How to Pay for Addiction Treatment With United Behavioral Health Insurance Plans
United Behavioral Health is the subsidiary of United Healthcare, the world’s largest healthcare company. If you’re covered by a long-term UnitedHealthcare plan, such as UHC Select, Select Plus, or Choice, then you have access to United Behavioral Health.
United Behavioral Health handles all the rehab insurance coverage, assessments and referrals for behavioral health disorders, including addiction.
- Healthcare Marketplace insurance: UBH is part of UHC Select, Select Plus, Choice, Navigate, Charter, and Compass plans on the Healthcare Marketplace.
- Employer-funded insurance: UBH is part of all UHC employer-funded insurance plans, including those named above.
- Medicare: UBH is part of UHC Medicare and Retirement, the company’s state-contracted services for people 65 and older.
- Medicaid: UBH is part of UHC Community and State, the company’s services for state-funded programs benefiting people who are low-income or have certain disabilities.
The only UHC plans that don’t include United Behavioral Health are short-term or temporary plans, which don’t cover pre-existing conditions like most mental health disorders. However, the vast majority of UHC plans are long-term plans, which do cover mental health disorders like addiction.
Not only does UBH manage your behavioral healthcare coverage, they also provide you and your providers with plenty of resources to support your recovery.
When you’re getting your addiction treatment covered, you’ll be in contact with UBH directly instead of UHC. If you call UHC, they’ll redirect you. You can find the phone number for United Behavioral Health on the back of your insurance card.
It’s best to know what to expect before going into the rehab health insurance coverage process. It doesn’t matter if it’s your first time going into addiction treatment or not. You don’t want to spend your time in treatment worrying about how to pay for rehab!
Learn the answers to the most commonly-asked questions about UBH addiction coverage:
Will My Addiction Treatment Be Covered By My United Behavioral Health Plan?
If your UBH coverage through your UHC plan is long-term coverage, then UHC is required to cover your treatment (as long as it meets the rules).
That’s because the Affordable Care Act of 2010 says that all health insurance companies must cover medically-necessary treatment for pre-existing conditions, including substance use disorders.
You may need to meet certain criteria to get your addiction treatment covered under UBH. For example, you may need to:
- Choose an in-network provider
- Get a prior authorization
- Ask your primary care provider for a referral
- Meet your plan’s deductible for the year, the amount that you’re responsible for paying out-of-pocket before your coverage begins
Depending on your plan and the program that you choose, you may get full or partial coverage for addiction treatment.
How to Check United Behavioral Health Addiction Treatment Coverage
You can’t estimate your coverage without knowing the specifics of your UBH plan. There are a few ways you can find your addiction coverage information:
- Check the online portal: MyUHC is the online portal for members to check their coverage through United Healthcare, including United Behavioral Health coverage.
- Call United Behavioral Health: You can call the phone number for UBH on the back of your insurance card. A representative will answer your questions about coverage and let you know what to expect.
- Call your healthcare provider: Your primary care doctor will most likely have to give you a referral to get treatment covered. When you ask for the referral, ask for information about your coverage as well.
- Call your addiction treatment provider: Your treatment provider will need to bill your insurance later anyway, so they’ll be happy to check the coverage beforehand. They’ll call the insurer on your behalf and get all the information, including how much coverage you get.
How Does United Behavioral Health Rehab Coverage Work?
United Behavioral Health coverage works in the same way as any other UnitedHealthcare plan—or any long-term healthcare plan.
To take advantage of your UBH addiction treatment insurance coverage, you must:
- Confirm your coverage: First, find your exact coverage by checking with one of your providers or with UBH. Let UBH know that you’re planning to use your coverage.
- Visit your primary care doctor: Your doctor can give you a referral to treatment, which helps UBH know that your treatment is medically necessary.
- Complete the prior authorization process: UBH has a paperwork process for documenting that your treatment is medically necessary. Your doctor or treatment center will handle this.
- Confirm your approval: Before you start treatment, UBH will reach out to you and let you know that you’re covered. They’ll send you an Explanation of Benefits, a document that shows how your coverage is applied.
- Confirm your financial responsibility: If you have partial coverage through UBH, you’ll need to check the amount you’re responsible for covering. The same is true if you have a deductible, copay, or coinsurance.
Do United Behavioral Health Insurance Plans Cover Addiction Treatment?
United Behavioral Health plans through UHC cover addiction treatment that’s evidence-based and medically necessary.
- Drug and alcohol detox programs
- Inpatient and residential treatment programs
- Medication-assisted treatment programs
United Behavioral Health Coverage for Detox Rehab Treatment
Detox is considered a medically-necessary part of treatment for almost all types of substance use disorder, so it’s almost always covered.
Your UBH plan may cover detox services such as monitoring and care, symptom management, medication, intravenous hydration, and more.
It’s very important to go to detox if you’re recovering from alcohol or benzodiazepines. These medications can cause seizures, coma, or death when you withdraw from them without medical help. Insurance plans always cover detox for alcohol and benzos.
United Behavioral Health Coverage for Inpatient Residential Rehab Services & Costs
UBH covers evidence-based inpatient and residential treatment programs for addiction. To get coverage, the program must be:
- Medically necessary for your substance use disorder
- Evidence-based, or scientifically proven
Most covered inpatient rehab programs include services such as:
- Behavioral treatment, such as cognitive-behavioral therapy or dialectical behavior therapy
- Counseling to address personal and social issues around addiction
- Medication-assisted treatment in some cases of opioid or alcohol use disorders
- Group therapy for social support and recovery skill-building
The cost of inpatient treatment varies significantly from facility to facility. Your coverage can vary too, so it’s hard to estimate how much you may pay out-of-pocket. Residential rehab can cost $5,000 to $20,000 or more before full or partial insurance coverage kicks in.
