United Healthcare Insurance for Drug & Alcohol Rehab, Detox, & Mental Health Coverage

United Healthcare Rehab Coverage

United Healthcare is one of the top providers of health insurance plans for individuals and employers, in addition to supplemental plans such as dental, vision and short-term health insurance. United Healthcare offers a range of services through United Behavioral Health, which includes United Healthcare mental health and United Healthcare substance abuse options.

United Healthcare may pay for some of the costs of inpatient, residential rehab, as well as things such as outpatient rehab and follow-up care.

Find out if Your United Healthcare Insurance Covers Rehab Now


Does United Healthcare Have Rehab Coverage?

Since the Affordable Care Act was implemented, an increasing number of health insurance providers have expanded their mental health, behavioral health and substance abuse treatment coverage options for members. United Healthcare does offer rehab coverage for policyholders who are seeking treatment for a substance abuse issue in many cases.

The network of behavioral health providers that are part of United Healthcare includes more than 80,000 certified and licensed professionals. As well as access to these specialty care providers, United Healthcare provides options for both inpatient and outpatient rehab treatment at more than 3,600 locations.

According to United Healthcare guidelines, when a member is seeking inpatient mental health services some stipulations apply including the fact that services must be provided under comprehensive, individualized treatment plans. There are also certain limitations to things such as the total number of inpatient services a patient may have covered in their lifetime.

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United Healthcare Mental Health Coverage & Benefits

United Healthcare does provide a range of treatment and benefit options for policyholders who need mental health. United Healthcare has a team of professionals who are available anytime to answer member questions about anything related to mental and health and substance abuse.

Their mental health customer service team can also provide members with names of participating facilities and doctors near them, help monitor progress to ensure they’re receiving the best care, and assist in managing any problems that may arise with treatment.

Is United Healthcare Mental Health Covered By Insurance?

As noted above, when the Affordable Care Act was enacted, it required that insurance carriers participating in state exchanges provide mental and behavioral health services as essential coverage. United Healthcare has since left some state exchanges, but still maintains much of the mental health coverage as regulated by the law.

Also according to law, insurance providers including United Healthcare, are required to cover mental and behavioral health services in the same way they cover medical services. What this means is that for comparable medical services, things such as copay requirements must be the same as what they would be for a mental health service.

In specific terms, The Mental Health Parity and Addiction Equity Act of 2008 stipulates that plans’ financial requirements and treatment limitations for substance use disorder and mental health benefits can be no more restrictive than what’s applied to medical or surgical benefits.

United Healthcare Behavioral Health

United Healthcare provides behavioral health services and benefits that help members deal with everything from less serious everyday problems, to severe challenges. A wide variety of specific services are covered if they’re declared medically necessary.

Is United Healthcare Behavioral Health Covered by Insurance?

United Healthcare is an insurance provider with a relatively extensive network of care providers ranging from therapists and counselors to psychiatrists. Some of the behavioral health issues for which United Healthcare may cover treatment include:

  • Anxiety and depression
  • Stress related to parenting, family, and eldercare, as well as relationships
  • Substance abuse and recovery
  • Issues surrounding domestic violence
  • Eating disorder

What To Expect From United Healthcare for Substance Abuse Rehab

While United Healthcare does provide coverage for some aspects of inpatient and residential rehab, there are some things to know.

First, this is something that would require pre-authorization in most cases, which applies to almost all mental health services you’re seeking coverage for from United Healthcare. Rehab may also require a copay, and people should look at their Summary of Benefits to determine what their pre-authorization requirements are, as well as their copay requirements.

United Healthcare may also require documentation highlighting why inpatient rehab is medically necessary, and detox can be covered as well if it’s determined reasonable and necessary.

There are some components of detox that United Healthcare won’t cover, including extra costs associated with outpatient care and methadone maintenance.

During a member’s lifetime, United Healthcare will cover only up to 190 days in a residential psychiatric hospital, and there will be the requirement for members to demonstrate a medical need for more than one admission to a substance abuse treatment facility.

Many United Healthcare policies will cover most of the therapy that takes place in residential rehab, including group and personal therapy, education services, and family therapy, among others.

At the same time, there are some limitations to what United Healthcare will cover when a policyholder is in a residential rehab setting.

The best option, along with reviewing your Summary of Benefits, is to contact a United Healthcare behavioral health representative who can guide you through any documentation you would need to prove medical necessity and help you understand your benefits as they pertain to rehab and substance abuse treatment.

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United Healthcare was last modified: August 4th, 2017 by The Recovery Village