As one of the largest health insurance providers in the United States, United Healthcare serves over 26 million Americans, offering a variety of consumer-oriented health benefit plans for individuals and families.1 With over 1.3 million physicians and healthcare professionals in their network, and over 6,500 hospitals, members of United Healthcare have access to care throughout the country.1
If you have United Healthcare insurance and are looking for drug and alcohol treatment for yourself or a loved one, you likely have some questions about the financial side of things: how much does it cost, and will insurance cover all or some of the expenses? Your United Healthcare insurance plan will provide financial coverage for addiction treatment. How much is covered depends on your policy, location, and the rehab center you choose.
You can call the number on the back of your insurance card for more detailed information about your specific plan. Rehab centers can also check your coverage based on the information you provide.
What Will United Healthcare Insurance Cover?
UnitedHealthcare covers alcohol and drug abuse treatment for its members. Covered addiction treatment services may include:2
- Detox refers to services provided during the acute stages of addiction and withdrawal, typically within the first 2-5 days, when you’re ready to stop using drugs and alcohol and get on the road to recovery.
- Inpatient or residential care. Live-in (inpatient/residential) treatment centers allow you to live at the facility for a certain amount of time, usually from 15 days up to 90 days, depending on the rehab you’ve enrolled in and your needs.
- Partial hospitalization program (PHP). A PHP allows you to live at home during treatment and requires you to spend your days at a treatment facility. This is often referred to as day treatment.
- Intensive outpatient (IOP) treatment. IOP programs involve attending treatment approximately 3 evenings a week. Participants can live at home and work during the day.
- Outpatient treatment. Outpatient treatment is best for people who have completed inpatient rehab. You can live at home but are required to attend 10 to 12 hours of treatment at a rehab center each week.
- Group, family, and individual therapy are provided by licensed counselors, psychologists, and/or physicians.
United Healthcare plans vary from state to state and offer several tiers of coverage. Three levels of care provide varying levels of coverage for addiction treatment:3,4,5
UnitedHealthcare Choice: Provides in-network coverage that includes more than 895,000 providers across the United States. You’ll have fixed copay amounts under this plan and can obtain specialty services such as rehab without a referral as long as you stay in-network.
UnitedHealthcare Choice Plus: This plan allows you to choose in-network and out-of-network providers. You can keep your out-of-pocket costs lower by choosing an in-network rehab.
UnitedHealthcare Options PPO: This plan offers savings for out-of-pocket costs when you receive healthcare services through a preferred network provider. You may also choose an out-of-network provider but staying in-network will help keep your expenses down.
Does United Healthcare Insurance Cover Mental Health Care?
Some people living with substance use disorder also have mental health conditions such as anxiety, depression, PTSD, and mood disorders. These are known as co-occurring disorders or dual diagnoses. According to the 2016 National Survey on Drug Use and Health, more than 8 million adults aged 18 or older had mental illness and substance use disorder in tandem.6
Mental health and substance abuse treatment are considered to be essential health benefits. As a result, all health insurance companies—including United Healthcare—must cover some of the costs of treatment. According to the Affordable Care Act (ACA), all health plans in the marketplace must cover behavioral health treatment (e.g., psychotherapy and counseling), mental health inpatient services, and substance use disorder treatment.7
If you have co-occurring disorders, it is best to treat both disorders at the same time, as they often impact each other. Treating one will not cause the other to just go away. For treatment to be most effective, both disorders must be treated together.8, p.41
How Long Does United Healthcare Insurance Cover Rehab?
Though every person’s experience with rehab and recovery is different, greater lengths of time spent in treatment are typically associated with better outcomes and long-term success. Research suggests that 3-6 months of treatment along with structured continuing care—such as outpatient treatment and counseling—is associated with better treatment outcomes, meaning better chances at long-term recovery and sobriety.8
The duration of treatment covered by your United Healthcare policy will depend on your plan. You can look up your plan information online or call the number on the back of your insurance card to learn more about what your plan covers for drug and alcohol rehab.
