facility, you may want to contact your insurance representative before looking for a treatment program.

If you or a loved one have a substance use disorder and are trying to find a drug and alcohol rehab treatment, you may be searching for one with rehab coverage offered by your UnitedHealthcare insurance provider.

When you are ready to begin your recovery journey, there is help available. Call our helpline number to speak with our addiction treatment experts, who can walk you through your insurance policy and coverage today.