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United Health Insurance Coverage for Drug and Alcohol Treatment

UnitedHealth Group was first established in 1977 to serve as a parent company for Charter Med Incorporated. Over the years, the company has grown and changed. It has multiple businesses under its umbrella, including UnitedHealthcare and Optum. While UnitedHealthcare provides health insurance benefits globally, Optum provides health services.

If you have health insurance through UnitedHealth, your policy will be managed by UnitedHealthcare. This provider is currently headquartered in Minneapolis, Minnesota, and works with millions of clients all around the world.

Who Accepts UnitedHealth Insurance?

United Health has a large network of doctors, hospitals and other providers all around the country and internationally. Currently, UnitedHealthcare partners with:

  • 1.3 million doctors
  • 6,500 hospitals

The exact providers available to you will depend on your plan and your location. However, the size of the network makes it easy for most covered individuals to find an appropriate addiction treatment program in their area. It is always important to verify that your treatment will be covered before you enroll in any program.

UnitedHealth Insurance Plans

UnitedHealth offers several different plan structures to meet the needs of consumers. Plans are available for employers, individuals and families. UnitedHealth also provides services to beneficiaries of Medicare and Medicaid, as well as short-term insurance and COBRA coverage.

UnitedHealth PPO Plans

UnitedHealth’s Preferred Provider Organization plans reward you for receiving your care from providers within a specific network. If you have this type of plan, you will not be required to get a referral from a primary care provider in order to see a specialist, nor are you required to seek care only from in-network providers. However, you will owe less out of your own pocket if you choose providers from within the network.

UnitedHealth HMO Plans

UnitedHealth’s HMO, or Health Maintenance Organization, plans help you save money with lower deductibles and lower monthly premiums. However, you won’t have as many options or as much freedom when it comes to choosing your addiction treatment programs. In order to qualify for coverage under an HMO plan, you must receive all of your non-emergency care from in-network providers. You must also obtain a referral from your primary care provider before you can receive care from a specialist.

UnitedHealth EPO Plans

UnitedHealth’s exclusive provider organization plans merge some of the characteristics of PPO and HMO plans. Like an HMO plan, EPO plans will cover non-emergency services only if you use in-network providers. However, like a PPO plan, you can see a specialist without a referral from your primary care provider. EPO plans offer lower premiums than some of the other options available.

UnitedHealth POS Plans

UnitedHealth’s point-of-service plans operate like an HMO, requiring you to get a referral from your primary care provider before you see a specialist. However, POS plans do not restrict you to seeing only in-network providers. Care you receive from providers within your network will be covered at a higher rate than care received outside of your network.

Can UnitedHealth Pay for Substance Abuse Treatment?

Yes, your substance abuse treatment expenses may be covered by your UnitedHealth insurance plan. However, the specifics of your coverage and out-of-pocket costs will depend on a variety of factors. For this reason, researching your coverage and costs in advance is highly recommended. Some of the factors that may impact how much you owe for treatment include:

  • Your plan’s deductible and past expenses during the year.
  • Whether you choose an in-network facility.
  • The length of your program.
  • The type of program you choose.
  • Your insurance coverage stipulations.
  • Your rehab program’s cost.

Because so many different factors come into play in determining out-of-pocket costs for rehab patients, it can be difficult to estimate your expenses on your own. Some patients may owe none of their own rehab costs, while others may owe a significant portion of the bill.

Does UnitedHealth Require Preauthorization for Addiction Treatment?

Preauthorization, which may also be called “prior authorization” or “precertification,” is a procedure sometimes required when someone plans to receive certain types of treatment services. This process is used to verify that the services you plan to receive is medically necessary and will be covered by your insurance policy.

If you have an insurance policy from UnitedHealth, you may need to obtain preauthorization before you begin your addiction treatment program. If this is the case, it is important to fulfill this requirement in order to avoid any unwanted charges or unnecessary hassle after you have already begun treatment. To find out whether you need preauthorization for your addiction treatment program, you can read through your policy documents. You can also get specific information about your coverage requirements by calling the number on the back of your insurance card and speaking to a representative from UnitedHealth.

In some cases, UnitedHealth may not approve your request for preauthorization immediately. Instead, they may ask for more information about your needs and intended program before making a decision. If this happens, do not be alarmed, as it does not mean that your treatment will be denied. Simply comply with the request for more information and speak to a representative from the insurance company if you have any additional questions.

Find Your Addiction Treatment Coverage and Cost

One of the first steps on the road to making a recovery from your substance use disorder is preparing to enter treatment. Determining your insurance coverage benefits and your costs is an important part of this process. However, because so many factors can impact your insurance provisions and out-of-pocket expenses, this can be a complicated process. Fortunately, you can get the help you need with our handy addiction treatment insurance coverage tool.

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