United Healthcare also offers additional coverage for those who qualify for Medicare/Medicaid. This coverage provides up to 190 days of inpatient rehabilitation in a psychiatric hospital or addiction rehab facility throughout a person’s lifetime.2
There may be exceptions to this rule. For example, an extended stay at an inpatient treatment facility may be covered if it is documented to be medically necessary. People who have United Healthcare policies under Medicaid have no limitation on the length of time covered for outpatient drug rehabilitation programs.
To learn more about how long your plan will cover your stay in rehab, you can look up your plan information through the member portal on the United Healthcare website. Or call the number on the back of your insurance card. A customer service agent can tell you more about what is covered by your insurance policy, and for how long.
What If My United Healthcare Insurance Policy Does Not Cover Drug Treatment?
It’s important not to let finances be a barrier from attending treatment and getting sober. Getting treatment now is a top priority and can save your life.
Most rehab facilities offer payment plans so you can gradually pay your out-of-pocket costs. Others offer grants and scholarships to people with financial need. Alternatively, your employer may offer an employee assistance program. Crowdfunding—asking friends and family—is another way to source the funds to pay for treatment.
Speak with admissions specialists at any rehab centers you are considering and ask about their financing and scholarship options.
UnitedHealthcare In-Network vs. Out-of-Network Rehab Centers
UnitedHealthcare has partnerships with drug and alcohol addiction centers throughout the United States to provide detox and treatment services at discounted rates to members. These facilities are referred to as in-network. As a UnitedHealthcare member, you can attend drug and alcohol rehab anywhere in the country, as long as you choose an in-network provider.
If you have a UnitedHealthcare Choice Plus or UnitedHealthcare Options PPO plan, you can work with an out-of-network provider, but your co-pay and other out-of-pocket expenses may be higher.5,6
Even at an in-network facility, you may be responsible for some treatment costs, deductibles, and copays. Choosing to stay in the network, however, will reduce your out-of-pocket expenses.
Some insurance plans require pre-authorization before providing coverage for drug and alcohol addiction treatment. This means you may need to get a referral from your primary healthcare provider. In most cases, UnitedHealthcare does not require prior authorization before covering drug and alcohol treatment programs. However, medically assisted detox services do require pre-authorization approval. For any services you will be receiving at rehab, United Healthcare asks members to give them a “heads up” before entering treatment.
Check United Health Care Coverage for Addiction Treatment
It’s always best to know ahead of time which costs will be covered by insurance and which you will be responsible for. This will help you establish a financial plan before entering treatment so you can focus on what matters—your recovery.
Contact UnitedHealthcare by calling the number on the back of your insurance card to determine what is covered (and in some cases, for how long). If you prefer, you can log in to your UnitedHealthcare online member portal to learn which drug and alcohol rehabs are covered by your insurance.
Ready to take the next step and get ready to enroll in a rehab treatment center? UnitedHealthcare is accepted at most American Addiction Centers facilities across the country, where you can receive treatment for substance use disorder and co-occurring health issues. To learn more about AAC and UnitedHealthcare’s partnership and how your rehab costs will be covered, call us at (866) 796-3480. Or verify your insurance by completing the form below.
- (2021). About Us.
- (2020). Alcohol, Chemical and/or Substance Abuse: Detoxification and Rehabilitation.
- UnitedHealth Group. UnitedHealthcare Choice.
- UnitedHealth Group. UnitedHealthcare Choice Plus.
- UnitedHealth Group. UnitedHealthcare Options – PPO.
- Center for Behavioral Health Statistics.SAMHSA – Substance Abuse and Mental Health Services Administration. (2017). Key Substance Use and Mental Health Indicators in the United States: Results from the 2016 National Survey on Drug Use and Health.
- gov. (2021). Mental Health & Substance Abuse Coverage.
- Eastwood B, Peacock A, Millar T, et al. Effectiveness of inpatient withdrawal and residential rehabilitation interventions for alcohol use disorder: A national observational, cohort study in England. J Subst Abuse Treat. 2018;88:1-8. doi:10.1016/j.jsat.2018.02.001