UMR Addiction Treatment

LEARN HOW YOUR INSURANCE CAN HELP

UMR Insurance

UMR is a form of insurance, but not a direct insurance provider. Instead, they work as a Third-Party Administrator (TPA) on behalf of United Healthcare. Still, UMR has close associations with many providers of PPO and HMO plans and benefits, so chances are, if you have it, you can find UMR addiction treatment in your area.

BECOME MORE EDUCATED ABOUT YOUR INSURANCE

Does UMR Insurance Cover Addiction Treatment?

So, can you get UMR addiction rehab as part of your plan? UMR does not directly provide rehab coverage because they are not an insurance provider. Because UMR works as a partner on behalf of different health care providers, you might get UMR rehab coverage through your other health care provider.

The Affordable Care Act requires insurance providers to offer mental health and substance abuse services. Your UMR policy and the network provider who works with UMR will determine what types of addictions can be treated under your policy. Usually, common addictions are included in every plan, such as:

Alcohol addiction
Prescription medication addiction
Cocaine addiction
Methamphetamine addiction

UMR rehab coverage can extend to mental health services. Within the healthcare network you have, you should be able to find insurance coverage for mental health services for:

Individual Therapy
Group Therapy
Cognitive Behavioral Therapy
Biofeedback
Family therapy

UMR rehab coverage can also cover medications and medication-assisted detox. UMR addiction treatment offers one of three tiers of medication coverage, depending on the plan you have.

For example, your plan might provide coverage for generic and brand-named FDA-approved medications. Some FDA-approved medications might fall under this category if you need medication-assisted detox as part of your opioid rehab. Usually, this type of rehab also includes behavioral therapies or individual psychotherapy as an ongoing requirement.

Prevail Recovery Center provides outpatient treatment in South Florida for addiction and mental health disorders. Contact us today if you are searching for a rehab that accepts UMR insurance.

ADDICTION TREATMENT INSURANCE

UMR Insurance Coverage

UMR can help you connect with a range of healthcare providers, therapists, doctors, and rehab centers. You will need an official diagnosis of substance abuse or alcohol use disorder from a doctor before you can qualify for rehab treatment. A doctor will usually sit down and ask about your history of substance abuse, the last time you used it, your history with rehab, and what you are looking for with rehab now. With UMR addiction treatment, you can get coverage for things like:

Detox

This might include medication-assisted detox, which, as aforementioned, may or may not be covered by your policy. For detox, you usually remain at a rehab facility or hospital for a few days.

Inpatient/Residential Rehab

This is a more comprehensive form of addiction recovery, lasting between 30 and 90 days. This is less likely to be covered by basic UMR plans. However, it is still worth investigating.

Outpatient Rehab

All tiers of insurance most commonly cover outpatient rehab. With outpatient rehab, you can undergo your detox followed by months of things like individual psychotherapy and medication management.

UMR health insurance companies are not required to deliver treatment for a set length of time. Instead, they suggest that you, as the patient, get a recommendation for UMR rehab based on your needs. So, you can’t use your insurance only to get coverage for rehab for one week or for one month.

Prescription Medications

Prescription medications to help you ease symptoms of withdrawal or to manage mental health conditions should always be covered to some degree, if not entirely, as part of your UMR rehab coverage.

Behavioral Therapy

Similarly, most UMR rehab coverage extends to behavioral therapies. Behavioral therapy can be used with inpatient or outpatient services. You might find individual therapy, group therapy, cognitive behavioral therapy, family therapy, marriage or relationship therapy, and more at different facilities. However, what gets covered by your UMR rehab coverage is something to be discussed with a staff member at each facility.

Outpatient Treatment Coverage

Does UMR Pay for Outpatient Addiction Treatment?

In many cases, yes, you can get coverage for outpatient rehab services. You should also be able to get coverage under the Affordable Care Act for inpatient services, detox, prescriptions, and therapy.

The exact amount that your UMR insurance will cover for UMR rehab is based on the type of plan you have and how much of your deductible has been paid. For most insurance providers, the higher your monthly premiums, the lower your deductible and vice versa. So, if you have an inexpensive plan with the cheapest monthly premiums, you can expect a higher deductible. The deductible is how much you have to pay out of pocket before your insurance will kick in.

For example:

Tina has a low monthly premium of $30 but she has a deductible of $10,000. This year she has already paid $570 of her deductible for other medications. So, if she wants to use her insurance to get rehab coverage, her insurance might make her pay out of pocket until she reaches the $10,000 total. In this case, she might have to pay out of pocket for the rehab services she wants for four months before her insurance takes over the costs.

By comparison, Doug has a high monthly premium of $400 but a deductible of $1500. He has already paid $350 of his deductible, so if he uses his rehab coverage, he might only have to pay the difference of $1,150 before his insurance kicks in.

You can generally expect a 20-30% reduction in your total rehab costs when you use your UMR rehab insurance benefits.

However, once you have met your deductible, everything else covered by your policy is 100% paid for by your insurance provider after that.

Prevail Recovery Center

How to Find In-Network UMR Outpatient Rehab

The best way to find out if you have UMR rehab coverage as part of your plan is to speak with professionals at the rehab centers you are considering. Specialists at our rehab clinic, for example, have experience reviewing the ins and outs of insurance policies like UMR. We can review whether you have UMR addiction rehab coverage in your area, what other options might be available if not, and more.

If you get treatment, you will not see an increase in your rates. It is against the law for insurance providers or third-party providers to increase their rates to you just because you used some of your benefits.

UMR provides coverage for rehab all across the U.S. If you need treatment in a state other than the one where you have insurance, you might be able to do so. Out-of-state treatment might not work for everyone, especially given the travel constraints. Still, it is something to consider, especially if you need to get away from your current environment to achieve real recovery (and are legally able to do so).

UMR works with many other insurance providers too. You might be able to find addiction coverage for yourself, or a loved one with benefits from UnitedHealthcare, Cigna, Beacon Health Options, or Blue Cross Blue Shield. If these options do not provide coverage for all of the services you want as part of your rehab, there are other ways. If you are far from your out-of-pocket maximum, we can work with you to find ways to find your treatment with personal loans, credit cards, and payment plans.

Prevail Recovery Center is an outpatient rehab center in South Florida that accepts UMR insurance coverage. Contact us today to learn how we can help you with detox, evidence-based therapy, and holistic treatment modalities.