Using United Healthcare Insurance for Rehab at South Shores
Back in 2015, the National Institutes of Health (NIH) shared that around 10% of US adults had a “drug use disorder at some point in their life”. What’s more upsetting was that around 75% of them reported “not receiving any form of treatment” for their condition.
However, we believe that finding drug and alcohol rehab facilities and treatment options should be accessible and we know that many people who struggle with finding addiction treatment do so because of the financial burden that can come along with detox and rehab.
If you are a UHC policyholder, the burning question is this: Does UnitedHealthcare cover rehab for drugs and alcohol?
At South Shores Detox, we accept many forms of United Healthcare insurance plans – which also include insurance coverage for substance abuse treatment and alcohol treatment.
Is it just a small safety net against the out-of-pocket costs? Or, does it really cover services like inpatient treatment and therapies for mental health disorders? Whatever you’re looking for, we can help you find the right network provider and treatment services that match that.
Get a confidential consultation to discuss health services and UnitedHealthcare insurance coverage for you!
Does United Healthcare Cover Rehab?
We will start with the basic and most important question, does United Healthcare insurance cover addiction treatment (ie: drug and alcohol rehab)? Yes, it does but it also offers many different types of insurance plans, most with differing levels of coverage.
While some may cover only emergency inpatient treatment for substance abuse, others might offer a more comprehensive drug rehab coverage. It will also depend on the treatment centers, whether they are in-network or not with the insurance provider.
So, to help you make an informed choice, we will summarize the factors that determine whether United Healthcare plans cover alcohol treatment and drug rehab services.
Your Specific United Health Insurance Plans
United Healthcare offers various insurance plans that may or may not cover the treatments for substance use disorder or alcohol addiction. Depending on the plan you choose, you could get a significant price reduction on outpatient addiction treatment, such as an intensive outpatient program.
On the other hand, you could also get insurance coverage for residential treatment, but it will depend on the plan details. Those plans include:
- Health Maintenance Organization (HMO)
- Preferred Provider Organization (PPO)
- Exclusive Provider Organization
So, make sure you check out the policy and coverage details of your specific United Healthcare plan by reaching out for a confidential insurance verification. You can discuss our rehab services – and what the cost of detox and treatment would be, if there is any cost with your coverage.
Type of Rehab Services and Treatment Plan
We already know that United Healthcare offers coverage for various rehab services. There are many health insurance plans from the UnitedHealth group that cover drug abuse (substance use disorder) and alcohol treatment. This could be services like:
- Inpatient treatment
- Outpatient treatment
- Mental health treatment
However, there are some health insurance plans that have certain restrictions on the overall healthcare coverage. For instance, some limit the number of days you can spend in a partial hospitalization program without bearing out-of-pocket expenses. So, it’s best to contact South Shores directly to let experts walk you through coverage details and understand what your plan covers.
In-Network vs Out-of-Network Providers
Next up, you have to consider in-network and out-of-network providers. For instance, United Healthcare coverage generally includes both an in-network and an out-of-network provider. However, the level of coverage could vary significantly.
If you use an in-network provider for your substance addiction treatment, chances are there will be lower out-of-pocket costs. To make sure you’re getting the right details, find information with the help of professionals at South Shores Detox. We can help you find coverage based on your United Healthcare plan details for a smooth recovery..
Types of Coverage by United Healthcare for Addiction Treatment
Remember, we mentioned that United Healthcare insurance offers coverage for many forms of treatment, including for detox and for drug and alcohol rehab as a whole. These range from hospitalization to therapies for co-occurring disorders like PTSD and anxiety (which are common among individuals struggling with substance use disorders) – here’s more.
Inpatient Rehab
Many United Healthcare insurance plans offer inpatient rehab coverage. What is inpatient rehab? It is a residential care program where you are treated in a compassionate and supportive on-site environment of the rehab facility.
You get access to a structured environment with 24/7 supervision of medical professionals, ready to assist. This is the recommended level of care for those struggling with substance use disorders and in need of intensive care to start their recovery journey. Also, this kind of program lasts around 30 to 90 days (depending on the severity).
Outpatient Rehab
If you or your loved one doesn’t require 24-hour intensive care, you can opt for outpatient treatment. In outpatient rehab treatment, you are still encouraged to be part of a structured environment for a holistic recovery journey. However, you have more flexibility because you can attend to other responsibilities – like personal or work-related.
