UnitedHealthcare Drug And Alcohol Rehab Insurance Coverage
- UnitedHealthcare Insurance For Drug Rehab
- Using Insurance To Pay For Treatment
- Do I Need To Stay In-Network?
- Out-Of-Pocket Costs
- Covered Treatment Programs
- Verify Your Insurance Coverage
UnitedHealthcare is an insurance provider in Massachusetts which offers drug and alcohol rehab coverage for its policyholders. Coverage offered by UnitedHealthcare insurance company may vary by individual plan, coverage tiers, where a person seeks alcohol and drug addiction treatment, and more.
UnitedHealthcare insurance offers coverage to millions of Americans across the United States. It provides coverage in the state of Massachusetts and may offer solutions to help with substance abuse treatment, mental health treatment, and other behavioral health services.
The specific amount of coverage in an individual’s policy may vary based on the details of their plan. Since UnitedHealthcare offers a variety of different plan options, individuals will need to evaluate the details to ensure that a specific type of alcohol and drug treatment is covered.
Generally, a policy will offer some assistance with residential treatment, outpatient treatment, or detox services. Whether your plan will be accepted for coverage could depend on the rehab center you choose.
Spring Hill Recovery Center works with a number of insurance companies to determine the exact costs of inpatient treatment or outpatient treatment, based on the needs of the individual.
Factors to consider when evaluating your insurance policy include:
- the coverage on your UnitedHealthcare policy
- the out-of-pocket costs that apply to your individual plan
- any verification details that may apply to your policy, such as referrals from a medical professional
Make sure you understand the details of your policy before you start treatment for addiction recovery. Each policy sets different standards for recovery programs, so you will want to verify your coverage as well as any requirements before you obtain treatment.
Massachusetts UnitedHealthcare Insurance For Drug Rehab
Insurance coverage from UnitedHealthcare for a substance use disorder depends on the details of your policy. Generally, the insurance carrier offers two Medicare healthcare plans.
The HMO policies are designed around the needs of elders and provide assistance in medical treatments and medical needs. The exact coverage in the policies for drug rehab or alcohol treatments differ based on the specific policy.
While the options available in Massachusetts through public sources are designed around seniors, an employer may also offer a group policy through UnitedHealthcare insurance. Group policies from an employer will offer different options and coverage rates based on the options an employer selects for employees.
Specific coverage for addiction treatment services may vary based on the policy and plan available to individuals. Policies through UnitedHealthcare will typically offer between 60 and 80 percent coverage for treatment after you pay the stated deductible.
Keep in mind that out-of-network treatments may require a higher out-of-pocket cost when compared to in-network treatments, so you will want to evaluate the policy to clarify the exact coverage of your plan.
Using UnitedHealthcare Insurance For Addiction Treatment
Behavioral health treatment for addicted individuals is an effective method of assisting with recovery goals. It is worth the costs associated with inpatient rehab or outpatient treatment.
When you do not have any insurance coverage, substance abuse treatment may be expensive or difficult to pay, so you will want to evaluate your policy to determine if you have coverage for addiction treatment programs.
UnitedHealthcare may help reduce the costs to seek treatment for addiction recovery. Although the insurance carrier offers solutions to help with the expense of treatment, there are steps you may need to take before your coverage applies to your situation.
Do You Need To Stay In-Network To Use UnitedHealthcare Insurance In Massachusetts?
UnitedHealthcare offers different types of insurance policies and plans, which means the standards for in-network providers and out-of-network providers may vary by policy and plan. Insurance plans in Massachusetts through UnitedHealthcare most often fall into two primary categories: HMOs and PPOs.
In the case of an HMO policy, UnitedHealthcare may require you to seek an in-network treatment provider. The policy may allow you to consider out-of-network treatments when it is referred by a provider or you do not have an in-network provider available; however, the details vary based on your policy.
PPO policies may allow you to seek out-of-network treatment, but you should be aware that policies may have reduced coverage or rates for out-of-network providers. You will want to look at the details of your specific policy to determine if the out-of-pocket costs will increase and the exact coverage details.
What Out-Of-Pocket Costs Can You Expect For Rehab?
When you work with UnitedHealthcare in Massachusetts, the out-of-pocket costs for drug and alcohol rehab may vary significantly based on your policy. These costs usually fall into three categories: copayments, deductibles, and treatments that are not covered by your policy.
A copayment is an amount you pay at the time of treatment or service. For example, if you enter an outpatient treatment program and your policy has a $25 copay, then you pay $25 at the treatment facility before you leave the building. You will often receive a bill from the treatment provider after it goes through UnitedHealthcare.
Deductibles refer to the costs you pay before the policy begins paying for your treatment. It is a fixed amount, such as $1,000 per year. After you pay the deductible for the calendar year, then your coverage applies to any future treatments.
Treatments that are not covered by your policy may vary widely based on the details of your plan. For example, a policy may not cover alternative therapies that do not have evidence to back the effectiveness of the treatment. If you decide to pursue treatments that are not covered by your policy, you are often responsible for the costs.
Finding Rehab Programs That Accept UnitedHealthcare
UnitedHealthcare plans are accepted by many rehab facilities for drug and alcohol treatment. If you are uncertain about your policy’s coverage or you want to verify that a rehab program is covered as an in-network provider, talk to a representative at UnitedHealthcare. Or, you may talk to a treatment representative at Spring Hill Recovery Center.
