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Does United Health Group Cover Drug Rehab

UnitedHealth Group plans cover drug rehab to some degree. The specifics of coverage depend on the particular plan.

UnitedHealth Group

UnitedHealth Group, Inc. is one of the top 10 companies in the United States as ranked by Fortune. It is a for-profit managed care company that offers health care products, health care services, and insurance services.

The total revenue generated by UnitedHealth Group was over $225 billion worldwide in 2018, making it the largest health care company globally.

Services Included

Under the conditions of the Affordable Care Act (ACA), insurance providers are required to provide the same level and quality of services for the treatment of mental health issues, including substance use disorder treatment, as they provide for other medical conditions. This means that UnitedHealth Group will cover drug rehab to some degree.

The full spectrum of services covered by the different plans is variable, but UnitedHealth Group offers:

  • Group plans for organizations and businesses.
  • Insurance for families and individuals.
  • Short-term health insurance.
  • Additional insurance that includes vision insurance, critical illness insurance, international insurance, disability income insurance, and dental insurance.

The amount of coverage for drug rehab will vary according to the specific plan. There will likely be limits on the overall dollar amount of coverage, the number of days of treatment, or the number of sessions in a calendar year.

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Overall Structure of Plans

health insurance plans

UnitedHealth Group offers commercial group health insurance plans under different product names with various offerings. Some of the major designations of their services include:

  • UHC Select, which is an exclusive provider organization (EPO) with no coverage for services rendered by out-of-network providers.
  • UHC Select Plus, which is the preferred provider organization (PPO) option. It offers reduced coverage for providers within the network, but individuals can go outside the network at a higher out-of-pocket cost.
  • UHC Choice, which is a health maintenance organization (HMO) plan that provides lower rates to members within the network.
  • UHC Choice Plus, which is an HMO that allows for out-of-network coverage at higher rates in addition to lower rates for in-network providers. 

Some of these different programs may require a referral from a physician to get coverage to see an out-of-network specialist.

Depending on the individual policy, some of the restrictions may not apply to emergency services. These services are covered even for out-of-network providers.

Levels of Coverage

Per the specifications of the ACA, UnitedHealth Group offers four levels of insurance coverage. These plans are organized to provide affordable monthly premiums to individuals and still allow them to get the type of coverage they need.

Covered services include medical services, laboratory services, hospitalization, and the cost of some prescription drugs.

  • The bronze insurance plan offers the most affordable monthly premium, but these plans have the highest out-of-pocket costs. In general, bronze plans will cover 60 percent of health care expenses. The remaining percentage is passed on to the client in the form of a deductible or copayment, or it can be covered by some other coinsurance plan if the client is enrolled in one.
  • The silver plan will typically cover up to 70 percent of health care expenses, leaving 30 percent of the costs to be covered by the client. This has higher monthly premiums and lower out-of-pocket costs.
  • Gold plans will cover up to 80 percent of health care expenses, with the client responsible for the other 20 percent. This plan has an even higher monthly premium than the bronze and silver plan.
  • Platinum plans have the highest monthly premiums, but they cover up to 90 percent of health care expenses, leaving the remaining 10 percent to be covered by the client.

When services are not specifically covered by their policy, clients are expected to pay for all associated expenses.

Short-Term Insurance

UnitedHealth Group offers custom short-term plans for people who have gaps in their health care coverage. These services typically cover outpatient services, laboratory services, emergency room and hospital services, and dental services, in some cases.

Short-term health care coverage ranges from 30 days to three months. In some states, clients may choose coverage that can last up to 364 days. The client can visit any doctor or specialist in the network of services without a referral from a primary care physician.

Supplemental Medicare Coverage 

UnitedHealth Group also provides supplemental coverage for Medicare subscribers (Part C) as well as plans for parts A, B, and D. 

Varying Coverage in Different States

Different states may have different policies and coverage available. Go to the UnitedHealth Group website to find out what specific policies, premiums, and coverage are offered in your immediate area, or contact them directly

If you have a UnitedHealth Group plan, contact the company regarding the exact amount of your coverage for drug rehab. A representative at a prospective drug rehab center can also help you ascertain your exact level of coverage.

It’s important to know beforehand what you will be expected to pay out of pocket for rehab services.

Sources

(2019) United Health Care Group. UnitedHealth Care, Inc. from https://www.unitedhealthgroup.com/

(2019) Who Made the List? Fortune Magazine. from http://fortune.com/fortune500/list/

Affordable Care Act (ACA). Healthcare.gov. from https://www.healthcare.gov/glossary/affordable-care-act/

(2019) United Health Care Products & Services. UnitedHealth Group. from https://www.unitedhealthgroup.com/businesses/unitedhealthcare.html

(October 2018) Medicare. UnitedHealth Group. from https://www.uhc.com/medicare

(2019) Contact Us. UnitedHealth Group. from https://www.uhc.com/contact-us

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