United Healthcare is one of the largest health insurance providers in the United States, and many drug and alcohol rehab centers accept United Healthcare insurance. However, it can be difficult to know which centers are the best fit for your specific needs.
About United Healthcare
UnitedHealthcare (UHC) is one of the largest health insurance companies, serving tens of millions of customers worldwide(1). You may be wondering, “does UnitedHealthcare cover rehab?” If you or a loved one has UnitedHealthcare insurance and you are wondering how to pay for drug or alcohol rehabilitation treatment, review the information below to learn about how addiction recovery programs may be covered under UHC plans. While specifics vary from plan to plan, this page can help you understand what you may be able to expect when it comes to insurance coverage for rehab with UnitedHealthcare.
This page is intended to be a general overview of how UnitedHealthcare covers addiction and mental health services, not a comprehensive guide on the subject. For specific questions about your plan and UnitedHealthcare coverage for addiction treatment contact a UnitedHealthcare representative directly and learn about how to pay for rehab.
United Healthcare Insurance Plan Options
United HealthCare, like most health insurance companies, offers coverage for substance abuse treatment. This can include inpatient and outpatient treatment, counseling, and medication-assisted treatment. The specific details of United Healthcare's substance abuse coverage will depend on the specific plan you have. You can contact United Healthcare directly or look at your plan's coverage details online to learn more about what substance abuse services are covered under your plan.
United Healthcare offers open-access plans, copay only plans, and high-deductible plans.
- Open-access plans allow you to choose your doctors; they don’t require a referral, and they don’t require a primary care physician.
- Copay-only plans will guarantee that your costs after paying your deductible are only copays, with primary care physician visits and generic drugs covered before you hit your deductible.
- High-deductible plans offer preventative care services before the deductible is met, and some coverage through a primary care physician before the deductible is met (with copay), and the option of a health savings account. To view your plan’s details, you can log into the member website.
- Bronze plans—These plans have lower premiums but have the highest deductibles, which will result in higher out-of-pocket expenses. United Healthcare covers about 70% of the cost of care services after the deductible is met.
- Silver plans—These plans cost more in premiums but have lower deductibles and have lower out-of-pocket expenses than bronze plans. United Healthcare pays about 80% of the cost of care services after the deductible is met.
- Gold plans—These plans have the highest premiums but have the lowest deductibles and will have the lowest out-of-pocket expenses. United Healthcare pays about 90% of the cost of care after the deductible is met.
Which Types of Addiction Treatment Does United Healthcare Cover?
All the plans listed above provide coverage for addiction and behavioral health treatment. Rehabilitation services are primarily provided through the following:
- Inpatient treatment
- Partial hospitalization programs (PHPs)
- Intensive outpatient programs (IOPS)
- Outpatient treatment
Does UnitedHealthcare Insurance Cover Inpatient Rehabilitation?
UnitedHealthcare drug rehab or alcohol rehab providers offer coverage for inpatient addiction treatment (this may exclude certain short-term insurance plans). Patients reside at the facility during inpatient treatment and their length of stay may vary. For example, they may choose a 28- or 30-day program or a more long-term 60-day or 90-day inpatient program. The level of coverage or plans available may change depending on:
- The state of residence.
- The employer.
- Whether your family members are included in the plan.
Additionally, medication may be used to help a person manage withdrawal symptoms, cravings and co-occurring disorders. Some UHC plans may require a separate deductible for medications used during treatment. After the deductible is met, there is a copayment for each prescription. The copay for medications varies widely depending on the type of medication and the UHC plan you have. Prescriptions obtained outside the network are not covered(2).
Does UnitedHealthcare Insurance Cover Outpatient Rehabilitation?
Outpatient rehab is the least intensive option of addiction treatment, requiring patients to attend a facility for a few hours several days a week. UnitedHealthcare provides coverage for outpatient drug and alcohol treatment. The specifics of your UnitedHealthcare rehab coverage will vary. There is no coinsurance for other outpatient services. Out-of-network outpatient treatment or prescription medication is not covered(3). Learn more about inpatient vs. outpatient treatment.
Does UnitedHealthcare Insurance Cover Mental Health Treatment?
Substance misuse, behavioral health and mental health are categorized together with UnitedHealthcare insurance plans. An inpatient stay or outpatient treatment period for behavioral health or mental health reasons has the same level of coverage as treatment in an addiction center(2,3).
There are a few different ways to check your UnitedHealthcare rehab coverage:
- Login to the MyUHC benefits portal. Creating an account requires your Member ID number and group policy number or your social security number (SSN) and zip code(4).
- Check the benefits packet you were given by your employer when you selected an insurance plan.
- Call customer service. For Medicaid members, use the number on your insurance card or login to the UHC community plan site(5).
In most cases, UnitedHealthcare insurance provides coverage for addiction treatment and mental health services. Just be sure you choose a facility that is within the UHC network or that your plan allows you to use out-of-network facilities.
Sources
- UnitedHealthcare. (2020). About UnitedHealthcare.
- UnitedHealthcare. (2020). Summary of benefits and coverage: what this plan covers & what you pay for covered services.
- UnitedHealthcare. (2020). Summary of benefits and coverage: what this plan covers & what you pay for covered services.
- UnitedHealthcare. (n.d.). Let’s get you registered.
- UnitedHealthcare. (2019). Contact us.