Does Optum Cover the Cost of Alcohol or Drug Rehab?

July 21, 2021 by Mark Adams

What Benefits Does Optum Offer For Treating Alcohol & Drug Rehab?

Realizing that you need professional help with a substance use disorder is definitely a step in the right direction toward regaining your life. Addiction is not only physically and mentally harmful, but this brain disease can also negatively impact so many other aspects of your life. Your friendships, job, schoolwork, family relationships, and responsibilities can all suffer when you suffer from substance addiction.

It may feel overwhelming at first to reach out for the help you need. Aside from the possible fears and anxiety, you may have about entering an alcohol or drug rehab program, you also might be worried about the costs involved.

If your health care insurance is with Optum, it’s very likely that some portion or perhaps all of your cost for alcohol or drug rehab will be covered. Optum is affiliated with the UnitedHealth Group. It was founded in 2011 and has strong relationships with organizations that include the Mayo Clinic, DaVita Medical Group, and Change Healthcare LLC.

If you or a loved one are struggling with addiction, call WhiteSands Alcohol and Drug Rehab today at 877.969.1993 to learn how we can help.

Of course, when you need help to overcome addiction, it’s important to find out which benefits Optum provides for alcohol and drug rehab. Your benefits will largely be dependent upon which state you live in and which type of plan you subscribe to.

Optum does cover drug and alcohol rehab treatment, including detox programs and other scientifically proven therapies for addiction and mental health disorders that co-exist with substance use disorders. This is especially true if your Optum plan was purchased from the Affordable Care Act marketplace, which requires that mental health and addiction treatment be covered for its customers.

Depending on your particular Optum plan, the benefits may potentially cover some or a large portion of your costs for various types of rehab treatment, including inpatient, outpatient, and aftercare programs.

Does Optum Cover the Cost of Rehab?

There is a strong possibility that your Optum plan will cover a portion of the cost of your alcohol or drug rehab services. Optum offers comprehensive coverage for rehab treatment within several of their health care plans.

This insurance group has support teams on staff that help with treatment decisions for their subscribers. The team assists you in finding the most cost-effective and evidence-based treatments that will help you achieve long-lasting sobriety.

How to Verify Your Optum Insurance Benefits For Addiction Coverage

To verify your Optum insurance benefits for addiction coverage, our counselors at White Sands can verify your insurance for you. Just give us a call with your information and we are glad to help you navigate your coverage.

You can also call the phone number listed on the back of your insurance card and speak to an Optum representative. That person should be able to outline in detail for you what your coverage is for different types of rehab.

Be sure to ask how much Optum will cover if you need inpatient rehab, outpatient treatment, detox, and other types of treatment, such as relapse prevention and aftercare.

Does Optum Cover the Cost of Attending Rehab For Spouses or Children?

There are many different insurance policies, some of which cover just you as an individual, while others cover your spouse and/or your entire immediate family. Typically, the coverage is the same for everyone on the policy, but you will have to check with our intake counselors at White Sands as to your exact rehab coverage for family members or an Optum representative.

Tiers of Optum and Benefits of Each Package

Most health insurance companies have various tiers of coverage, with different benefits provided within each package. Optum is no different. This company has insurance plans in various states, and each state may provide different levels of coverage.

In one state you may be covered for primary care, specialty care, and surgeries, while in another state your benefits may cover more or less a percentage of services.

Optum offers Preferred Provider Organization (PPO) and Health Insurance Organization (HMO) insurance plans that typically cover medical, dental, and vision care, with each providing its own types of benefits. Find out which specific plan you have with Optum, which is something we can help you with when you assist you in verifying your insurance coverage.

If you have an Optum HMO, your out-of-pocket expenses will usually be lower than those with a PPO; you may not even be billed a co-pay in some instances. You would require a referral to see a specialist, however, and you have to use an in-network provider to be covered for those services. Your Optum representative can assist you in finding an in-network provider for your rehab needs.

If your Optum insurance plan is a PPO, your out-of-pocket costs and co-pays will be higher, but you probably don’t need a referral to see a specialist. You should also be able to go to any substance use disorder treatment provider you prefer, whether they are in or out-of-network.

If Optum is your Medicare or Medicaid plan, you may very well be covered for alcohol or drug addiction treatment services, depending upon the state you live in.

Does Optum Cover the Cost of Inpatient Rehab?

Inpatient rehab can be costly. Your meals, accommodations, activities, and various types of treatment add up when you live full-time at a rehab facility for a number of weeks or months. Inpatient rehab, however, has been one of the most successful types of rehab treatment in terms of achieving a successful, long-lasting recovery.

Speak with your Optum insurance representative or an intake counselor at White Sands to help you determine whether inpatient costs will be covered for your rehab treatment needs. We will do our very best to find out what all of your coverage options are as they apply to residential treatment.

Does Optum Cover Substance Abuse & Mental Health Residential Stays?

If you are challenged with both a substance use disorder and a co-existing mental health disorder, this dual diagnosis is best suited to simultaneous treatment at a reputable rehab center.

Although Optum has a stellar reputation for covering mental health and behavioral disorders, including benefits for addiction treatment, your policy will determine how much and to what extent that coverage will entail. Your dual diagnosis treatment might be covered with little or no out-of-pocket costs if you choose an in-network facility that is partners with Optum.

Does Optum Pay for Outpatient Rehab?

After you’ve completed a detox and inpatient treatment program, most people also need some time spent in outpatient rehab. You’ll receive different types of therapy as an outpatient as you continue to live at home during this treatment. Optum, depending upon your policy benefits, may cover these treatments.

How Long Will Optum Cover the Rehab Stay For?

A typical inpatient rehab stay can range anywhere from 30 to 90 days or longer. Optum’s coverage for your rehab stay will depend on your needs, your policy plan, and the state in which you live. Call Optum to find out more about what your individual plan will cover.

Call Us Now To Verify Your Insurance Benefits

Patients come to us from Tampa, Fort Myers, Orlando, Sarasota, Brandon, Gainesville, Naples, and more. We can help you verify your insurance benefits with Optum as they pertain to your alcohol or drug rehab needs. It just takes a quick phone call to us with your insurance information and we’ll contact your carrier to help you determine which treatments you’re entitled to receive. Don’t let the financial worries about insurance and costs interfere with getting the help you need to renew your life for the better and regain your sobriety.

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If you or a loved one needs help with abuse and/or treatment, please call the WhiteSands Treatment at (877) 855-3470. Our addiction specialists can assess your recovery needs and help you get the addiction treatment that provides the best chance for your long-term recovery.

About the Author

Mark is a proud alumni member of WhiteSands Treatment. After living a life of chaos, destruction and constant let downs, Mark was able to make a complete turnaround that sparked a new way of life. He is serious about his recovery along with helping others. At WhiteSands Treatment, we offer support to you in your homes or when you are out living in your daily lives.