Using United Healthcare with Optum Insurance for Drug & Alcohol Rehab
UnitedHealth Group is the parent company to both United Healthcare and Optum. The fastest-growing company under UnitedHealth Group, OptumHealth is a clinical service used to coordinate specialty services (including addiction treatment).1,2 OptumHealth aims to help members find the right care in the right setting at a reasonable cost.3
Because United Healthcare and OptumHealth work with a vast network of providers and facilities, it’s highly likely that you can use your UHC/Optum coverage at a facility near you. UHC and Optum operate in Florida.
Does UHC Insurance with Optum Cover Addiction Treatment?
Most healthcare plans in Florida are mandated to cover mental and behavioral health services, including treatment for substance use disorders.4-6 This means that your United Healthcare plan probably provides coverage in some capacity for your addiction treatment. Mental health and substance use parity laws dictate that this coverage must be equitable to the coverage provided for medical or surgical care.7
However, what your UHC plan with Optum actually covers and the extent to which a service is covered may vary depending on the plan you have and where you seek care. Every health plan has different coverage levels, but there are many treatment centers in Florida that accept UHC insurance in some capacity.
You can quickly check your UHC/Optum benefits using our online coverage check. The our requires just a few basic pieces of information, including your:
- Insurer name.
- Email address.
- Insurance policy number.
Within minutes, you’ll receive an email with information about your coverage and how it may apply at Recovery First Treatment Center in Hollywood, FL. If you prefer, you can also obtain more information in person 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 incurred by using UHC/Optum for rehabilitation treatment depend on several factors. These may include:
- Your specific United Healthcare plan.
- The treatment facility and whether it is within the UHC network.
- The level of care provided (residential treatment, outpatient care, etc.).
- How long treatment lasts.
The summary of benefits and coverage for your Optum and United Healthcare policy will contain specific information on how your coverage is applied. Here’s generally how it works:
- You will likely have to pay the annual deductible before Optum begins covering costs.8
- After you’ve paid your deductible, you may be charged a co-insurance percentage of the total costs. For example, if the co-insurance rate is 20%, Optum will cover the remaining 80%. Sometimes, with outpatient treatment, you may be charged a co-payment dollar amount for each visit to the facility in lieu of a co-insurance percentage.9,10
- If you end up paying your out-of-pocket limit within a year, Optum will pay the total cost of remaining treatment for the rest of the plan year.11
If your UHC insurance plan doesn’t fully or partially cover the cost of your treatment, don’t despair. In many cases, your treatment facility may have alternative financing options available to you. For example, the Recovery First Addiction Treatment Center in Florida provides a host of alternate payment options that you can use to help handle the costs of addiction treatment.
How Do I Use UHC Insurance and Optum to Pay for Rehab?
Using your United Healthcare insurance for rehab may seem like a daunting task, but it doesn’t have to be. Once you’ve chosen a facility that is within the UHC network, you will likely have to obtain pre-authorization before you use United Healthcare insurance and Optum for rehab.
Essentially, pre-authorization means:12,13
- Treatment is considered medically necessary for your condition.
- The treatment program outlined is the ideal course of action.
- Your insurer accepts the costs of the treatment program outlined.
Getting prior authorization is important, as failure to do so may result in your claim being denied. Often, the treatment facility staff can obtain this preauthorization on your behalf, especially if the facility is in your plan’s network.
You can begin your journey to recovery now by reaching out filling out our benefits form and seeing what treatment may be covered by your UHC/Optum benefits.
You can also reach for immediate help from an admissions navigator who can answer questions regarding your insurance and the care provided at Recovery First, discuss the admissions process with you, help coordinate transportation to our Hollywood, FL facility, and more.