Check Your Policy Coverage
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Please fill out the form below to verify your insurance coverage.
UnitedHealthcare (UHC) is one of the largest health insurance companies, serving tens of millions of customers worldwide.1 If you or a loved one has UnitedHealthcare insurance and is considering drug or alcohol rehabilitation treatment, you’re probably wondering if substance abuse treatment is covered. While specific coverage varies from plan to plan, this page will help you understand what to may be able to expect when it comes to coverage for addiction treatment through UnitedHealthcare.
This page is intended to be a general overview of how UnitedHealthcare covers addiction and mental health services, not a comprehensive guide on the subject. For specific questions about your plan and what it covers at American Addiction Centers’ facilities, call or speak to a UnitedHealthcare representative directly.
About UnitedHealthcare Insurance
The main types of policies UnitedHealthcare insurance offers are:
- Affordable Care Act (ACA) marketplace plans. These plans were developed after the ACA was passed. Since an employer makes no contributions with these plans, monthly premiums tend to be higher than standard healthcare. Premiums are set based on your income and the number of people in your household.2
- Group benefit plans. These plans are provided through your employer.3
- Government assistance plans. These include Medicare (mostly available for seniors) and Medicaid (mostly for low-income families and individuals). UHC allows Medicare and Medicaid customers to choose plans that provide additional coverage above the minimum.4
UnitedHealthcare Insurance Plans
UnitedHealthcare plans fit into two categories:3
- Open access plans. These plans typically restrict your coverage to facilities that contract directly with UnitedHealthcare. There are two plans in this category:
- UnitedHealthcare Choice, which only covers physicians and treatment facilities within the UHC network.
- UnitedHealthcare Choice Plus, which covers providers outside the network; however, you will pay more out-of-pocket if you take this route.
- Preferred Provider Organization (PPO):
- The UnitedHealthcare PPO plan does not restrict you to providers within the network. If you choose out-of-network care, it will need to be approved beforehand and you will have to seek reimbursement from UHC afterward. Costs for these services will be greater than choosing a UHC-network facility.
Does UnitedHealthcare Cover Drug and Alcohol Treatment?
All the plans listed above provide coverage for substance abuse and behavioral health treatment. Rehabilitation services are primarily provided through:
- Inpatient treatment, where someone stays at a facility 24 hours a day, 7 days a week, receiving treatment for drug or alcohol use disorder. Often, this is done in a hospital setting so patients can be monitored by medical staff.
- Outpatient treatment. This is the least intensive option, which requires patients to attend a facility for a few hours several days a week.
Does UnitedHealthcare Insurance Cover Inpatient Rehab?
UnitedHealthcare benefits include coverage for inpatient treatment for alcohol or drug addiction (this may exclude certain short-term insurance plans). The level of coverage or plans available may change depending on:
- The state of residence.
- The employer.
- Whether your family members are included in the plan.
Medication may be used to help a person manage withdrawal symptoms, cravings, and co-occurring disorders. Some UHC plans may require a separate deductible for medications used during treatment. After the deductible is met, there is a copayment for each prescription.
The copay for medications vary widely depending on the type of medication and the UHC plan you have. Prescriptions obtained outside the network are not covered.5
Does UnitedHealthcare Insurance Cover Outpatient Rehab?
UnitedHealthcare also provides coverage for outpatient drug and alcohol treatment. The specifics of your coverage will vary. There is no coinsurance for other outpatient services.
Out-of-network outpatient treatment or prescription medication is not covered.6
Does UnitedHealthcare Insurance Cover Mental Health Treatment?
Substance misuse, behavioral health, and mental health are categorized together with UnitedHealthcare insurance plans. An inpatient stay or outpatient treatment for behavioral health or mental health reasons has the same level of coverage as treatment in an addiction center.5, 6
How to Check My UnitedHealthcare Insurance Coverage
There are a few different ways to check your UnitedHealthcare coverage:
- Login to the MyUHC benefits portal. Creating an account requires your:7
- Member ID number and group policy number or your social security number (SSN) and zip code.
- Check the benefits packet you were given by your employer when you selected an insurance plan.
- Call customer service:8
- Medicaid members: Use the number on your insurance card or login to the UHC community plan site.
In most cases, UnitedHealthcare insurance provides coverage for substance use and mental health services, just be sure you choose a facility that is within the UHC network, or that your plan allows you to use out-of-network facilities.
To find out if your insurance plan covers treatment at an American Addiction Centers’ (AAC) facility, you can reach out to an admissions navigator, use the “Verify Your Insurance” portal.
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