UnitedHealthcare provides coverage for mental and behavioral health services, including addiction treatment. If you need help fighting drug and alcohol addiction and have UnitedHealthcare, treatment for your substance use disorder may be covered by your plan.
Continue reading to learn more about behavioral health coverage under UnitedHealthcare, and how to confirm whether your plan will help pay for addiction treatment.
About UnitedHealthcare Insurance
UnitedHealthcare has nearly 49.5 million members, including Medicare and Medicaid beneficiaries. This major health insurer partners with more than 1.3 million healthcare professionals and 6,500 healthcare facilities throughout the United States.
In terms of behavioral health services, UnitedHealthcare prides itself on offering a variety of evidence-based treatments for addiction—particularly opioid use disorder. Medication-assisted treatment (MAT) and methadone maintenance are some of the many proven addiction treatments UnitedHealthcare offers to its members who are struggling with opioid dependence.
UnitedHealthcare insurance is accepted by many drug and alcohol rehab centers in all 50 states, making it relatively easy for members to find nearby addiction treatment in their local areas. Benefits and coverage will vary from one member to the next based on their type of plan, so it helps to know about your benefits before seeking treatment.
Which Addiction Treatment Services Are Covered By UnitedHealthcare?
Addiction is considered a behavioral health condition, and behavioral health treatments and services are covered by UnitedHealthcare. Medical detox, inpatient rehab, and MAT are some of the many addiction treatment services covered by this health insurer.
Medical detox is an essential addiction treatment for people who are physically dependent on drugs and alcohol. Withdrawal symptoms for alcohol, opioids, and benzodiazepines can be severe and life-threatening for some, and increase the risk of complications including seizures and heart failure. Medical detox provides patients with 24-hour medical care as they go through withdrawal.
In medical detox, medications are often used to reduce withdrawal symptoms and help patients feel more comfortable for the duration of treatment. Some of these medications can also reduce drug cravings. Patients are encouraged to rest and relax during medical detox or do mild exercises that can help them experience relief.
The length of medical detox varies from one patient to the next based on the type of drugs they were using and the severity of their symptoms. For instance, withdrawal from benzodiazepines can last up to eight weeks or longer, while withdrawal from alcohol can last two to 10 days, reports the World Health Organization. After medical detox is over, many patients transition into a drug and alcohol rehab program to receive counseling and behavioral therapy for addiction.
Inpatient rehab is a short-term recovery program that provides 24-hour medical care and supervision in hospitals or other medical settings. This program is ideal for patients who need continued medical care after medical detox, and after acute withdrawal symptoms have gone away.
Many patients in inpatient rehab programs need to be stabilized due to psychological conditions, including severe aggression, depression, and paranoia. These symptoms are common among patients in recovery from crack, cocaine, and methamphetamine addiction.
Other patients who can benefit from inpatient rehab are those with severe alcohol use disorder. Seizures are a common complication of severe alcohol addiction and may require weeks of hospitalization, according to MedlinePlus.
Inpatient rehab programs usually last several days or weeks. After inpatient rehab, many patients transition into a residential or outpatient rehab program to continue their addiction treatment.
Residential rehab provides patients with a comfortable, home-like recovery environment that separates them from drugs, alcohol, and negative influences. This program is ideal for patients who need 24-hour supervision and access to support as they adjust to a sober lifestyle without drugs and alcohol. This program also benefits those who are unable to live at home while receiving treatment due to unstable living conditions or homelessness.
Residential rehab programs typically last 30 to 90 days, though longer programs are also available. Patients receive several hours of therapy a day and are provided with nutritious meals and amenities that can enhance their recovery. Therapy focuses on helping patients change harmful behaviors and beliefs related to drug and alcohol use.
UnitedHealthcare covers residential treatment, though the number of treatment days covered will depend on your plan details.
UnitedHealthcare provides coverage for several outpatient rehab programs, including partial hospitalization programs (PHPs), intensive outpatient programs (IOPs), and standard outpatient programs. Outpatient rehab programs are for patients who want to live at home or in a sober living community while receiving addiction treatment.
