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United Healthcare (UHC) Coverage for Opioid Rehab Near Me

On this page, you will learn about United Healthcare health insurance coverage for substance abuse treatment and how to confirm what benefits are available under your specific plan.
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United Healthcare Insurance for Opioid Addiction Treatment Programs

Provider Overview

United Healthcare (UHC) Coverage for Opioid Rehab Nationwide

Opioid addiction affects the brain and as such is a chronic issue that causes people to compulsively seek out drugs even when they are aware of the consequences.1 The decision to take drugs for the first time is a voluntary decision in most cases, but over time, it can lead to changes in the brain that affect struggling individuals’ behavior and compromise their ability to maintain sobriety despite of strong desire to keep taking the drugs.2

In 2008, Congress passed the federal law, called Mental Health Parity and Addiction Equity Act or MHPAEA, that prevents insurers from imposing less favorable benefit limitations on mental health issues than on medical/surgical benefits. This means that UHC should cover at least some part of your mental health and addiction treament in the same way as other medical conditions.3

United Healthcare works with a network of nationwide addiction treatment centers that are equipped to deal with opioid misuse and provide rehab programs for various mental health issues. Call the phone number on your United Healthcare Plan Membership Card to enquire with your UHC health care provider about the details of your coverage or simply call a dedicated hotline that will provide you with all the information and details.

What Aspects of Opioid Treatment Does United Healthcare (UHC) Insurance Cover?

Rehabilitation is a recovery process that helps people change their lives by improving their health and well-being through specialized treatment and long-term sobriety. It enables individuals take back control and live a drug-free life.4 

This rehab and treatment process may include the following components:4

Quality opioid rehab should include both medical and mental health services as needed.1 United Healthcare (UHC) rehab coverage for opioid misuse will depend on your individual UHC plan you have. Individually tailored treatment with follow-up procedures constitutes comprehensive care and is crucial for a successful treatment.5

Your UHC opioid abuse coverage can include:6

  • Professional interventions and initial screening.
  • Detoxification from harmful opioids in a safe setting.
  • Treatment and counseling at an Inpatient facility.
  • Outpatient programs as a form of post-treatment care.
  • Different types of behavioral therapies.
  • Assessment for possible co-occurring mental health disorders.

In most cases, UHC drug treatment starts with a professional screening and assessment, which is an important part of preventive treatment. It helps identify symptoms and design a treatment plan to avoid or entirely reduce serious consequences.7 Some patients need to undergo opioid detox before they proceed onto the next step. Further treatment typically includes some type of behavioral counseling or rehab for co-occurring mental health issues, such as depression or anxiety.5

What Services Aren’t Included in United Healthcare (UHC) Insurance Coverage?

Most UHC healthcare plans will not cover elective or cosmetic procedures, beauty treatments, off-label drug use, or brand-new and unproven methods.8 Non-medical amenities, like assistance with eating, dressing, bathing, or maintenance of personal hygiene, preparation of meals, transportation, and similar types of assistance are usually not covered.8

Additionally, some treatment options are only covered in certain states, and even then, insurers may deny coverage, so it’s always best to check with your preferred company directly.9

Furthermore, off-label drug use won’t typically be covered.10 You should also not expect your UHC rehab coverage to apply to alternative therapies that involve unproven treatment techniques, brand-new technologies, and untested procedures, as well as recreation programs, food delivery, and additional treatment amenities.8

How Much Will Opioid Rehab Cost?

The expected cost of addiction treatment for opioid abuse will depend on several factors. One of the important factors is the type of your individual UHC healthcare plan because insurance coverage can vary from one person to the next. Another important factor is the state in which you claim your insurance benefits because every state has its laws and legislature.1

The cost of rehab will also depend on the services included in your treatment plas, as well as their scope and intensity. One struggling individual might have three appointments per week whereas in other cases, one appointment per week could be enough.11 The same goes for treatment duration. Some individuals may need to undergo treatment for a couple months, while others might need longer treatment that can last for a year or more.11

Amenities are another factor that can affect the cost of UHC addiction treatment. Not all treatment facilities offer the same level or quality of care. There is also an option of attending executive and luxury treatment programs in high-end settings that can be more expensive. 

Inpatient Treatment for Opioid Addiction: What’s the Cost?

Inpatient treatment may be a very effective option for those who suffer from severe types of opioid addiction issues or co-occurring disorders.5 Since they offer 24-hour care and medical attention, inpatient programs can be more expensive than other types of rehab.5 Different facilities will incorporate different approaches and amenities, so the choice of inpatient drug rehab center can be a big factor in determining what the overall cost of addiction treatment will be.12

Another very important factor that can influence the cost of inpatient UHC-covered opioid rehab centers is the duration of treatment. 

