United Healthcare Insurance Coverage for Drug and Alcohol Rehab
UnitedHealthcare (UHC) is an international leader in the health insurance industry, with tens of millions of policyholders. UHC provides health insurance policies in 130 different countries and all 50 U.S. states, serving more than 70 million customers in the US. You may be curious whether UnitedHealthcare provides coverage for rehabilitation services.
This page will provide an overview of the drug abuse coverage alternatives available to you via UnitedHealthcare. However, the specifics of your plan will decide the scope of your coverage.
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Typically, co-insurance percentage range from 20% to 40%, and the insurance company clears the rest.
The amount you pay out-of-pocket for treatment before the health plan starts helping with payments.
Co-pay is a fixed amount you must clear (usually when you receive treatment) for covered treatment services.
UHC Plans: Paying for Rehab with United Healthcare
President Obama's decision to sign the Affordable Care Act (ACA) into law in 2010 was a watershed moment for the healthcare industry. It has made the process of paying for recovery much more accessible. With the passage of this legislation, health insurers, like UnitedHealthcare, are obligated to adhere to the law and help cover the costs associated with your drug or alcohol addiction treatment.
The following are the primary classifications of insurance plans that UnitedHealthcare insurance provides:
Marketplace plans under the Affordable Care Act
These policies emerged after the passage of the ACA during President Obama's term in office. Since the employer is not chipping in, the monthly premiums for these plans are often more than regular health insurance. Your monthly premium is calculated as a percentage of your household's gross income.
Group Benefit Plans
These programs are offered through employers.
Government Assistance Plans
Medicare, mainly provided to senior adults, and Medicaid, offered primarily to low-income Americans and their families, fall into this category. UHC offers health insurance policies to Medicare and Medicaid beneficiaries that go above and beyond the minimal requirements set by the government.
The following are the two primary groups that the UnitedHealthcare plan types fall into:
Open Access Plans
Typically, with these plans, you may only get care at clinics and hospitals with formal contracts with UnitedHealthcare (in-network facilities). In this kind of policy, there are two options to choose from:
If you choose this option, you can only get care from doctors and hospitals that are part of the UHC network.
UnitedHealthcare Choice Plus
This option extends coverage to non-network providers but comes with higher out-of-pocket costs for you.
Preferred Provider Organization (PPO)
With UHC's PPO plan, you may see any doctor you choose. Care from a provider outside UHC's network requires prior authorization, and patients must then submit claims for reimbursement. However, when you go outside the UHC network for care, you should expect to pay more.
Rolling Hills Recovery Center
Dr. Williams presently serves on the board of Directors for two non-profit service organizations. He holds a Master’s degree in Human Services from Lincoln University, Philadelphia, Pa, and a Ph.D. with a concentration in Clinical Psychology from Union Institute and University. In Cincinnati, Ohio. He is licensed to practice addictions counseling in both New Jersey and Connecticut and has a pending application as a practicing Psychologist in New Jersey.
What portion of the price of rehabilitation is reimbursed by United Healthcare?
The main concern when seeking treatment is often how much rehab will cost you out-of-pocket. Your coverage is mainly determined by your plan and the kind of treatment you need.
Out-of-Pocket UHC Payments
Before your UHC coverage begins to pay out, you may need to reach the deductible and copayment threshold. The deductible is the maximum sum of medical expenses you must pay out of pocket each year before your health insurance starts to pay for treatments.
The payment of a copayment, which is a type of co-insurance, is typically necessary to maintain coverage under health insurance policies. Your UHC plan may require paying a specific copay (for example, $40) for accessing a covered medical service after reaching your health plan's deductible. It refers to the part of a service cost that the insured must pay out of pocket.
The cost of treatment sessions often runs from $15 to $50; in best-case scenarios, they may be entirely covered. Thus you wouldn't have to pay anything beforehand. In worst-case scenarios, you will be required to pay the entire session price, typically from $80 to $200 for each session. A typical UHC reimbursement plan works as follows:
After you've met your deductible, your therapy appointments with an in-network therapist from UHC will cost you $15 to $50 for each session. Your copay is between $15 and $50.
The following scenarios that fall under the umbrella of "In-network Outpatient Mental Health" may be relevant to your case:
Copayment of $15 after a deductible of $5,000.
If you spend over $5,000 on healthcare this year, each treatment session will only cost $15.
Copayment of $15 after a deductible of $1,000.
If you spend over $1,000 on healthcare this year, each treatment session will cost $15.
The co-payment is $15, and there is no associated deductible.
No matter how high your deductibles go, you will only have to pay $15 out of pocket for each treatment session you attend.
If you have a PPO plan and see a therapist, not in UHC's network, expect to pay anywhere from $50 to $100 per session (20% to 50% of the total price your therapist costs).
After the deductible has been met, PPO plans often pay for treatments received from providers outside the PPO's network. In the "Out-of-Network" OMH (Outpatient Mental Health) section of your Summary of Benefits, you may notice the following illustrations:
After meeting a $5,000 deductible, each session with the therapist costs $100 plus 20 percent coinsurance.
Your plan reimburses $80 for each session once you've spent $5,000 on healthcare this year, bringing your net cost per session to $20.
20 percent coinsurance, after attaining a $1,000 deductible, the therapy costs $150 per session.
Your plan reimburses you for $120 of your therapy price for each claim once you've spent $1,000 on healthcare this year, bringing your effective treatment cost down to $24 per session.
If you have a UHC EPO or HMO Plan and you see a mental health professional, not in UHC's network, your plan will likely not cover the cost of your sessions. If your plan does not cover therapy, you will be responsible for paying the entire price of each session upfront. Look for a psychotherapist who provides a sliding scale or reduced session rates depending on financial necessity if the treatment expense prevents you from getting help.
Why Recover With RHRC?
There are affordable options for addiction treatment
Rolling Hills Recovery Center works with a variety of healthcare providers.
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What Types of Addiction Treatment Does United Healthcare Cover?
Like almost any health insurance company, United Healthcare limits the types of substance abuse treatment covered by its various plans.
Most UHC plans provide a range of services for substance abuse, including:
It's when you get help for an addiction to drugs or alcohol on a round-the-clock, seven-days-a-week basis in a licensed facility. This often occurs in a hospital environment so that a doctor can keep an eye on you. There is no set duration for each inpatient program. You can enroll in shorter 28- or 30-day programs or longer 60- or 90-day inpatient treatment programs.
With this option, you need to spend a few hours per day and a few sessions each week at a rehab facility, making it the least intense alternative. Outpatient programs include:
Standard outpatient programs (OPs)
Intensive outpatient programs (IOPs)
Partial hospitalization programs (PHPs)
In no way should the expense of therapy prevent you or a loved one from obtaining help. Addiction to drugs or alcohol is now covered by insurance in all 50 states because of recent legislation that has broadened the scope of treatment by categorizing addictions as diseases. Reach out to Rolling Hills Recovery Center for assistance understanding and using your UHC health insurance policies to fund rehabilitation.
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UHC covers many addiction treatment services.
Rolling Hills Recovery Center accepts a variety of UHC insurance coverage.
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