Does UnitedHealth Group Insurance Cover a Drug Treatment Facility?

Content Overview

I have health insurance through UnitedHealth Group. Does it cover a drug treatment facility?

It might, depending on the plan you’ve purchased and the symptoms of addiction you’re facing. Contact the company either online or over the phone, and ask about what is and is not covered under your benefit plan. Or, consider choosing a treatment facility and asking the staffers there to call UnitedHealth for you. They may be able to get answers faster.

A community-minded company that is both diverse and innovative, UnitedHealth Group is a forerunner in healthcare coverage in the United States.
 
As a company, UnitedHealth Group is technologically advanced and thinks on a global scale, while investing time and energy into the overall wellbeing of local communities. UnitedHealth Group wants to help make the world a better place by improving healthcare and healthcare coverage around the world and close to home.

UnitedHealth Group recognizes the issues that substance abuse and dependency may create, and provides grants and support to community outreach and behavioral health services in local communities across the country. According to Open Society Foundations, only one out of every 10 people who need treatment for a drug or alcohol abuse or dependency problem actually gets the help they may need. This may be due to a variety of factors, not the least of which is the lack of applicable health insurance coverage, or knowledge on how to successfully use it. The Affordable Care Act was passed in 2010, which enhanced mental health and substance abuse treatment coverage in the United States by considering mental health and substance abuse treatment as one of the 10 “essential health benefits” that are required to be covered under most basic health insurance plans, opening up access to treatment services for more people in need of them.

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Using UnitedHealth Group Insurance for Drug Treatment

getting treatment A drug treatment program can enhance recovery and lower lifetime costs related to substance abuse for families, individuals, and society overall. A drug treatment program may use pharmacological and therapeutic methods in an outpatient or residential setting.

Medications may be used during medical detox to reduce withdrawal symptoms, drug cravings, and prevent relapse. Counseling and therapy sessions, as well as life skills training and educational methods, may be part of a treatment program as well as mental health services when necessary. Recovery services may include support groups, 12-Step meetings, and relapse prevention programs.

Finding a drug treatment program that accepts UnitedHealth Group Insurance may be accomplished by calling a United Behavioral Health phone number for authorization for services at contracted or network providers in some coverage areas, or by logging onto liveandworkwell.com to find covered providers. This site will also allow members to better understand coverage options provided through Optum, which is now part of the UnitedHealth Group.
In some cases, an appointment with a primary care physician (PCP) may be the first step in order to obtain a referral for in-network substance abuse treatment services. Different regions and coverage plans will have different methods for finding and enrolling in drug treatment programs. Logging into myuhc.com can help individuals find detailed information on their specific healthcare coverage and what the exact steps for finding, receiving, and paying for treatment may be.

Group Insurance Plan Details

UnitedHealth Group offers a variety of insurance options and services, such as:

  • Individual and family plans are available for those under the age of 64 through the UnitedHealth One program that insures close to 29 million people in the United States.
  • Military members and veterans in the TRICARE West region may use UnitedHealth TRICARE
  • Health and wellness information, tools, and resources are provided for UnitedHealth Group members through the Optum Health business model.
  • Medicare-enhanced services are available for individuals over the age of 65 who wish to expand their federal Medicare coverage. They may enroll in a UnitedHealth Medicare Advantage plan or prescription drug plan.
  • Individuals who qualify for Medicaid or other government healthcare programs may be eligible for the UnitedHealthcare Community Plan.
  • Hospice and palliative care are available from UnitedHealth Group through the Optum Palliative and Hospice Care program designed to support individuals and families with serious or long-term illnesses.

UnitedHealth and Optum have a large network of behavioral health services to choose from, with over 130,000 facilities and clinicians providing a range of services including treatment for substance abuse. Coverage may be in the form of a healthcare savings account (HSA), or a traditional copay plan. An HSA can be set up by individuals or employers, and both may contribute tax-free funds to this account that can then pay for medical services. HSAs are usually an addition to health insurance plans.


Traditional copay health insurance plans require copays for most services, although preventative services may be covered without requiring a copay.


Most plans will have a deductible that individuals must reach before services are covered at a set percentage. Many plans may cover services at 80 percent, for example, after the deductible is met, meaning that individuals must pay a coinsurance rate of 20 percent. Annual maximum out-of-pocket expenses cap how much a person pays in annual medical expenses and services.

UnitedHealth Group may also offer catastrophic plans in certain coverage areas, which are plans with low and affordable monthly premiums and high deductibles. These plans may incur more out-of-pocket expenses, but they do have a safety net maximum amount for unexpected or big medical costs. Each plan is slightly different, depending on the level of coverage desired, monthly premiums paid, type of coverage, and coverage area.

A sample Gold Co-pay Select Plan in Georgia covers outpatient substance abuse and mental health services with a $25 copay required for in-network providers and coinsurance rates of 20 percent after the deductible is met, with penalties and higher out-of-pocket expenses when using an out-of-network provider.


Inpatient services for drug treatment programs covered by UnitedHealth Group insurance may be found by using the “Facility Search” tool on the website while outpatient clinicians may be found through the “Clinician Search” tool.


Insurance companies like UnitedHealth Group are able to provide a Summary of Benefits and Coverage (SBC) that has complete details of an individual’s health insurance coverage, including what may be covered; specifics on the deductible, out-of-pocket amount, and maximum annual amount; and whether or not a copay will be required. For more specific information on whether or not a treatment center takes a particular type of insurance or a certain insurance plan, individuals can contact the facility or provider directly. The provider can provide information regarding what insurance may cover, how to use the coverage, what is required to obtain coverage or enroll in a covered program, and how to fund any additional expenses.

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