UnitedHealthcare Rehabilitation Coverage: Insurance Coverage for Addiction Treatment

UnitedHealthcare Group is the largest health insurance provider in the United States. As such, the company offers health insurance to some 49.5 million people. This is good news if you’re looking for drug rehab coverage for substance abuse. UnitedHealthcare offers an extensive network of drug and alcohol rehab clinics and hospitals. However, there is still a lot to research and learn about your coverage and your specific insurance plans before you go to rehab.

For example, UnitedHealthcare insurance offers vastly different coverage depending on your addiction treatment plan. That’s also true if you have UnitedHealthcare rehab coverage through your employer. This means you’ll have to check your insurance coverage with your employer to assist with your recovery journey.

Does UHC Insurance Cover Substance Use Disorders?

Yes, UnitedHealthcare insurance offers coverage for substance use disorders and mental health conditions. Every insurance provider in the United States covers addiction treatment programs. That’s because it’s required under the Affordable Care Act.

In addition, as UnitedHealthcare Insurance is one of the largest insurance providers in the country, you’re very likely to have your insurance accepted by most clinics and drug rehab providers. UnitedHealthcare plans also have one of the largest networks of PPOs on the market for policyholders.

Finding Rehab Facilities That Accept UnitedHealthcare

You may be wondering, “What does UnitedHealthcare cover?”. UHC offers support for most rehab facilities. Thus, UnitedHealthcare Plans cover inpatient rehab and outpatient rehabilitation. It is best to contact your insurance company to understand UnitedHealthcare rehabilitation coverage and your benefit plan. UHC covers various outpatient rehabilitation services and other addiction rehab treatments to improve your overall well-being.

These include:

However, it’s important to keep in mind that your actual addiction treatment will depend on the rehab center you go to. If you want dual diagnosis treatment, you’ll need a treatment center that provides it. If your rehab facility is in UHC’s network, they will offer coverage.

Understanding the Costs With UnitedHealthcare Rehab Coverage

UHC divides its plans by provider and by scale. You can get a PPO (Preferred Provider Organization), a Health Maintenance Organization (HMO, a Point of Service (POS), or an Exclusive Provider Organization (EPO), which are then divided into tiers. Therefore, those points will affect the following policy documents and costs:

• Bronze – $9,100 deductible with a matching out-of-pocket limit. However, you won’t pay anything else. You cannot go to an out-of-network provider.
• Silver – UFC’s silver plan has a $2,000 deductible with a $9,100 out-of-pocket limit. You’ll also pay a $20 per-visit copay for outpatient rehab or outpatient therapy services and a $750 copay for inpatient services. Out-of-network providers are not covered. In addition, you may pay more without a referral. 
• Gold – UFC’s Gold plan has no deductible. You’ll also pay $5,000 out of pocket for in-network providers. Otherwise, costs are the same as the silver plan.
• Platinum – The Platinum plan does not have a deductible. In addition, you’ll pay a maximum of $3,000 out of pocket for in-network providers. There are no costs with an IHCP provider. However, you can expect a $500 per admission at a non-IHCP provider with a reference. Out-of-network providers are not covered.

Your actual coverage can vary greatly, and it will vary further based on the specific type of your plan.

Can You Go to Out-of-Network Providers?

UHC allows out-of-network providers, depending on the type of plan. For example, if you have an EPO, you cannot go out of network. On the other hand, most other plans will allow you to do so. However, you will pay extra costs.

In most cases, UHC does not support out-of-network providers. Nevertheless, you may be able to waive some costs by attending a specific type of provider with a referral. However, you’re always better off attending an in-network provider. With over 760 treatment centers accepting UnitedHealthcare, that should be relatively easy. With almost 300,000 behavioral health providers, UHC offers plenty of coverage for counseling, therapy, and aftercare as well.

UnitedHealthcare Rehab Coverage: Steps for Getting Coverage

One of the largest insurance providers in the United States is UnitedHealthcare. In fact, it lists that over 29,000 people have used its insurance policies to attend rehab centers between 2020 and 2023. UHC has an extremely large network, which makes it relatively easy to move forward with the provider.

Here, you’ll want to:

• Go to your healthcare provider and get a referral; this ensures you get maximum coverage, although not all plans will need it
• Choose an in-network provider to go to. You can do this with your physician or with the help of your rehab counselor
• Check what your specific plan covers and how much it covers, so you understand your total out-of-pocket costs
• Request prior authorization for treatment, either through your doctor or through the UHC dashboard

From there, you can go to treatment and get coverage for your substance use disorder, just like you would for any other medical service or treatment. UHC will follow up on your claim in the same fashion as anything else.

Keep in mind that if you have UHC insurance through your employer, you’ll have to use their terminal. However, the employer is not legally allowed to know what you’re getting medical treatment for or the level of care you are receiving. For that reason, prior authorization always goes through UHC and not through your employer. 

UnitedHealthcare Group is one of the largest insurance providers in the United States. It’s also one of the options with the most extensive networks. That’s good, because they rarely offer coverage for out-of-network clinics. However, with over 760 treatment centers in the network, you’ll still have plenty of options to get the treatment you want and make informed decisions.

Stairway Resource Center is an in-network provider for UnitedHealthcare Insurance. If you or a loved one is seeking healthcare services for drug or alcohol abuse, contact us at Stairway Resource Center today. At Stairway Resource Center, we provide a 60 to 90-day outpatient program that takes place in an engaging and supportive community setting. We offer dual diagnosis treatment and daily group and individual therapy for our clients, in addition to fun community-based events and activities.

UnitedHealthcare Group is the largest provider of health insurance in the United States. As such, the company offers health insurance to some 49.5 million people. Call us at (888) 450-2701 for help getting started.