Medication-Assisted Treatment Services & Costs
Medication-assisted treatment programs are highly effective, so UBH covers them for:
- Alcohol use disorder
- Opioid use disorder
The covered services often include med checks, drug screenings, medication appointments, behavioral treatment, and the medication itself.
For alcohol use disorder, the covered medications are acamprosate, disulfiram, and naltrexone. For opioid use disorder, they are methadone, buprenorphine, and naltrexone.
Prescription medications are often covered in full. The cost of the appointments, screenings and behavioral treatment varies too much to predict, so it’s important to check with your treatment provider and insurer.
United Behavioral Health Coverage for Outpatient Treatment
UBH typically covers outpatient treatment programs such as:
- Standard outpatient, which may be just a few appointments per week or month
- Intensive outpatient, which includes 20-30 hours per week of care
- Partial hospitalization, which is the highest tier of outpatient care with 40+ hours per week of care
The services included in outpatient care typically include:
- Counseling and behavioral treatment
- Medication-assisted treatment
- Drug screenings
- Progress checks and other appointments
Outpatient programs have a lot of variation in cost, so it’s important to check the cost and coverage by calling your insurer and treatment center.
What Types of Addictive Substances Are Covered by Insurance?
United Behavioral Health covers addiction treatment for any substance that causes physical dependence. That typically includes:
- Prescription stimulants such as Adderall and Ritalin
- Prescription opioids such as OxyContin or Vicodin
That’s not a full list of all addiction types that are covered, so check with your insurer if you want treatment for a drug that’s not listed.
Is Alcohol Addiction Treatment Covered by United Behavioral Health Insurance?
United Behavioral Health covers alcohol addiction treatment including:
- Alcohol detox
- Inpatient treatment for alcohol addiction
- Medication-assisted treatment including disulfiram, acamprosate, or naltrexone
- Outpatient treatment including behavioral treatment and medication
Is Cocaine Addiction Treatment Covered by United Behavioral Health Insurance?
Your United Behavioral Health plan covers cocaine addiction treatment including:
- Cocaine detox
- Inpatient or residential treatment for cocaine addiction
- Outpatient treatment including behavioral treatment
Medication-assisted treatment is not covered, since it’s not evidence-based for stimulants.
Is Heroin Addiction Treatment Covered by United Behavioral Health Insurance?
United Behavioral Health policies cover heroin addiction treatment that includes:
- Medical detox from heroin
- npatient or residential treatment for heroin use disorders
- Medication-assisted treatment such as buprenorphine, naltrexone, and methadone
- Outpatient treatment including behavioral treatment and medications
Is Meth Addiction Treatment Covered by United Behavioral Health Insurance?
As long as it’s evidence-based, UBH covers meth addiction treatment including:
- Detox programs for the first stage of meth recovery
- Inpatient and residential treatment for stimulant use disorder
- Outpatient treatment including behavioral treatment and counseling
UBH does not cover medication-assisted treatment for meth because it’s not evidence-based.
Is Prescription Drug Addiction Treatment Covered by United Behavioral Health Insurance?
United Behavioral Health covers prescription drug addiction treatment that includes:
- Detox programs for stimulant and opioid drugs
- Residential treatment for stimulant or opioid prescription addiction
- Outpatient treatment including behavioral treatment for stimulants and medication for opioids
- Medication-assisted treatment for prescription opioid use disorder
UBH does not cover MAT for prescription stimulants, since it’s not scientifically supported.
Do Treatment Centers Need to Be In-Network?
Your treatment center may need to be in network in order to get coverage from United Behavioral Health.
In-Network vs. Out-of-Network Coverage for PPOs
If your UBH plan is a Preferred Provider Organization plan, then your provider does not have to be in-network.
With a PPO, you pay more out-of-pocket for an out-of-network provider and less for an in-network provider.
In-Network vs. Out-of-Network Coverage for HMOs
If you have a Health Maintenance Organization plan, then your provider must be in-network to receive any coverage.
With a PPO, you can only get coverage for in-network providers and can only attend out-of-network rehab if you pay 100% out-of-pocket.
How Can I Pay the Costs Not Covered by My United Behavioral Health Plan?
It’s common for health insurance plans to have partial coverage for addiction treatment services. If your United Behavioral Health coverage leaves part of the financial responsibility to you, they’ll let you know.
You’ll want to make a plan before entering rehab to cover your treatment costs. Some options include:
- Appealing to United Healthcare to see if they can overturn the decision on your coverage
- Rehab scholarships such as 10,000 Beds, which offer no-strings-attached treatment coverage
- State-funded resources, such as gap coverage through state-run Medicaid if you qualify
- Community resources, such as churches, YMCAs, community centers, 12 Steps, and other recovery-friendly organizations that offer charitable contributions to medical expenses
United Behavioral Health Addiction Resources
United Behavioral Health offers a variety of resources for members seeking addiction and behavioral healthcare, including:
- United Behavioral Health offers a variety of resources for members seeking addiction and behavioral healthcare, including:
- Telehealth Services: UBH offers telehealth appointments with in-network doctors from the comfort of your home.
Verify Your United Behavioral Health Coverage at Bedrock Recovery Center
If you’re still struggling to figure out your coverage, Bedrock Recovery Center can help you.
Our admissions team will call United Behavioral Health to navigate your coverage for you, then help you understand what’s covered and what’s left to do.
Bedrock’s evidence-based addiction programs are staffed with compassionate addiction professionals and full of evidence-based care such as DBT, CBT, and MAT.
Call Bedrock Recovery Center today to learn how we can verify your coverage and get your treatment started!