United Healthcare

united healthcare

What is UnitedHealthcare?

UnitedHealthcare is one of the world’s leading insurance companies. They cover individuals and businesses in all 50 states in the USA and over 130 countries. Not only does UnitedHealthcare cover individuals it also covers businesses. As well as the self-employed and provides Medicare plans as well. They offer specialized plans for each pool of clients. UnitedHealthcare has a whole bureau dedicated to helping people who are the victims of addictions. They can help you find addiction treatment

What UnitedHealthcare Policies Cover Addiction Recovery?

Many of UnitedHealthcare’s insurance policies offer addiction recovery insurance to varying degrees. The only exception to this practice is their short-term or “bridge” policy. Short-term policies are not intended to be permanent. Short term policies are usually purchased to cover the gap between insurance policies that might occur if you change jobs or you are looking for a new one and your only previous insurance was under your old employer. Unfortunate short-term health insurance does not qualify for the Affordable Healthcare Act of 2010. This means that it is not required to provide addiction recovery services.

Can I Get in Trouble for Getting Addiction Recovery Help at Work?

With the exception of the short-term health insurance policy, all policies are required to offer some degree of coverage for addiction recovery. They are for people who are between insurance policies or missed open-enrollment under the Affordable Care Act of 2010 and do not qualify for special enrollment.

Why do People Have Short-Term Insurance?

Reasons that people have short-term policies are:

  • They are waiting for their ACA coverage to start
  • They are 26 and coming off their parent’s insurance
  • They are under 65 and healthy
  • Can I Get Addiction Recovery Help on My Former Employer’s Insurance Plans

Do I Have Insurance if I am Between Jobs?

Another reason that someone might have a short-term policy is they are between jobs that offered employer-funded health care, or they have a job that offers employer-funded health care, or their benefits from their new job have not started yet. Most employer’s insurance and human resources (HR) departments will work together to help someone who is suffering from an addiction disorder get help discreetly and anonymously.

What Types of Insurance Does UnitedHealthcare Provide?

UnitedHealthcare offers five groups of insurance policies:

  • Individual/Family
  • Self Employed
  • Employer
  • Medicare
  • Short Term Health Insurance

What Do I Do If I Can’t Afford Addiction Recovery Clinics?

For some people, short term health insurance might be new. Short term health insurance helps bridge the gap between different insurance policies and it is not meant to be permanent. Unfortunate short-term health insurance does not qualify for the Affordable Healthcare Act of 1010. This means that it is not required to provide addiction recovery services. With the exception of the short-term health insurance policy, all policies are required to offer some degree of coverage for addiction recovery.

Will My Boss Help Me Get Addiction Recovery Help?

Most employer’s insurance and human resources (HR) departments will work together to help someone who is suffering from an addiction disorder get help discreetly whether or not their benefits from their new job have started yet. If your employer does not keep your information private, they may suffer legal action.

Does UnitedHealthcare Provide Medicare?

Some other plans that you might be familiar with are:

  • Medicare Advantage
  • Medicare Supplement Insurance Plans
  • Medicare Prescription Drug Plans

What are Co-occurring Disorders?

Co-occurring disorder or dual diagnosis as it is also known as a combination of both addiction and another mental health disorder. If you have co-occurring disorders such as depression and alcoholism, you might want to also ask UnitedHealthcare about its Medicare Prescription Drug Plan and/or any other medication component to your current plan. One example of this is depression and heroin addiction. 

Your plan might cover the medication for depression and/or other mental health medication you might have. All components of the co-occurring disorder will need to be treated on an ongoing basis while the person continues on the recovery journey. Someone with dual diagnosis might have more than one original underlying mental illness like anxiety and depression, that initiated the addiction.

What Parts of the Addiction Recovery will UnitedHealthcare Cover?

The most common drug and alcohol rehab services covered by UnitedHealthcare are:

In drug/alcohol detoxification your body naturally purges itself of the harmful drugs and alcohol in your system. This process can be made much more comfortable with medical tapering which introduces medications into your system which lessen the discomfort of detox. In reputable addiction recovery facilities, trained staff are on hand 24/7 to deal with any problems that arise during the detoxification process.

This program starts after an individual has detoxified from the harmful levels of drugs and/or alcohol in their system. During residential treatment, the patient lives in the treatment facility. This decreases the risk of relapse as drugs and/or alcohol are not allowed in the facility. Patients are also kept on a strict schedule to help them to begin to adjust to a more conventional life.

