Optum Insurance Coverage for Rehab and Detox
Does Optum Insurance Cover Rehab for Drugs and Alcohol?
Optum insurance does offer coverage for drug or alcohol addiction treatment, which includes detox or rehab. Whether you are dealing with prescription drug use, opioids, cocaine, alcohol, or something else, you’re not alone during your journey to recovery.
Optum offers a comprehensive behavioral health plan through their insurance coverage. The Optum plan covers many behavioral health issues, such as anxiety, depression, anger, marital problems, and more. Notably, it also covers addiction issues and medication management.9
Optum addiction treatment coverage depends on which plan you have and where you live, so it is important to review options you have available in your state and for your specific needs.
Types of Treatment Covered by Optum Insurance
As part of Optum substance use coverage options, they provide access to community support groups and cognitive behavioral therapy .10,11
The types of services you can expect under the Optum plan include:
These services are performed by licensed clinicians and are conducted in either a private office setting or at a facility such as a rehab clinic or hospital.9, Patients covered by the state Medicaid program also have coverage for behavioral health issues including substance abuse and addiction.12 If you’re concerned about getting help for a family member who is dealing with a substance abuse issue, Optum does provide coverage for all dependents under the age of 26.13 As with any healthcare plan, there may be deductibles and co-payments, so it is best to check with your provider about your plan’s details.
How to Check My Optum Benefits for Rehab
Checking your Optum benefits to determine your rehab coverage can be as easy as visiting a website. Your insurance card will likely have links and website urls that will direct you to a member portal, where you may be able to determine your Optum coverage. You can also reach out to an Optum representative directly by calling their member services. Additionally, rehabs may be able to check your Optum benefits for you.
How to Use Optum to Pay for Rehab Treatment
Once you’ve decided to receive addiction treatment, you’ll need to use your Optum insurance benefits to cover some or all of the cost. An important first step is to determine what the extent of your Optum coverage is and if you require preauthorization before beginning treatment. You can determine this by contacting a Optum representative. Additionally, you’ll also need to check if the rehab you’re going to is in-network. This can be done by contacting the rehab directly and asking if they are in-network with Optum. While you can still attend treatment at an out-of-network facility, your Optum coverage and benefits may be greatly reduced.
How Much Does Optum Insurance Cover?
The exact amount that Optum insurance will cover can vary greatly depending on a number of factors. Some of these factors may include:
- The type of Optum insurance plan.
- Where you receive treatment.
- If a rehab is in-network with Optum.
- Intensity of treatment.
- Length of treatment.
- Accommodations and amenities offered by a rehab.
It’s important to reach out to any prospective rehab centers before committing to treatment to determine if they are in-network with Optum.
Do Rehab Centers Need to Be In-Network with Optum?
In most cases, to receive the maximum coverage from your Optum insurance plan, you’ll need to attend an in-network facility. In-network facilities will partner with Optum to provide their members with quality care. While you can still receive treatment at an out-of-network facility, you may see your Optum benefits severely reduced. It’s important to determine if a rehab is in-network with Optum before committing to treatment.
Types of Optum Insurance Plans
Optum serves approximately 120 million people worldwide and 80% of health plans.2 They provide healthcare coverage in Arizona, California, Colorado Connecticut, Florida, Indiana, Massachusetts, Nevada, New Jersey, New Mexico, New York, Ohio, Texas, Utah, and Washington.
Substance abuse and addiction in the United States has soared in the last couple of decades, with overdose deaths rising from 38,329 to 70,237.3 Getting treatment for substance addiction is essential before the problem escalates. If you’re one of the many people who are facing an addiction crisis in your life, then understanding your drug rehab insurance coverage options is essential.
Optum works with a wide variety of health insurance solutions. Since they are affiliated with the UnitedHealth Group, they manage all the major health insurance plans. These include the following:4
- Pro-Health Insurance Plans.
- Medicare Advantage HMO Health Insurance Plans
- HMO Health Insurance Plans
- Covered California
- Cal Mediconnect Plans
- OptumCare Medical Group Network Choices
To know more about the specifics of your plan, you can login to your Optum patient portal7
Optum, Medicare, & Medicaid
You may be wondering about your insurance coverage for rehab if you have Medicare. Current Medicare patients have the Medicare Advantage plan. This plan includes OptumCare. Through the OptumCare solution, you’ll have access to a wide range of network providers and healthcare solutions.8
Finding Rehabs that Accept Optum Insurance
Find hope and a new future if you’re struggling with an addiction problem by reaching out to American Addiction Centers (AAC). Our premier treatment centers are qualified to assist those with substance use disorders. Certified professionals will provide evidence-based treatment for drug and alcohol addiction.
At American Addiction Centers, you can count on our staff to provide superior service. Our high staff-to-patient ratio ensures you receive a personalized experience. Additionally, we use a wide variety of professionals, such as physicians, psychiatrists, licensed social workers, registered nurses, and psychologists to meet the needs of our clients.
With centers throughout the United States, you can find a treatment center located near you. We work with a wide variety of insurance providers, including Optum, so you are assured of easy access to the healthcare you need.
Our compassionate staff is always on hand to guide you through this process. Whether you need help with the paperwork, the insurance process, finding the right facility, or setting up a treatment plan, we’re on hand 24/7. Your journey to healing is just a phone call away. Call our rehab hotline today at or text us for personalized, confidential help.
American Addiction Centers (AAC) is committed to delivering original, truthful, accurate, unbiased, and medically current information. We strive to create content that is clear, concise, and easy to understand.
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