Does Optum Cover Drug and Alcohol Rehab?
Yes, if you have health insurance, there is a strong possibility that your drug or alcohol addiction treatment will be partially (if not fully) covered. However, many factors contribute to the extent of your rehab service coverage. For example, your particular healthcare plan, your location, and the rehab center you choose will all be taken into careful consideration when determining the breadth of your addiction treatment coverage.
Please note that Optum is not an insurance company but a care delivery service that contracts with most insurance plans to facilitate care to members. It is a network of thousands of primary and specialty care doctors. If your insurer utilizes Optum for addiction treatment services, you should be able to find covered evidence-based treatment.
Call to speak to a knowledgeable admissions navigator at American Addiction Centers for assistance with your specific situation.
Getting the help you need to treat your addiction can feel overwhelming. You can rest assured that if you have health insurance, you can use your coverage to make treatment more affordable.
It is crucial to verify your health insurance coverage for alcohol and drug rehab before entering a substance use treatment facility. There are several ways you to check your insurance coverage, and verifying your benefits can be easy. First, Optum has online member portals for access to information about your insurance coverage and plans. Optum also has representatives available to answer any questions you have about coverage and options.
If there is a specific treatment center you are interested in attending, it is a good idea to contact the facility directly. The treatment facility can verify whether they contract with Optum and help you ascertain what services will be covered.
Finding the Right Treatment Options with Optum
Treatment for addiction and substance use isn’t a one-size-fits-all endeavor. Many different services fall under the umbrella of substance use treatment. Your treatment plan will be tailored to your specific addiction challenge, mental health, finances, and insurance needs.
Depending on your insurance plan and the treatment center you choose, you may need a referral from your primary care physician. If you are unsure, check with both the treatment center and Optum. Speak to an Optum representative and let them know which treatment center you are interested in. They can help you determine whether you need a referral from your primary doctor and what paperwork may be required prior to your admission.
Inpatient Treatment Through Optum
Insurance plans generally cover inpatient treatment, a level of care that involves staying full-time in an addiction treatment facility. In inpatient treatment, clients generally receive 24/7 medical and behavioral care as they go about their daily activities of eating, sleeping, and socializing. Individual and group behavioral therapy can help address unique challenges that accompany substance use and mental health issues. Remember, it is important to make sure that your plan covers inpatient services and that your treatment provider is accepted by your insurance.
Detox—the process by which substances are eliminated from the body—is the first step toward inpatient treatment and recovery for many people. It generally takes place under the direction of addiction professionals. Many detoxification programs incorporate the use of medications to aid in the reduction of withdrawal symptoms.
Outpatient Treatment with Optum
Outpatient treatment is considered the least restrictive form of substance use treatment. It usually occurs after detox and inpatient treatment have been completed. In outpatient treatment, you can expect to receive individual, family, and group therapy options. Outpatient treatment services for substance use may be covered by Optum. Like inpatient treatment, your outpatient treatment plan will be customized to your personal needs.
Does Optum Cover Medication-Assisted Treatment?
Detoxification services and medication-assisted treatment (MAT) may be covered under your insurance plan. Some rehab facilities use MAT to help reduce withdrawal symptoms and increase clients’ level of comfort.4 MAT uses specific medications that have been approved by the Food and Drug Administration for treating substance use disorders such as alcohol and opioid use disorder.4 The controlled environment of MAT is one of the benefits of detoxing in an inpatient program.
Does Optum Cover Sober Living?
If detox is considered the starting point for many in their recovery journey, sober living can be thought of as the last step before you resume your life in your normal environment. Sober living facilities are homes for people in the early stages of recovery from drugs and alcohol. While it’s not a requirement for treatment, it is often a good option for many people.
Sober living homes are somewhat less restrictive than inpatient treatment. Still, residents are expected to adhere to certain practices. Staff members—some of whom may be in recovery themselves—ensure that house rules and schedules are followed. Drug and alcohol tests are also common practice in sober living homes. Sober living is not often covered by insurance but there may be exceptions.
American Addiction Centers and Optum
Support is available for those who want to find a rehab program that contracts with Optum. Many American Addiction Centers (AAC) facilities work with Optum, and they can help you verify your coverage before you enter treatment.
From detoxification and inpatient to outpatient services and sober living, you can rest assured that American Addiction Centers will work with Optum to provide the services you need to live a successful life in recovery from drugs and alcohol. There is hope. If you are struggling with drug and alcohol addiction, American Addiction Centers will work with you and your insurance provider to ensure you receive the best treatment possible.