During the PHP stage, patients have more freedom in their day to day activities. However, they are still kept to a schedule. Learning how to cope in the outside world while avoiding the temptations of drugs and/or alcohol is emphasized as well as therapy.

During the IOP stage, patients live at home but spend considerable time at the clinic in therapy and developing skills they need to help try to make their life changes permanent. For some people, it is possible to move straight to an IOP after detoxification. This usually depends on what type of drugs the person has been abusing and how long they have been abusing them. While it might sound appealing to try to skip ahead to an IOP, if you need residential treatment there is no way around going through the longer process if you want the best results

Are All Parts of Addiction Recovery Covered by my Insurance?

It is important to remember that not all of these treatments are covered and the ones that are covered may not be covered to the same degree. However, in-network providers are still much cheaper than out-of-network providers.

What is the Difference Between an In-Network provider and an Out-of-Network provider?

In-network health providers have been carefully screened by your insurance agency to guarantee the maximum benefits of their program. While out-of-network providers are not necessarily worse, they have not yet been screened by your insurance company or they have failed the screening process. In certain situations, your healthcare company will cover a part of your out-of-network treatment. The price of your treatment will still be higher than if you went to an in-network provider though.

Does UnitedHealthcare Provide an Aftercare Program?

For many addiction recovery clinics, aftercare is a large part of their program, often UnitedHealthcare will supplement or cover at least part of the clinic’s aftercare program. Some, such as Sana Lake, even provide housing for their alumni (patients who have successfully undergone their program) to live in as they learn how to return to their communities. Some insurance companies will offer their own aftercare programs that include group therapy and weekly social activities.

Are there Aftercare Options Beyond UnitedHealthcare’s Plan?

Often there are local 12-step programs that will help you on your recovery journey and serve as part of your support system. The most popular 12-step programs are Alcoholics Anonymous (AA) and Narcotics Anonymous (NA). Neither AA nor NA is affiliated with any outside business or organization. They only accept funding from donations from current members.

Who Do I Ask About My Addiction Recovery Plan?

Some services that most addiction recovery centers will provide when you are considering their clinic are insurance screening. Many clinics such as Sana Lake will work with you to get the full benefit from your insurance by:

  • Reviewing your insurance plan:

No insurance plans are the same. Not only does every client have different needs than they took out insurance for, there are different laws and requirements in every state that relate to health insurance.

  • Determine how much your insurance plan will pay for your treatment

Find out which substances are covered. Some cover might ensure alcohol recover but not heroin recovery.

  • Assess which components of your treatment your insurance will cover
  • Check on all Ways to Fund My Addiction Recovery Clinic Other Than Health Insurance

How Do I Get the Maximum Benefit from My Insurance?

It is important to check all of your plans, and not just your healthcare plan. It is unlikely that any other plan will cover addiction recovery, but driver’s insurance might cover alcohol addiction recovery to some degree under certain circumstances. It will only take a few phone calls to find out and your addiction recovery clinic will likely be happy to ask the company themselves.

What Insurance Policies are Most Likely to Cover my Drug Rehab?

There are two types of policies. In one type of policy, only hazards that are stated are covered. For example, if someone has that type of policy and they explicitly buy wind insurance for their house, it will not cover flood or lightning damage. The other type of policy is more inclusive. In these policies, everything is covered except the hazards that are explicitly excluded. For example, if someone has that type of policy and they buy insurance that states their home is fully covered in a storm but not a fire they would be covered if their home is flooded during a storm. It would not cover the policy owner if the house burns down. It is worth checking all of your options.

When you are ready to seek help please contact us. You can also reach us by dialing (636) 707-2097.

References: 

https://www.healthcare.gov/health-care-law-protections/

https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/addiction-health

https://www.uhc.com/individual-and-family/short-term-health-insurance

 

Article Reviewed by David Sherman, MD

David Sherman, MDDavid Sherman, MD is a Fellow of the American Society of Addiction Medicine (FASAM) and board certified in Addiction Medicine with the American Board of Preventive Medicine. He is a native Missourian and graduated medical school at the University of Missouri-Columbia School of Medicine. Dr. Sherman completed a two-year fellowship in Addiction Medicine at the University of Florida in Gainesville. He leads a highly trained staff of master level certified addiction professionals. Men and women from all over Missouri and the United States come to Sana Lake Recovery Center to get the care they need and deserve.