UHC/Optum Insurance Coverage for Drug & Alcohol Rehab

UHC Rehab Coverage

The Recovery Village accepts insurance from most providers, including UnitedHealthcare/Optum. If someone requires addiction treatment for drugs or alcohol, it should be readily accessible. One barrier to treatment for many people is a concern about how they’ll pay for rehab. In most cases, insurance coverage will include addiction treatment. UnitedHealthcare/Optum is a company that offers addiction treatment and mental health coverage as part of most plans.

UHC with Optum Provider Overview

UnitedHealth Group is the larger parent company of UnitedHealthcare and Optum. OptumHealth is a clinical service for coordinating specialty services, including addiction treatment. UnitedHealthcare operates throughout the country and provides coverage to individuals and families, as well as to Medicare and Medicaid beneficiaries.

UHC/Optum Coverage Levels and Plans

The plans available through UnitedHealthcare vary depending on the state and the level of coverage you opt for. In general, there are three broad options.

• First is UnitedHealthcare Choice, with in-network coverage for around 895,000 providers nationwide. There isn’t coverage through this plan for out-of-network providers.
• UnitedHealthcare Choice Plus offers savings on the cost of care if you stay in-network, and there’s a lower level of coverage if you see a provider out-of-network.
• The UnitedHealthcare Options PPO includes savings on out-of-pocket costs for members who use a preferred provider network.
• You can work with an out-of-network provider with ChoicePlus or the Options PPO if you’re willing to pay a higher co-pay.
• Optum Care is available in certain states and provides primary care through a network of physicians and specialists.

Does UHC/Optum Insurance Cover Drug and Alcohol Rehab?

Generally, UnitedHealth Group insurance policies will cover substance misuse treatment. The coverage amount someone has will depend on their particular plan, provider and location. You can contact your insurance company to learn more about your coverage and find approved rehab facilities. Alternatively, you can contact The Recovery Village, and our Recovery Advocates can help you verify coverage.

Does UHC/Optum Cover Mental Health Services?

Many people who receive addiction treatment have a co-occurring mental health condition that must be treated simultaneously. UHC/Optum does offer coverage for mental health care and related services in many circumstances. 

Because of the Affordable Care Act, mental health services are classified as an essential benefit, meaning insurance companies have to offer coverage equal to what they offer for certain physical care. Eye movement desensitization and reprocessing (EMDR) therapy, which involves processing traumatic memories, is one type of mental health service that may also be covered.

Does UHC/Optum Cover Behavioral Health?

Behavioral health covers mental health, substance use disorders and stress-related symptoms. Behavioral health care includes anything to prevent, diagnose or treat those conditions. As a result, yes, UHC/Optum covers behavioral health.

UHC/Optum and Medication-Assisted Treatment (MAT)

Medication-assisted treatment includes using Food and Drug Administration (FDA) approved medications to help with substance withdrawal symptoms and dependence. These medications can improve treatment outcomes and help people stay in treatment longer. Most insurance plans will cover MAT’s costs, which is true for UHC/Optum.

Specific medications that insurance may cover as part of MAT include:

• Acamprosate, which helps prevent alcohol relapse. Acamprosate works to decrease cravings and urges to drink alcohol.
•  Antabuse, which blocks an enzyme that’s needed to process alcohol. Also known by the generic name disulfiram, this medication creates unpleasant side effects when combined with alcohol.
• Naltrexone is approved to treat both alcohol use disorder and opioid use disorder.

Insurance may cover medications other than just the ones listed above.

What To Expect From UHC/Optum for Rehab

UHC/Optum is likely to cover rehab costs, including inpatient treatment. As a patient, you may still be responsible for some out-of-pocket expenses, however. Your out-of-pocket expenses will depend on your treatment plan, coverage, whether you receive treatment in or out of network and other factors. 

You can check on the details of your plan with the company and learn more about preauthorization requirements, copays and coinsurance. You can also take the next step by speaking with a Recovery Advocate at The Recovery Village or verifying your insurance benefits instantly online.

Reach out today and begin your recovery.

Editor – Abby Doty

Abby Doty graduated from Hamline University in 2021 with a Bachelor's in English and Psychology. She has written and edited creative and literary work as well as academic pieces focused primarily on psychology and mental health. Read more