United Healthcare Drug Rehab Coverage
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Getting Help Covering Addiction Treatment
United Healthcare Insurance
Once you decide to take control of your life and seek a treatment program for your addiction, it’s important to focus on your recovery. You shouldn’t have to worry about whether you can afford to complete drug and alcohol rehab that’s designed around your individual needs. We’re here to do the research for you and determine what insurance benefits are available under your current UnitedHealthcare policy.
UnitedHealthcare is part of UnitedHealth Group, which was established in 1977 under the name Charter Med. In 1998, UnitedHealth Group restructured its business to have five independent companies, including UnitedHealthcare. With operations in more than 125 countries, UnitedHealth Group processes more than 600 billion digital transactions each year. As of 2017, UnitedHealthcare had just under 50 million subscribers, making it the largest health insurance company in the United States. As a result, your UnitedHealthcare plan is likely to cover at least some of your drug addiction treatment costs.
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Where rehab is covered
UnitedHealthcare Insurance Coverage Areas
Because UnitedHealthcare is the largest insurance company in the United States, it serves customers in all 50 states and multiple US territories, giving subscribers access to a broad network of treatment providers. In addition to group plans offered by employers throughout the United States, UnitedHealthcare sells Medicare Advantage plans, individual plans and plans designed for the self-employed.
Each plan offered to individuals in the marketplace is classified as Bronze, Silver, Gold or Platinum. These names have nothing to do with the quality of the services provided but rather with the amount of coverage offered under each type of insurance plan.
- Bronze: Bronze plans have the lowest premiums, which can help you save money every month. They also tend to have the highest co-pays, deductibles, coinsurance requirements and annual out-of-pocket maximums. Under a bronze plan, you may be responsible for about 40% of the cost of a covered benefit.
- Silver: Silver plans also have affordable premiums. Like Bronze plans, they tend to have high out-of-pocket costs. Under a UnitedHealthcare silver plan, you can expect to pay around 30% of the cost of your treatment, provided the treatment is a covered benefit.
- Gold: Gold plans have higher premiums, but they typically have lower co-pays, deductibles and coinsurance requirements. UnitedHealthcare gold plans typically have an 80/20 split — you pay 20% of the cost of covered benefits, while UnitedHealthcare pays the remaining 80%.
- Platinum: Platinum plans have the highest monthly premiums, but they also have the lowest co-pays, deductibles and coinsurance amounts. UnitedHealthcare typically covers 90% of the cost of covered benefits, leaving you to pay the remaining 10%.
The exact percentage covered depends on your plan and the treatment facility you choose.
Learn the difference
In-Network and Out-of-Network Rehab Centers
UnitedHealthcare offers two main types of plans: health maintenance organizations (HMOs) and preferred provider organizations (PPOs). HMOs provide access to doctors, therapists and medical facilities within a single network. A PPO plan also has a network of providers, but many PPOs allow their subscribers to see out-of-network providers at a higher out-of-pocket cost. The type of plan you have affects your coverage in the following ways:
- HMO plans usually only cover treatment facilities that are in their networks. Out-of-network treatment centers may not be covered.
PPO plans give you more flexibility in selecting a treatment center. If you choose an out-of-network facility, you may have to pay a larger portion of the costs, but your PPO plan is likely to cover at least some of your treatment-related expenses.
Substance Abuse Treatment and UnitedHealthcare
UnitedHealthcare Coverage for Mental Health and Addiction Treatment
How much network coverage is available for behavioral health and addiction treatment depends on what’s included in your plan, but UnitedHealthcare typically works with many substance abuse treatment centers. A United Healthcare policy may cover detox, inpatient and outpatient treatment for drug and alcohol addiction.
Detoxification
UnitedHealthcare covers medically necessary treatments, which are services that meet the accepted standards of medicine and are used to diagnose or treat a disease or an injury. A substance use disorder is a disease, so detoxification services may be considered medically necessary to help you stop using alcohol or drugs.
If you need detoxification services, UnitedHealthcare may cover some of the costs. With an HMO plan, you’ll probably be required to choose a treatment facility that is in the HMO’s network. If you have a PPO plan, you may be able to stay at an out-of-network treatment center, but doing so can increase your out-of-pocket costs.
Inpatient Rehabilitation
Inpatient rehabilitation is ideal for individuals who need to focus on their recovery and avoid the distractions associated with working, going to school and maintaining family relationships. If you choose an inpatient program instead of an outpatient one, UnitedHealthcare may pay for some of the costs. The level of coverage provided sometimes depends on whether you’re staying in a hospital or a standalone treatment facility.
As with any medical service, how much UnitedHealthcare covers depends on the type of plan you have. If you have a Bronze plan, your out-of-pocket costs are likely to be much higher than those of someone with a Platinum plan. The amount of coverage provided also depends on whether you have an HMO plan or a PPO plan.
Outpatient Rehabilitation
If you’re unable to stay in a residential treatment facility due to work or family obligations, outpatient rehabilitation is a good alternative. In an outpatient program, you’ll continue to live at home, but you’ll go to the treatment facility each day to receive counseling, participate in group therapy and learn how to cope with life’s challenges without turning to alcohol or drugs. Outpatient programs typically cost less than inpatient treatment, and they only take about 10 to 12 hours per week, which means you can continue working or taking classes.
UnitedHealthcare may cover some of your outpatient rehabilitation costs. The exact level of coverage depends on your deductible and coinsurance amounts, as well as whether you have an HMO plan or a PPO plan.
Start Recovery Now at Our Drug Rehab Center
UnitedHealthcare provides coverage for addiction treatment, but before you get started, you’ll need to determine exactly what your plan covers. If you or a loved one would like one of our admissions counselors to verify your benefits or walk you through the enrollment process, call 866-986-2486.