Addiction Treatment Through UHC Health Insurance & Optum

Both UnitedHealthcare (UHC) and Optum fall under the parent company UnitedHealth Group.¹ UHC provides insurance coverage to more than 26 million consumers in the United States alone,² while Optum offers specialty behavioral health services to customers through 3 businesses focused on health, insight, and pharmacy care.³

This page will discuss using Optum services and UHC insurance for addiction treatment.

Does Optum and UHC Cover Substance Abuse Treatment & Rehab?

Yes, under the Affordable Care Act (ACA), insurance companies are mandated to cover at least a portion of mental health services and addiction treatment costs.⁴

However, the extent of coverage will vary depending on your specific insurance policy. Distribution of coverage for addiction treatment and mental health services must also be equal to the given plan’s other medical benefits per the Mental Health Parity and Addiction Equity Act (MHPAEA).⁵

UnitedHealthcare Plans for Drug and Alcohol Addiction Treatment

Specific provider networks that meet the ACA marketplace and employer plan requirements include:⁶

• HMO: With most HMO plans, you must see an in-network primary care physician (PCP). Since these plans keep costs low, there is commonly a low (or no) deductible and low premiums.
• PPO: PPO plans allow the flexibility of seeing providers inside and outside your network. Premiums and deductibles tend to be higher.
• POS: POS plans are a combination of HMO and PPO plans. You’ll have some coverage to see out-of-network providers with a referral but often have a higher co-pay.
• EPO: With an EPO, you can see any provider within your network without a referral, but there are no out-of-network benefits.

How to Use Optum and UHC Insurance to Pay for Addiction Rehab

To use UHC insurance for rehab, you must first find a treatment facility that accepts UHC coverage.

Oxford Treatment Center is in the Optum/UHC provider network. Verify your insurance coverage at Oxford confidentially by using the .

You can also find providers in your insurer’s network by calling the number on the back of your insurance card or checking the UHC and Optum websites.

Some plans may require prior authorization before treatment begins.⁷ If you need assistance using UHC for rehab, our admissions navigators at Oxford Treatment Center are standing by at .

How Much Does Rehab Cost with UHC Insurance Coverage?

The out-of-pocket cost of using United Healthcare insurance coverage for substance use treatment will depend on a variety of factors specific to your plan, like the deductible, copayment, co-insurance rate, and out-of-pocket limit.

These insurance terms are defined as:

• Deductible: The yearly amount you pay out-of-pocket for services before your insurance company starts to pay.⁸
• Copayment: The fixed amount for a covered service. Your plan may require a copay at each outpatient visit.⁹
• Co-insurance rate: The percentage of costs you pay for a covered service after you’ve paid your deductible. For example, if your co-insurance rate is 20%, UHC would cover 80% of the costs.¹⁰
• Out-of-pocket limit: The maximum amount you pay for covered healthcare services out of pocket in a year. Once you’ve reached this amount, UHC would cover 100% of the remaining costs.¹¹

Which Types of Substance Abuse Treatment are Covered by UHC and Optum?

Your UHC plan may cover some or all of the costs for different types of addiction treatment, including:

• Medical detox.
• Residential treatment.
• Outpatient addiction treatment.
• Intensive outpatient programs.

Benefits of Using Your UHC Insurance to Pay for Your Addiction Treatment Rehab

Using your UHC insurance to pay for addiction treatment makes treatment affordable and accessible by providing access to various providers in many locations.^1,2,3

Seeking help for addiction is the first step to recovery. Our staff is available 24/7 at to help you use your UHC coverage for drug and alcohol rehab, find other ways to pay for rehab or start the admissions process at our outpatient or inpatient drug and alcohol rehab in Mississippi.