  • Short-term inpatient residential treatment usually lasts from 3 to 6 weeks. It consists of hospital-based treatment that can be followed by an outpatient program and participation in some type of group therapy.11 
  • Longer-term UHC inpatient drug rehab is an option for individuals with complex addiction and mental health concerns. It can last for a year or even longer.12

Outpatient Treatment for Opioid Addiction: What’s the Cost?

According to NSDUH, there were approximately 10.1 million people aged 12 or older, who misused opioids in 2019, with a large majority of them suffering from misuse of prescription pain relievers. Many of them are typically not severe cases and don’t have to commit to a UHC substance abuse treatment facility. Instead, they have the option of choosing one of outpatient treatment programs for substance abuse.13

Since patients have different needs and backgrounds, outpatient rehabilitation can include various types of treatment and can offer services of different intensities. In general, outpatient rehab is typically more affordable than inpatient treatment. One of the reasons for this is the fact tha it doesn’t entail living in a facility 24/7.11 

Partial Hospitalization Programs (PHP): What’s the Cost?

In terms of treatment intensity, partial hospitalization programs, also called PHP, are somewhere between inpatient and outpatient programs. This type of treatment is similar to inpatient rehab in many ways, with the main difference being that you don’t have to stay overnight. Medicare Part B medical Insurance may provide partial hospitalization coverage, but you will have to meet certain criteria and your doctor will have to confirm that your issues will be best dealt with in an inpatient treatment.14

However, you may still have to pay for some aspects of treatment. This may depend on the following:14

  • The type of facility you chose
  • The cost of your doctor’s services
  • Whether your medical professional accepts Medicare payment terms
  • Whether any additional medical items, tests, and services are needed

Your medical professional may suggest services that your UHC insurance coverage plan doesn’t cover. In this case you may have to cover some of the treatment expenses out of pocket. To find out more about the exact details of your plan, you can call the UHC nationwide helpline.

Medication-Assisted Treatment (MAT): What’s the Cost?

Medication-assisted treatment (MAT) combines the use of approved medication with counseling and behavioral therapies and is often called a “whole-patient” approach.15 It has proved clinically effective in facilitating the process of detoxification.15 MAT helps normalize brain chemistry and may implement several prescribed medications including:15

  • Methadone, a synthetic opioid that’s been in use for more than 40 years in preventing and managing withdrawal symptoms and relieving drug cravings.
  • Buprenorphine, a partial opioid that provides up to 6 months of sustained medication delivery that will eliminate the need for daily dosing.
  • Naltrexone, an injectable and long-acting antagonist that stops other opioids from binding to and activating opioid receptors.

MAT medications help with opioid withdrawal and craving while restoring brain chemistry. When used as prescribed and in consultation with a medical professional, they are typically safe to use for a long period of time, in some cases even a lifetime.15 Therefore, all of these variables affect the cost of MAT, so it’s advisable to contact a UHC insurance helpline for more information.

How Does Cost of Rehab Compare to Opioid Addiction Expenses?

Since addiction is a life-changing condition, it can impact your everyday life, rendering you unfit for regular activities like work, studying, or hanging out with your family and friends. According to CDC research, the economic cost of opioid use disorder in the United States amounted to 471 billion dollars during the year 2017, while fatal opioid overdose cost approximately 550 billion. This means that a total of 1.021 trillion dollars were spent tackling this issue.16

Financing your treatment is less expensive than the total cost of addiction. The average cost of 1-year methadone treatment amounts to approximately $4,700 per patient compared to 1 full year of imprisonment that can cost 5 times more, or approximately $24,000 per person.17

Opioid addiction can lead to a life of crime and poor decisions. In general, 1 dollar put into addiction treatment will return 4 to 7 dollars in reduction of drug-related crimes, theft, and overall criminal justice-related expenses. If healthcare-related savings are included, the total ratio can be up to 12 to 1.17

How Can I Use My United Healthcare (UHC) Insurance for Opioid Rehab?

As of October 29, 2020, United Healthcare partners with more than 1.3 million physicians and healthcare professionals in 6,500 hospitals and other care facilities nationwide to provide health benefit programs for all ages and lifestyles.18 Treatment for opioid addiction will generally be covered by the UHC mental health component of your UHC insurance coverage.9

The first step in finding an appropriate treatment facility and using your insurance plan is to schedule a consultation with a doctor. A medical professional will ask about your situation to find a suitable program that will be tailored to your individual situation.5, 11 After you complete these steps, you can contact one of UHC rehab centers to determine your ability to use insurance and the specific coverage you are entitled to.