Now, depending on your United Healthcare plan, you could get coverage for intensive outpatient programs (IOPs) or partial hospitalization programs (PHP). Most of these programs are flexible and include local services like sober activities and community engagement as well.
Mental Health Treatment
You may already know that struggling with substance abuse disorders and alcohol addiction brings other health challenges. To be specific, it brings a lot of mental health challenges, some of which include:
- Post-traumatic stress disorder (PTSD)
- Anxiety and stress disorders
- Depression
- Psychiatric disorders
- Cognitive and behavioral issues
For treating such co-occurring disorders, you or your loved one will need a comprehensive treatment plan. Thankfully, United Healthcare plans do offer coverage for mental health treatment. It begins with dual-diagnosis treatment and carries on to group therapy and support groups for best results.
Medication-Assisted Treatment (MAT)
Some clients at South Shores Detox also qualify for what is called “medication-assisted treatment” or MAT. In an inpatient or outpatient treatment program that also includes MAT, you will get prescribed medications to help you with addiction.
Many of the prescribed medications work as opioid receptor blockers and might even make a huge impact on your durability against withdrawal symptoms (and cravings).
What Are The Out-of-Pocket Costs and Insurance Benefits?
Yes, you can qualify for substantial insurance benefits for your alcohol and substance abuse treatments. However, there might still be some extra expenses that your insurance provider won’t cover. These are what we call “out-of-pocket expenses”.
Deductibles
There is nearly always a deductible in United Healthcare plans that you have to meet before the coverage kicks in. This means that if you don’t meet the deductible, the insurance will not cover the full cost of your rehab treatments.
And since the deductibles can vary based on your plan, make sure you review the policy or get information from your insurance provider directly. We recommend that you reach out to the admissions team at South Shores Detox to clarify the coverage details and smoothen the process.
Copay and Coinsurance
Co-pays or co-insurance are where you will have to bear some part of the total treatment cost. Take the example of support services like group therapy or an outpatient rehabilitation program. You might have to pay an “out-of-pocket” fee for each session.
More Information on In-Network vs Out-of-Network Coverage
You will most likely have lower out-of-pocket expenses if you use in-network providers. But if you go for a rehab facility that is an out-of-network provider, those extra fees might increase, but not always. You can call and talk about your rehab needs – and insurance coverage – with South Shores Detox.
How to Qualify for Inpatient Rehab with United Healthcare?
You can qualify for inpatient rehab through United Healthcare insurance plans. It will get you access to 24-hour expert care and lots of tools and resources to continue your recovery process. However, you will have to meet certain criteria to get United Healthcare coverage for inpatient treatment.
Medical Necessity
Firstly, your treatment provider or primarily healthcare expert must deem it “necessary” for you to get inpatient rehab due to the severity of your substance use disorder.
Pre-Authorization
Secondly, you will have to get pre-authorization for inpatient rehab services based on your United Healthcare plans. To avoid any confusion, it is best to reach out the admissions team at South Shores Detox to help you make sure the authorization is smooth.
Medical Assessment
Then, UnitedHealthcare might require a medical assessment from you. This would typically lead to experts sharing their authentic advice and analysis about whether inpatient is really necessary for your condition – or if outpatient will be sufficient.
Insurance Plan Limits
Finally, you will have to check the length of the insurance coverage UnitedHealthcare is offering. While most relevant plans might cover 30 days, you could still extend the coverage for your treatment if it is deemed necessary.
Consult a Professional at South Shores Detox to Begin Your Treatment
Finding the right rehab services should begin with looking for a treatment provider that matches your health insurance coverage. At South Shores Detox, we accept UnitedHealthcare insurance to help you bring down the out-of-pocket expenses for a less burdensome, less challenging recovery process.
UnitedHealthcare insurance offers substantial coverage for drug and alcohol rehab. However, the specifics of the insurance benefits will depend on the individual’s insurance plan. So, take a look at your insurance policy with help from one of the best rehab centers in Orange County and, we feel, the entire Golden State.
South Shores Detox can help you – or your loved one – receive the health services that they need. Please don’t wait, discuss your recovery support needs with a team of compassionate addiction treatment center through a confidential consultation today.