United Healthcare

United Healthcare is one of many options that patients have in health insurance coverage, and for those who struggle with substance abuse, a number of treatment services are covered as long as they are deemed medically necessary. In some cases, documentation of that need may be required, and patients are encouraged to call customer service with questions in order to make sure that certain services are covered before embarking on treatment if they require the financial assistance of insurance.

For qualified plan holders, we accept United Healthcare insurance for alcohol, drug and substance abuse rehab, detoxification and therapeutic services.

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United Healthcare covers the cost of “chemical aversion therapy,” or medications used to treat alcohol dependence. They note three medications as being the most commonly used for this purpose – lithium, emetine, and apomorphine – and point out that they are not yet approved by the Food and Drug Administration (FDA) for the purposes of detox; patients who utilize these must be under medical observation. They also state, however, that medical detox can be conducted on an outpatient basis and that “documentation” is required to support the medical need for inpatient care.

Opiate detox as well as associated medications if administered by a doctor and deemed “reasonable and necessary” are also covered.

United Healthcare does not cover the following detox services:

Addiction treatment

Detox is an excellent first step in comprehensive treatment, but it is not a treatment unto itself. Patients will require follow-up and intensive mental health treatment through psychotherapy that addresses their personal challenges to staying clean and sober.

United Healthcare will cover the cost of inpatient drug addiction treatment as long as Medicare coverage requirements are met. It’s important to note that:

  • Only up to 190 days in residential treatment at a psychiatric hospital will be covered in a lifetime.
  • Multiple admissions for alcohol rehabilitation must each meet the criteria for medical need and will not be tacked on to previous stays as an extension. In these cases, documentation will be required to demonstrate that a readmission will result in “an improvement of the patient’s condition.”
  • Patients requesting treatment in rehab programs that combine detox and addiction treatment services must demonstrate that they meet the criteria of need for both services.

Treatments that are covered by United Healthcare during inpatient rehab include:

  • Group therapy sessions
  • Personal therapy sessions
  • Extended inpatient care when medically necessary
  • Educational and psychotherapeutic services provided in a group setting
  • Family therapy
  • “Chemical aversion therapy” for the treatment of alcoholism when medically necessary

United Healthcare does not cover the following treatment services during inpatient rehab:

  • Extra services provided by the rehab not medically connected to treatment (e.g., life coaching, employment assistance, recreational activities, meals, transportation, etc.)
  • Electrical aversion therapy
  • Electric convulsive therapy (ECT)
  • Methadone maintenance
  • Court-ordered drug testing unless medically necessary
  • Outpatient drug therapy unless the plan includes it and then those drugs must be obtained from a provider in that network

Get the help you need to overcome addiction

Insurance is just one of many ways that most patients cover the cost of comprehensive care in addiction treatment. While it is a good place to start, few health insurance policies cover the cost of all treatment services that are recommended in order to build a solid foundation in recovery. Contact us today at The Recovery Village to learn more about the options available to you.

We accept most major health plans. Please call for verification of benefits coverage or check with your health insurance carrier for final determination regarding specific covered services. All products, logos, and company names are trademarks™ or registered® trademarks of their respective holders. Use of them does not imply any affiliation with or endorsement by them.

United Healthcare was last modified: November 14th, 2016 by The Recovery Village