Using United Healthcare with Optum Insurance for Drug & Alcohol Rehab

UnitedHealth Group oversees both UnitedHealthcare and Optum, which are active in Florida. Among its subsidiaries, OptumHealth is the fastest-growing entity, focusing on coordinating specialty services, including addiction treatment.^1,2 Its mission is to connect members with appropriate care in the best setting, all while keeping costs manageable.³ With a broad network of providers and facilities, it’s likely that you can utilize your UHC or Optum coverage at a location near you.

Does UHC Insurance with Optum Cover Addiction Treatment?

In Florida, most healthcare plans are required to cover mental and behavioral health services, including treatment for substance use disorders.^4-6 This means your UnitedHealthcare (UHC) plan likely offers some level of coverage for addiction treatment. Mental health and substance use parity laws ensure that this coverage is on par with that of medical or surgical services.⁷

However, the specific benefits and extent of coverage under your UHC plan with Optum can vary based on your individual plan and the provider you choose. While coverage levels differ, many treatment centers in Florida accept UHC insurance.

To quickly check your UHC/Optum benefits, you can use our online coverage verification tool . Simply provide a few details, including:

• Insurer name.
• Email address.
• Insurance policy number.

Within minutes, you’ll receive an email detailing your coverage and its applicability at Recovery First Treatment Center in Hollywood, FL. Alternatively, you can get in-person assistance by speaking with an admissions navigator at .

You can also carefully review your summary of benefits and coverage or call the number on the back of your insurance card for more information about your plan.

How Much Does Substance Abuse Treatment Cost with United Healthcare and Optum? 

The out-of-pocket costs for rehabilitation treatment through UHC/Optum can vary based on several factors, which include:

• Your specific United Healthcare plan.
• Whether the treatment facility is in-network with UHC.
• The level of care provided (residential treatment, outpatient care, etc.).
• The duration of the treatment. 

Your Optum and UnitedHealthcare summary of benefits will provide detailed information on how coverage applies. Here’s a general overview of how it works:^8-11

• Deductible: You’ll likely need to meet your annual deductible before Optum starts covering costs.
• Co-insurance: After the deductible, you may be responsible for a co-insurance percentage of the total costs. For instance, if your co-insurance rate is 20%, Optum will cover the remaining 80%. For outpatient treatment, you might pay a fixed copayment per visit instead of a percentage.
• Out-of-Pocket Maximum: Once you reach your out-of-pocket limit within a year, Optum will cover all remaining treatment costs for the rest of the plan year.

If your UHC plan does not fully or partially cover your treatment, don’t worry. Many treatment facilities offer alternative financing options. For instance, Recovery First Addiction Treatment Center in Florida provides various payment options to help handle the costs of addiction treatment.

How Do I Use UHC Insurance and Optum to Pay for Rehab?

Using your UnitedHealthcare insurance for rehab can feel overwhelming, but it doesn’t have to be. Once you select a facility within the UHC network, you’ll typically need to obtain pre-authorization before utilizing your UnitedHealthcare and Optum coverage.

Pre-authorization essentially confirms that:^12,13

• The treatment is deemed medically necessary for your condition.
• The proposed treatment program is the most appropriate course of action.
• Your insurer agrees to cover the costs associated with the treatment plan.

Securing prior authorization is crucial; without it, your claim could be denied. Fortunately, the staff at your chosen treatment facility can often handle this process for you, especially if they are within your plan’s network.

You can start your path to recovery today by filling out our benefits form to see what treatment options may be covered by your UHC/Optum benefits.

You can also get immediate assistance from an admissions navigator at Recovery First. They can answer your questions about insurance, explain the care options available, discuss the admissions process, and help coordinate transportation to our facility in Hollywood, FL, among other support services.