Will UnitedHealth Insurance Cover Drug Treatment Programs?
Does UnitedHealthcare Insurance Cover Drug Treatment?
Navigating the world of health insurance doesn’t have to be overwhelming. If you have UnitedHealthcare Insurance or are curious about UnitedHealthcare plans, you may be wondering whether UnitedHealthcare covers substance abuse treatment.
Deciding to enter a substance abuse treatment program can be one of the most important decisions of your life. It is important to understand your insurance coverage and the treatment options available to you based on your specific insurance plan. Rehabilitation centers can check and verify your coverage based on the information you provide them.
UnitedHealthcare is available in most states across the country. The specifics of your coverage depend on your state and your plan. To understand what services are covered under your UnitedHealthcare plan, call the number on the back of your insurance card.
What Will UnitedHealthcare Insurance Cover?
UnitedHealthcare (UHC) offers a number of plans for individuals, families, and employers as well as Medicaid and Medicare plans.1 Coverage is determined by factors including your budget, health status, current and future health needs, and location. If you have UnitedHealthcare and are looking for substance abuse treatment services, many of your treatment services may be covered.
Like many insurance providers, UnitedHealthcare covers some, if not most, of the costs associated with mental health and substance abuse treatment. Substance abuse rehabilitation can include services such as inpatient and residential treatment, outpatient therapy, intensive outpatient programs (IOPs), and partial hospitalization programs (PHPs). Each level of service varies in intensity, duration, and cost. Be sure to check with your insurance provider to determine how much of your substance abuse treatment services will be covered.
UnitedHealthcare’s Medicare Advantage Plan covers services such as medical detoxification in a substance abuse treatment facility—or in a hospital setting if medically necessary—as well as inpatient and outpatient rehabilitation (including individual and group therapy).2(page 1) There are no limits to the number of outpatient therapy sessions you receive; extended stay in a drug and alcohol rehabilitation program is also covered if medically necessary.2(page 2 and 3)
UHC Choice and Choice Plus plans allow you to select your in-network provider without a referral. However, there may be additional costs if you receive services that are outside of UnitedHealthcare’s network. Most preventative care services are completely covered under this plan.
Choice Advanced and Choice Plus Advanced have lower co-pays and greater co-insurance. You are still required to receive services in-network, although you don’t have to select a primary care physician with this plan. UHC also offers preferred-provider organization plans that may require referrals for services; some allow out-of-network services, although your out-of-pocket costs will be higher if you choose an out-of-network provider.
Does UnitedHealthcare Insurance Cover Mental Health Care and Co-occurring Disorders?
Under the Affordable Care Act (ACA), most insurance companies that offer individual and small company coverage are required to cover mental health and substance abuse services.2(1st paragraph) UnitedHealthcare mental health coverage is available in many of their plans. UnitedHealthcare understands the importance of mental health in your overall health and wellness. They also understand that many people who struggle with substance abuse disorders may also experience mental health disorders, so it is important to address both in treatment.
Functionality and quality of life are significantly impacted by mental health and substance abuse problems. The ACA ensures coverage for people who struggle with co-occurring disorders—that is, both mental health and substance abuse disorders. Treating these issues is as important as treating physical health disorders. In fact, in order for substance abuse treatment to be effective, mental health and addiction must be addressed simultaneously.
Failure to treat a mental health disorder can significantly impact your recovery journey. For example, many people use drugs and alcohol to self-medicate mental health disorders such as anxiety, depression, and post-traumatic stress disorder. Neglecting the underlying contributors to addiction may make you more vulnerable to relapse in the future.
How Long Does UnitedHealthcare Insurance Cover Rehab?
Many factors go into determining the type of substance abuse treatment interventions and rehab services you will receive, and for how long. The state where you live, available treatment facilities, your age, underlying mental and physical health concerns, length of substance use, types of substances used, and your insurance coverage all play a role in establishing your personalized treatment plan. If you meet the criteria for inpatient rehab, your chosen facility can work with you and UnitedHealthcare to determine the most appropriate length of stay for you.
Research shows that successful treatment outcomes are associated with length of stay in inpatient rehab. People who remain in substance abuse treatment for longer amounts of time are more likely to achieve their recovery goals, and those who stay in treatment for at least 3 months are more likely to have a successful outcome than those who do not.4(Goals and Effectiveness of Treatment-5th paragraph) Your length of time in treatment will depend largely on your insurance plan. You can access your UnitedHealthcare Insurance rehab coverage by calling the number on the back of your card or logging in to their online portal here.
What if My UnitedHealthcare Insurance Policy Does Not Cover Drug Treatment?
If your insurance plan doesn’t cover drug treatment services, you may qualify for scholarships or financing, depending on the drug treatment facility you choose. Many treatment facilities will work with you and your insurance provider to make recovery affordable and accessible. They understand that time is of the essence.
Getting help for your addiction should not be pushed aside or prolonged. Each day of addiction is another day of suffering, so don’t wait to seek treatment.
In-Network vs. Out-of-Network Rehab Centers
Your insurance plan will determine whether you need to choose an in-network or out-of-network treatment facility. By definition, in-network providers are providers, suppliers, and facilities that have contracts with your insurance provider.5(top of page) Out-of-network providers are providers, services, and facilities that do not have a contract with your particular insurance provider.
You have probably heard of health maintenance organizations (HMOs) and preferred provider organizations (PPOs). While the specifics of each type of plan are a bit beyond the scope of this piece, the main differences involve out-of-pocket and monthly costs and your ability to choose your providers. With an HMO, you pay lower monthly premiums and are required to choose in-network doctors and providers. Failing to do so could mean that your services will not be covered. PPOs usually have higher monthly premiums and out-of-pocket costs, but you have the freedom to choose your in- or out-of-network providers.
If you have an HMO plan, make sure that your chosen treatment provider is in-network. You can contact UnitedHealthcare to verify your substance abuse coverage and confirm whether the treatment facility you choose is in-network. You can also contact the treatment facility to confirm that they accept your insurance and your specific plan.
Check Your Benefits
American Addiction Centers (AAC) is a leader in providing effective substance abuse treatment in facilities across the country. AAC can verify if they are an approved UnitedHealthcare drug treatment provider and confirm that your plan is accepted at your chosen facility. You can input your information in the insurance verification form underneath to immediately see whether the facility is in-network or not. Another option is to call our helpline at 877-640-1943.
AAC has trained and compassionate admissions navigators available to you 24/7 to help answer any questions you may have about your addiction or your loved one’s addiction. You can be sure that your call is 100% confidential and that you will be treated with the utmost respect and care. AAC understands how difficult it can be to make the decision to end an addiction. They also know how important substance abuse treatment is on the road to recovery.
You don’t have to live a life in addiction any longer. Contact AAC today.
- UnitedHealthcare. (n.d.). Health insurance plans.
- U.S. Department of Health and Human Services. (2019). Does the Affordable Care Act cover individuals with mental health problems?
- UnitedHealthcare. (2020). Coverage summary.
- U.S. National Library of Medicine. (n.d.). Chapter 5- Specialized substance abuse treatment programs.
- U.S. Centers for Medicaid & Medicaid Services. (n.d.). Network.