Does UnitedHealthcare Cover Addiction Treatment?
For individuals who suffer from a substance use disorder, addiction treatment is essential. Addiction is a legitimate mental health disorder that can rarely be managed using personal will power alone. However, quality addiction treatment can allow people to escape the vicious cycle of substance abuse and begin leading normal lives. While addiction treatment requires an investment of both time and money, individuals who are insured through UnitedHealthcare can easily access high quality addiction treatment programs.
The vast majority of plans offered by UnitedHealthcare offer assistance for alcohol and drug addiction treatment programs. The upfront costs that plan-holders are expected to pay depend upon the nature of their specific UnitedHealthcare Policy and which state they live in. The Affordable Care Act requires health insurance companies to cover addiction treatment the same way they would any other physical health issue.Ultimately, all policy-holders with United Health Care have guaranteed access to some degree of addiction treatment coverage.
Since it was founded in 1974, UnitedHealthcare has become one of the largest health insurance companies in the United States, providing insurance to over 28 million people in the United States. In fact, it actually consists of 2 distinct companies: Optum and UnitedHealthcare. These companies have a presence in all 50 states of America, as well as 130 other countries.
UnitedHealthcare offers a diverse range of policies that are suitable for people with different healthcare needs. Each policy has differing degrees of coverage, but a significant number of them offer assistance for addiction treatment. Upfront payments differ considerably from plan to plan, depending upon the specific policy and the state in which the policy-holder resides.
UnitedHealthcare and Addiction Treatment
UnitedHealthcare puts great emphasis on the importance of quality addiction treatment. In an effort to guarantee that their policy-holders have access to the best addiction resources possible, UnitedHealthcare has actually created a distinct division called United Behavioral Health. United Behavioral Health works with policyholders to get their addiction treatment needs met. They offer confidential consultations so that people with addictions can speak with substance use disorder experts and get connected to the resources and services they need.
Coverage for Substance Abuse at UnitedHealthcare
UnitedHealthcare offers a wide range of alcohol and drug addiction treatment programs in their policies. These programs include:
- Inpatient medical detox centers
- Outpatient detox centers
- Inpatient rehab programs
- Outpatient rehab programs
Individuals who are covered by a PPO network policy with UnitedHealthcare generally have access to a more diverse array of addiction treatment facilities than those with non-PPO plans. Certain policies require policy-holders to pass pre-certification requirements before they receive treatment, though this can depend upon whether or not the rehab is residential or outpatient. Outpatient programs tend to be easier to qualify for.
Types of UnitedHealthcare Plans
The details of the plans UnitedHealthcare offers depend upon an individual’s state of residence. The company offers multiple tiers of coverage, but these can generally be divided into 3 main levels of care.
- UnitedHealthcare Choice. This plan offers in-network coverage with over 895,000 health care providers in the United States. Its out-of-network coverage, however, is more limited.
- UnitedHealthcare Choice Plus. This plan is cost-effective for people using providers within the UnitedHealthcare network.
- UnitedHealthcare Options PPO. This PPO plan has the lowest out-of-pocket expenses for individuals using a provider in the preferred provider network.
Individuals who are covered through Optum Care can take advantage of a large network of primary care physicians and specialists.
Out-of-Network Rehabs and UnitedHealthcare
While many insurance companies require individuals to stick with their vetted list of in-network treatment centers, UnitedHealthcare offers a higher degree of flexibility. Policy-holders are not required to attend in-network rehabs. Instead, they can choose from a wide assortment of high quality addiction treatment centers.
While most plans with UnitedHealthcare offer this kind of flexibility, upfront payments can differ from plan to plan. Certain plans have more expensive coinsurance percentages or copays when people choose healthcare providers outside of the network. A few plans do not cover out-of-network rehabs at all, in which case the patient is responsible for covering all the associated costs.
While it is not necessary to stick with an in-network rehab, it is usually a good course of action to talk with your UnitedHealthcare representative. Their addiction and mental health division, United Behavioral Health, offers free consultations so that you can get a better sense of what options are available to you — and what the out-of-pocket costs will be.
Outpatient Addiction Treatment with UnitedHealthcare
UnitedHealthcare plans cover outpatient addiction treatment, since outpatient programs are widely regarded as effective evidence-based programs. Outpatient programs can benefit individuals who have substance use disorders of any severity, since they offer many different levels of care.
These levels of care, from the most acute to the least, include partial hospitalization programs (PHPs), intensive outpatient programs (IOPs), outpatient programs (OPs), and aftercare planning. Research shows that making use of multiple levels of treatment for extended periods of time results in the greatest rates of long term sobriety, and a significant reduction in the likelihood of relapse. UnitedHealthcare covers patients as they pursue recovery and progress from one level of care to another.