PHPs provide the highest level of outpatient care. Patients in PHPs receive four to six hours of therapy a day, five days a week. These day treatment programs are ideal for patients with safe homes and highly supportive friends and family who can help them stay sober.
IOPs provide a lower level of care than PHPs. Patients in IOPs receive 12 weeks of therapy that teach them how to become more independent and avoid daily triggers that could potentially lead to relapse. IOPs usually offer various day and night classes that can be scheduled around a patient’s work and family schedules.
Standard outpatient rehab programs meet less frequently than IOPs for a few hours on one or two days a week. This outpatient program is ideal for patients who need continued support as they rebuild their lives and reconnect with family. Twelve-step support group meetings, family behavior therapy, and medication management services are some of the many useful services available through standard outpatient programs.
Opioid Treatment Programs (MAT and Methadone Maintenance)
UnitedHealthcare provides coverage for many opioid treatment programs, as it recognizes that opioid addiction remains a serious public health crisis in the United States. MAT and methadone maintenance are covered by UnitedHealthcare to help people recover from opioid dependence.
MAT combines the use of medications with counseling and behavioral therapy for a whole-person approach to addiction treatment. The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that the medications used in MAT can normalize brain chemistry and block the pleasurable effects of opioids. UnitedHealthcare reports that patients who receive MAT are 50% more likely to stay abstinent from opioids compared to those who receive only detox or psychosocial treatment.
Methadone maintenance therapy (MMT) is a service that provides patients with a daily dose of methadone to reduce opioid cravings and other withdrawal symptoms. Methadone works on the same brain receptors as other opioids, but without producing the same pleasurable effects that make it habit-forming. Methadone can eliminate opioid withdrawal symptoms—including drug cravings—to help patients stay abstinent from opioids.
Sober Living Communities
UnitedHealthcare may cover some costs associated with sober living homes if the facility offers outpatient treatment services. Sober living communities provide patients with a structured environment where all residents are in recovery from addiction. These environments can often motivate and empower residents to stay sober and engaged with their treatment plans.
Sober living homes are a good option for patients who recently transitioned from residential rehab into outpatient rehab and need a safe place to call home until they’re ready to become more independent. Residents are expected to adhere to a set of rules that teach them how to be more responsible, such as being home by curfew and attending weekly support group meetings. Many sober living homes also provide residents with transportation to and from drug and alcohol rehab centers so they continue to receive addiction treatment.
How Can I Check My Coverage and Benefits With UnitedHealthcare?
UnitedHealthcare makes it easy for you to check your benefits and coverage at any time.
Visit the UnitedHealthcare member services website and sign in to your MyUHC account, or select the option to register if you do not have an account. Then, follow the instructions provided to check your plan benefits.
If you have a UnitedHealthcare member ID card, call the number on your ID card to learn more about your plan benefits. If you do not have your member ID card, call (866) 414-1959 to speak to a UnitedHealthcare representative about your benefits and coverage.
Another way to confirm your benefits under UnitedHealthcare is to contact your addiction treatment provider directly. Many drug and alcohol rehab centers are happy to check your benefits for you and find out which services are covered by your health plan.
America’s Rehab Campuses accepts UnitedHealthcare insurance plans and can quickly verify your benefits and coverage so you begin treatment as soon as possible. Contact America’s Rehab Campuses at 833-272-7342 to verify your insurance coverage.
What If UnitedHealthcare Doesn’t Cover My Addiction Treatment?
If your UnitedHealthcare plan doesn’t cover the addiction treatment services you need or covers only a portion of the costs, contact your drug and alcohol rehab center for further assistance.
Many addiction treatment providers offer a variety of financing options that can make treatment more affordable. Monthly payment plans and sliding scale fees that adjust the cost of treatment based on your income level are examples of financing options offered by many rehab centers. Contact America’s Rehab Campus directly to learn more about whether it accepts your UnitedHealthcare health insurance.