What Facilities Covered Under United Healthcare (UHC) Insurance Are There?

If you or a loved one are dealing with opioid misuse, American Addiction Centers (AAC) can be the solution you need to complete a rehab program. AAC has a network of certified treatment centers that accept United Healthcare (UHC) insurance coverage and can provide you with a program designed to your needs.

You can just call AAC’s free and user-friendly hotline. Compassionate and knowledgeable admission navigators are available 24/7 to give you all the information and assistance to help you make that crucial first step. All calls are free and privacy confidentiality is guaranteed. With one phone call, the AAC team can help you verify your coverage with UHC, check your benefits, and answer any other questions you might have concerning your insurance or treatment.

AAC operates a network of leading treatment centers across the country that provide people with the highest quality of care. ACC treatment centers are located nationwide, giving you the possibility to pick the option that best suits your needs.

How to Read Your Insurance Provider Card
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  • 1Insurance Provider Name
  • 2Policy Member's Full Name
  • 3Policy Membership/Subscriber ID
Sources
  1. MedLine Plus. (2020). Opioid Misuse and Addiction Treatment.
  2. U.S. Department of Health and Human Services. (2020). What Are Opioids?
  3. Centers for Medicare & Medicaid Services. The Mental Health Parity and Addiction Equity Act (MHPAEA).
  4. U.S. Department of Health and Human Services. (2020). What is Recovery?
  5. National Institute on Drug Abuse. (2019). Treatment Approaches for Drug Addiction DrugFacts.
  6. Medicaid.gov. (2017). Overview of Substance Use Disorder (SUD) Care Clinical Guidelines: A Resource for States Developing SUD Delivery System Reforms.
  7. Iragorri, N., Spackman, E. Assessing the value of screening tools: reviewing the challenges and opportunities of cost-effectiveness analysis. Public Health Rev 39, 17 (2018).
  8. Medicare.gov. What’s not covered by Part A & Part B?
  9. Medicare.gov. How Original Medicare works.
  10. American Cancer Society. Off-label Drug Use.
  11. National Institute on Drug Abuse. (2018). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition)
  12. FindTreatment.gov (2019). Treatment options.
  13. Substance Abuse and Mental Health Services (2021). Alcohol, Tobacco, and Other Drugs.
  14. Medicare.gov. Mental health care (partial hospitalization).
  15. Substance Abuse and Mental Health Services (2022). Medication-Assisted Treatment (MAT).
  16. Centers for Disease Control and Prevention. (2017). State-Level Economic Costs of Opioid Use Disorder and Fatal Opioid Overdose.
  17. National Institute on Drug Abuse. (2018). Is drug addiction treatment worth its cost?
  18. UnitedHealthcare. About US.

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Frequently asked questions

What Opioid Treatment Duration Does United Healthcare (UHC) Cover?
The length of opioid treatment varies from one individual to another and no single treatment plan will be an ideal fit for everybody. Longer treatment duration is typically more intensive and effective. It gives health care professionals more time to review and modify the program to fit patients’ changing needs.5 Staying in rehab long enough is crucial and can be a deciding factor whether the overall treatment program will be a success.11 So, it’s advisable to quickly check all the details of your UHC coverage with your insurance provider or preferred treatment center. You can call a UHC or AAC helpline to explore different options for paying for treatment.
Should I Pick a United Healthcare (UHC)-Covered Inpatient or Outpatient Opioid Treatment?
Whether one type of treatment is more effective than the other will largely depend on each person’s unique situation. However, there are several important factors to take into consideration when deciding between inpatient and outpatient treatment. Outpatient treatment can be a better option for people who have a stable home situation, supportive environment, or a steady employment.5 In some cases, people who underwent inpatient treatment will continue with outpatient programs to reduce the risk of relapse. In many outpatient rehab programs, group counseling may be a major component.5 Inpatient treatment provides patients with continuous 24/7 care under the supervision of medical experts. This affords patients with the greatest quality of care and constant monitoring of mental and physical progression through rehab.11 Inpatient treatment offers patients a focused environment free from triggers and provides them with a support group of people who deal with similar challenges.5
What Does Opioid Stand For?
Opioids are a type of drug that includes strong prescription pain relievers like oxycodone, hydrocodone, fentanyl, and tramadol, as well as illegal street drugs such as heroin. Prescription opioids can be generally safe if you take them for a short period of time and as prescribed.1 Your doctor may prescribe opioid medication if you:1 - Are undergoing a dental procedure. - Had some major injury. - Underwent surgery. - Feel severe pain due to specific health conditions like cancer. - Suffer from chronic pain.

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