Does UnitedHealthcare Cover Inpatient Rehab?
UnitedHealthcare insurance policies cover a portion of inpatient or residential rehab programs for drug or alcohol abuse and co-occurring mental health disorder through many plans. The exact amount of coverage you can expect for residential treatment varies based on your policy and the details of your plan.
Inpatient treatment programs differ based on the type of treatments an addicted individual needs for his or her health goals. Generally, the rehab programs will last from a few weeks up to 90 days.
You should be aware that exact durations for residential treatment differ for each program, and many programs may require detox services before you start inpatient rehab. A detoxification program may last from three to seven days, depending on the substance abused and the health risks.
UnitedHealthcare may require you to provide proof that you need treatment before covering the cost of residential drug rehab. You should also be aware that some policies may set limitations on the duration of treatment.
A referral from your medical doctor or treatment at a hospital may show medical necessity and allow you to seek residential rehab services.
Is Medical Detox Covered By UnitedHealthcare?
Medical detoxification is often the first step in treating a substance use disorder. Many rehab programs require individuals to go through drug and alcohol detox before they start treatment, so it is often covered by UnitedHealthcare policies.
Look into the details of your insurance plan to determine if detox is covered by your plan and any requirements set by the insurance company to start treatment. In some cases, you may need a referral, or you may need to contact the insurance provider before you start treatment.
Does UnitedHealthcare Cover Outpatient Treatments?
UnitedHealthcare policies often cover outpatient treatment services for drug and alcohol addiction. In most cases, you will have a copayment and a coinsurance rate that you pay for the treatment, so you will want to clarify your coverage before you start an outpatient program.
Use of insurance benefits from UnitedHealthcare may require a referral, proof of medical necessity, or preapproval from the insurance provider before you start treatment. Check your individual plan to determine if you need to contact the insurance provider or get a referral from your medical doctor before starting a treatment program.
Is Partial Hospitalization Covered By A UnitedHealthcare Policy?
Partial hospitalization treatment programs may be covered by a UnitedHealthcare policy in some situations. Since each policy has different standards in relation to partial hospitalization, you should evaluate your specific plan to ensure that you are covered.
Is Intensive Outpatient Treatment Covered By UnitedHealthcare?
Intensive outpatient treatment programs are often covered by UnitedHealthcare policies; however, each plan has different requirements for coverage.
Since intensive outpatient programs may be offered as part of a residential rehab program or other treatment program, they may be covered by your policy. Find out if you need a referral or precertification from the insurance provider to seek intensive outpatient care.
Does UnitedHealthcare Cover Sober Living Facilities?
The cost of transitional living facilities or sober living facilities may be covered by a UnitedHealthcare policy in some circumstances. Since the treatment facility may pair transitional outpatient services with the sober living facility, some policies may offer coverage.
Keep in mind that your policy may not cover a sober living facility if it considers the treatment center as a form of housing rather than a treatment program. Details vary by policy and coverage details, as well as by rehab facility.
Is Medication-Assisted Treatment Covered Through United Healthcare Policies?
Medication-assisted treatment (MAT) is usually covered by UnitedHealthcare plans. Since treatment is evidence-based and considered effective for certain substances, the insurance provider offers coverage for the treatment in most plans.
The details of your policy may limit coverage for MAT programs, so you want to look at your plan to ensure that you understand your coverage.
Is The Cost Of Methadone Covered By UnitedHealthcare?
Methadone treatments are often used for opioid abuse and substance use disorders related to opiate drugs. While the medication may be covered under many UnitedHealthcare policies, your plan may set limitations on the dosage or method of delivery for treatment.
Will UnitedHealthcare in Massachusetts Cover Suboxone Therapy?
UnitedHealthcare in Massachusetts may cover the costs of Suboxone. Since the medication is used for medication-assisted treatments, policies may assist with the costs of the medication. Certain policies may set limitations on the amount of medication allowed for treatment.
Checking Your UnitedHealthcare Drug Rehab Coverage
When you or a loved one is considering treatment for a substance use disorder, you want to start by verifying your UnitedHealthcare coverage. Your insurance coverage may vary based on your specific policy and the type of plan you obtain in Massachusetts.
If you are concerned about your policy or unclear about your coverage, Spring Hill Recovery Center can assist with your concerns. Our team can look at your health insurance and help you clarify if you are covered for rehab treatments.
To learn more about drug and alcohol rehab treatment options in the Massachusetts area or for more details about your UnitedHealthcare policy, contact Spring Hill Recovery Center today.
Written by Spring Hill Editorial Team
©2021 Spring Hill Recovery Center | All Rights Reserved
This page does not provide medical advice.
- UnitedHealthcare—Massachusetts Health Plans https://www.uhccommunityplan.com/ma
- UnitedHealthcare—Substance Use Helpline https://www.uhc.com/individual-and-family/member-resources/health-care-programs/substance-use
- UnitedHealthcare—Summary of Benefits and Coverage Sample Document https://www.uhc.com/content/dam/uhcdotcom/en/IndividualAndFamilies/PDF/2017-SBC-Sample-MM508.pdf
- UnitedHealthcare—What is an HMO or PPO? Understanding provider networks https://www.uhc.com/individual-and-family/understanding-health-insurance/hmo-ppo-networks