Outpatient programs help people recover from addictions by helping them address underlying causes, develop new coping tools, and rebuild their lives. While attending an outpatient program, clients live at home, attending treatment on a regular basis a few times a week. As such, they are considerably cheaper than inpatient rehabs, which require 24 hour residency. For this reason, UnitedHealthcare is generally willing to cover treatment at outpatient rehabs on a long term basis.
Outpatient rehab coverage through UnitedHealthcare varies depending on the specific UnitedHealthcare plan an individual has. The majority of health insurance plans that UnitedHealthcare offers are family and individual insurance plans, but they also offer more short term health policies that people can take advantage of if they need substance abuse treatment.
Cost of Outpatient Treatment Services
UnitedHealthcare’s short-term plans generally pay for addiction treatment programs, including outpatient rehab. However, the lowest premium plan, known as Short Term Medical Value, does not cover all of the costs of addiction treatment. All of the rest of UnitedHealthcare’s plans cover drug and alcohol addiction treatment to some extent.
UnitedHealthcare’s more comprehensive plans, alongside its Short Term Medical Plus policies, require policyholders to pay a 20-30% deductible. “Deductible” is a technical term that refers to the amount of money an individual is expected to pay before their insurance will begin covering the costs. The total cost of this deductible is generally between $1000 and $10,000. However, it is important to be aware that UnitedHealthcare’s short term plans have a term maximum of $3,000.
UnitedHealthcare and the Affordable Care Act
The Affordable Care Act, sometimes known as the ACA, was written into law to help Americans get broader access to health insurance coverage. To that end, the Affordable Care Act classifies addiction treatment as an “essential health benefit.” This means that insurance companies, including UnitedHealthcare, are legally required to cover substance use disorder treatment.
The ACA also guarantees something known as “parity.” Parity means that addictions and mental health disorders must be treated with the same seriousness as physical health conditions. If seeing a doctor for a cold, for instance, requires an individual to pay $50 out-of-pocket, then seeing a doctor about a substance use disorder cannot cost more than that.
Lastly, the Affordable Care Act ensures that people who suffer from addictions cannot be denied coverage on that basis. Substance use disorders cannot legally be considered pre-existing conditions. This means that anyone, no matter how developed their addiction is, can purchase a UnitedHealthcare plan and get the treatment they need.
Comorbid Mental Health Disorders and UnitedHealthcare
The Affordable Care Act not only makes addiction treatment an essential health benefit. It also makes mental health services essential health benefits. In fact, these two conditions are often intertwined. Half of people suffering from substance use disorders experience mental illness, and half of all people with mental health conditions develop an addiction. In many cases, it is impossible to treat one condition without also addressing the other.
UnitedHealthcare offers mental health treatment for all policyholders, through the specific coverage can vary from plan to plan. For individuals who have been diagnosed with a comorbid mental health disorder, UnitedHealthcare often recommends enrollment in an outpatient treatment program. Quality outpatient rehabs offer a type of treatment known as integrated treatment, which is designed to address multiple conditions for dual diagnosis patients.
What Does UnitedHealthcare Cover For Me?
If you are covered by UnitedHealthcare, there is a strong likelihood that you are covered for outpatient treatment. However, it is important to note that UnitedHealthcare offers a wide variety of policies, each with different benefits, copayments, and deductibles. Your level of care depends on the specific policy you are paying for as well as your state of residence.
Navigating your insurance benefits can be confusing and intimidating. One option is calling your health insurance representative directly. Their number is usually listed on the back of your insurance card. Rehabs like NuView Treatment Center, however, are often willing to help you determine your coverage. Contact us at (310) 984-1730, and we will help you evaluate your needs and the best way to get the services your situation demands.
Addiction Treatment at NuView Treatment Center
NuView Treatment Center is an outpatient rehab located in West Los Angeles. Our modern facility offers evidence-based addiction treatment at all levels of care. NuView Treatment Center is also covered by the vast majority of UnitedHealthcare insurance policies. For UnitedHealthcare policyholders, NuView Treatment Center offers cost-effective addiction and mental health treatment.
Our highly qualified and trained staff design individualized treatment plans for all clients. It is our belief that addiction treatment should be holistic, compassionate, and comprehensive. Through evidence-based therapeutic interventions, we help clients address underlying issues, develop new coping tools, and rebuild their lives in recovery.
If you are ready to put an end to the vicious cycle of substance abuse, reach out to NuView Treatment Center today.