United Healthcare Addiction Treatment Information

If you’re struggling with substance abuse and your insurance carrier is United Healthcare, addiction treatment coverage may worry you. The good news is that United Healthcare plans cover some level of addiction treatment, although specific coverage will vary depending on your location and your particular plan. 

Does United Healthcare Cover Drug Rehab?

UnitedHealth rehab coverage 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 substance abuse.

The best way to determine the specifics of your United Healthcare substance abuse coverage is to review your enrollment materials. You can also visit the member website or call the number on your membership card.  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 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.

United Healthcare Substance Abuse Treatment Details

Depending on your benefit plan, United Healthcare drug rehab providers may pay for:

  • Science-based treatment
  • Detox, including inpatient or medical detox
  • Inpatient treatment (residential rehab)
  • Partial hospitalization (PHP)
  • Treatment for anxiety, depression, or other disorders that often go along with addiction (dual diagnosis)
  • Group therapy and individual counseling
  • Relapse prevention
  • Recovery and life skills coaching

Some United Healthcare substance abuse programs may pay for:  

  • Massage therapy or chiropractic care
  • Art or equine therapy
  • Mindfulness programs

The Affordable Care Act (Obamacare) and United Healthcare Addiction Treatment

If you have United Healthcare or other health insurance, you’re entitled to treatment for substance abuse and mental and behavioral health inpatient services. Check your policy carefully, as your treatment may be limited to 28, 30, or 45 days, or it may cover only outpatient treatment. 

According to the U.S. Department of Health and Human Services,  the Mental Health Parity and Addiction Equity Act of 2014 requires insurance companies to provide the same level of care for behavioral health and substance abuse that they provide for medical care or surgery. Benefits must be similar and can’t be more restrictive than limits for other types of health care. All plans must include:

  • Behavioral health treatment like psychotherapy and counseling
  • Mental and behavioral health inpatient services
  • Substance use disorder (commonly known as substance abuse) treatment

Depending on the state you live in and your health plan, the specific behavioral health benefits will vary.

Understanding Your United Healthcare Substance Abuse Coverage

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

Your premium is your regular payment for health insurance, which is 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 remainder.   

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.  

United Healthcare Substance Abuse Facilities: Treatment In-Network or Out-of-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 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 Healthcare 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 Healthcare’s network.  In general, your insurance will pay the prevailing rate based on “usual, customary, and reasonable amount” for treatment providers in a certain geographic area.

Medicare: If you’re on Medicare and have a United Healthcare supplement or an advantage plan, or United Healthcare Community Plan drug rehab, rates are usually determined differently. 

United Healthcare Inpatient Drug Rehab: You May Need Prior Authorization

Your United Healthcare plan may require prior authorization for treatment, which means health care professionals, including rehabs, must obtain approval from United Healthcare before providing services. Requirements depend on your benefit plan and also vary from state to state. 

United Healthcare Substance Abuse Providers: Finding Drug Rehab Centers That Accept United Healthcare

To check out your benefits and an up-to-date list of rehabs and treatment providers, visit the United Healthcare website and click on the Behavioral Health Directory. The Directory will provide specific information on clinics, treatment, and services for substance abuse disorders or mental health conditions. 

Be sure to request an estimated cost of treatment and approximately how much United Healthcare will cover after you pay any required co-pay, co-insurance, or deductible.  

Take the 1st Step Today

If you need help with a substance use disorder or addiction, we’ll be happy to verify your United Healthcare insurance coverage and get treatment started as soon as possible. You can also give us a call at 855-425-4846. If your United Healthcare plan doesn’t cover the total cost, we’ll provide confidential information about alternative ways of paying for treatment.  

Reviewed for Medical & Clinical Accuracy by Brittany Polansky, MSW, LCSW

Brittany Polansky, MSW, LCSWBrittany has been working in behavioral health since 2012 and is the Assistant Clinical Director at our facility. She is an LCSW and holds a master’s degree in social work. She has great experience with chemical dependency and co-occurring mental health diagnoses as well as various therapeutic techniques. Brittany is passionate about treating all clients with dignity and respect, and providing a safe environment where clients can begin their healing journey in recovery.