United Healthcare Substance Abuse Treatment Coverage

United Healthcare is one of the largest health insurance providers in the United States. The company offers plans for individuals and businesses, and coverage options vary widely. If you’re a United Healthcare member, you may have questions about whether your plan covers treatment for alcohol and substance use disorders.

In this guide, we’ll walk you through United Healthcare substance abuse treatment coverage. We’ll help you understand how United Healthcare plans cover these treatments, and we’ll provide information on the specific treatment options that may be available to you through United Healthcare.

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Does United Healthcare Cover Alcohol and Drug Rehab?

Yes, most United Healthcare plans provide coverage for alcohol and drug rehab. Due to the Affordable Care Act, if you purchase your United Healthcare insurance through the Health Insurance Marketplace, your plan must provide coverage for alcohol and substance use treatment. In addition, the Affordable Care Act requires all United Healthcare individual insurance plans and United Healthcare plans provided by small employers to cover alcohol and substance use treatment.

If you receive your United Healthcare plan through a large employer, your plan may include treatment for alcohol and substance use disorders. In addition, your plan might offer access to an employee assistance program. Typically, these programs can help you with understanding treatment options and obtaining referrals to treatment centers.

How Does the Mental Health Parity and Addiction Equity Act Impact My United Healthcare Coverage?

The Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 applies to health insurance plans offered by businesses with at least 50 employees. If a plan from a large employer includes coverage for alcohol and substance use treatment, the plan must adhere to certain rules.

For example, under the law, an insurer can’t charge higher co-pays for alcohol and substance use conditions. Annual and lifetime dollar limits for alcohol and substance use treatments must be roughly equivalent to those for medical care. If a plan provides medical benefits, mental health benefits and out-of-network medical coverage, it must offer out-of-network mental health coverage, including out-of-network alcohol and substance use treatment. After the passage of the Affordable Care Act in 2010, individual and small business plans were subject to similar restrictions.

With all types of health insurance plans, insurers will determine whether alcohol and substance use treatments are medically necessary.

Which United Healthcare Plans Cover Alcohol and Substance Use Treatment?

United Healthcare offers plans through the marketplace, small employers and large companies. Most of these plans include coverage for alcohol and substance use treatments.

United Healthcare Choice and United Healthcare ChoicePlus are open-access plans. In order to receive coverage for alcohol and substance use treatments with United Healthcare Choice, clients must receive care at facilities that are in United Healthcare’s network. The physicians and providers must also be members of the network. United Healthcare ChoicePlus offers coverage for treatments from out-of-network providers and facilities, but the out-of-pocket costs are higher.

United Healthcare PPO (Preferred Provider Organization) plans cover alcohol and substance use treatment from providers and facilities that are inside and outside of the United Healthcare network. Out-of-network care requires prior approval, and patients will be reimbursed for covered costs.

Which Alcohol and Substance Use Treatments Are Covered Under United Healthcare’s Plans?

United Healthcare covers inpatient and outpatient care. The specifics of your coverage depend on your state of residence and your employer. In addition, when making coverage decisions, United Healthcare will look at whether or not you have family members on your insurance plan.

Generally, inpatient stays of 28 to 90 days are included with United Healthcare substance abuse treatment and alcohol misuse treatment coverage. Many plans cover treatment at in-network and out-of-network facilities, and coverage includes the withdrawal period and treatment after withdrawal. If a client needs medications during inpatient treatment, an in-network provider must write the prescriptions. United Healthcare does not cover out-of-network prescriptions. In addition, some United Healthcare plans may have a separate deductible for medicines. Once the deductible is met, patients will need to pay a co-pay for each prescription.

For outpatient coverage with United Healthcare, clients must receive treatment at an in-network facility. In-network providers are required for all prescriptions, and clients need to fill the prescriptions at in-network pharmacies. United Healthcare does not cover outpatient care at out-of-network facilities. They will not pay for out-of-network prescriptions for outpatient clients.

Are Behavioral Health Treatments Covered by United Healthcare?

Yes, United Healthcare covers behavioral health treatments that are provided as part of treatment for alcohol or substance misuse. Behavioral health treatment can include individual, group and family therapy. For example, patients may receive cognitive-behavioral therapy and dialectical behavior therapy, and they might participate in a contingency management program.

Where Can I Find Out More About My United Healthcare Treatment Options?

To find out about your coverage for alcohol and substance use treatment, you may want to start by going to the United Healthcare website. You can create a MyUHC account with your Social Security number and ZIP code. If you wish, you may use your member identification number and your group policy number to create your account. After logging in, you’ll be able to see the specific benefits that your plan provides.

To find information about your plan benefits without an online account, you can check the United Healthcare benefits packet you receive from your employer when you sign up for insurance. You can contact United Healthcare customer service if you need more details.

Does United Healthcare Provide Coverage for Treatment at Northern Illinois Recovery?

Your United Healthcare plan may provide coverage for alcohol and substance use treatment at Northern Illinois Recovery in Crystal Lake. Depending on the plan you have, inpatient care, outpatient treatment, medications, counseling and aftercare may be covered. You can verify your insurance here.

What Services Are Available At Northern Illinois Recovery?

Northern Illinois Recovery provides residential treatment, partial hospitalization, intensive outpatient and regular outpatient care. Intervention services, detox programs, medication-assisted treatment and medication management programs are offered, and clients may choose to participate in 12-step programs. The treatment center provides aftercare, sober living programs and recovery coaching.

In terms of behavioral health services, Northern Illinois Recovery offers individual, group, and family therapy sessions. Gender-specific therapy is available. The therapists provide cognitive-behavioral therapy, dialectical behavior therapy and holistic therapy. If desired, clients can participate in yoga therapy at the treatment center.

Where Can I Get Advice About My Insurance Options for Treatment at Northern Illinois Recovery?

At Northern Illinois Recovery, our admissions team can help you find out about the coverage options you have with your United Healthcare plan. We provide an insurance verification service that you can start online. After you complete our online form with your phone number and insurance information, we will call you back to discuss how we can help. We look forward to being part of your journey to recovery.