United Health Drug Rehab Coverage

United Healthcare has a huge network of behavioral health services to choose from, with over 130,000 facilities and clinicians providing a variety of services including treatment for drug and alcohol addiction.

The best way to determine the specifics of your United Healthcare coverage is to review your enrollment materials. You can also visit the member website or call the number on your membership card to speak with an agent. Insurance companies are required to provide a summary of your benefits, including those for mental health and addiction treatment.

If you’re worried about your use of drugs or alcohol, or if you’re concerned about a family member, you can call United Healthcare’s convenient Substance Abuse Hotline at 855-780-5955 any time of day or night. The hotline, staffed by substance abuse recovery advocates, is free and confidential for members and their families. Provide your member information if you’re looking for details of your plan, or remain anonymous if you’re not ready to provide your name or other personal information.

The best way to understand your addiction treatment coverage with United Healthcare is to verify your insurance with one of our trusted admissions coordinators at 1st Step Behavioral Health. We can verify your benefits, help you understand your coverage, and select the right treatment program for you.

The ins and outs of insurance can get complicated, so it’s essential to understand basic terminology. Otherwise, unexpected expenses may catch you by surprise.

Your premium is your regular health insurance payment, typically paid by the month. If your employer provides your insurance, a portion of the cost is covered.

Deductible refers to the amount you will have to pay before your insurance coverage kicks in and pays your claim. The amount of your deductible depends on your particular plan. Still, in general, if you have a lower monthly payment for insurance, you’ll probably be required to pay a higher deductible. In comparison, a higher monthly payment generally indicates a lower deductible. Also, you may have an individual deductible or a family deductible.

Co-insurance is a predetermined percentage you’ll be required to pay for treatment. Many plans are 80/20, which means you’ll pay 20 percent after you pay your deductible. United Healthcare will pick up the remaining 80%.

Co-pays are flat fees that you pay for treatment, but the amount depends on your plan and the type of treatment you receive. In some cases, you may be required to pay both co-insurance and a co-pay.

Your out-of-pocket maximum is the most you’ll pay for covered services in a year. Once you pay the required deductibles, co-insurance, and co-pay, you’ll have 100 percent coverage and won’t be required to pay more for services until next year.

How much drug and alcohol rehab coverage you receive from United Healthcare also depends on whether or not the program you choose is in their network.

In-network refers to treatment centers and rehabs that have agreed to work with United Healthcare. The cost of treatment in-network is lower because United Healthcare and the rehab center have agreed on lower rates. If you don’t have a plan covering in-network services, treatment from an out-of-network rehab is likely to be substantially more expensive. You may also be required to pay higher co-pays and deductibles.

Out-of-network treatment is likely to cost more or may not be covered at all if United Health and the treatment provider haven’t established an agreement for lower rates. However, if your plan includes out-of-network benefits, you may be entitled to payment for a treatment provider out of United Health’s network. In general, your insurance will pay the prevailing rate based on the “usual, customary, and reasonable amount” for treatment providers in a certain geographic area.

If you’re on Medicare and have a United Healthcare supplement, an Advantage plan, or a United Healthcare Community Plan, rates may be determined differently.