Insurance Provider Information
How Optum Rehab Coverage Works for Substance Abuse Treatment
Optum rehab coverage depends on your plan’s specifics. Before you check yourself into a rehab facility, it’s always essential to verify what your plan does and doesn’t cover in terms of services. This helps you prepare to pay for any services not covered under your plan.
Optum does maintain a Substance Use Disorder Helpline, where you can gain access to resources to start your road to recovery. The helpline offers referrals to drug rehab resources and other immediate assistance.
Types of Addiction and Mental Health Services That May Be Covered by Optum
Optum Health may cover several different services offered through behavioral health centers dealing with mental health and addiction. They include:
Medical Detox
Starting the path to recovery means ridding your body of the dangerous substances that perpetuate an unhealthy lifestyle. Medical detox is the safest way to ensure that as you wean off drugs or alcohol, you don’t suffer any adverse health events. Many policies pay for this part of the process, as it helps protect you as you start your recovery journey.
Inpatient Treatment
Some people need more intensive rehab than others, and inpatient treatment is best in these cases. While it’s more expensive, some policies will pay for at least part of the cost of inpatient treatment for patients who need it. These programs consist of group and individual therapy while you live at the rehab facility and learn how to live a sober, healthy life.
Outpatient Treatment
For those who can’t receive inpatient treatment or don’t need such intensive therapy, outpatient treatment is another option for drug rehab. Many policies will pay for outpatient treatment, which teaches you how to overcome your addiction and maintain sobriety while remaining in your home environment.
Partial Hospitalization Program
Some Optum plans offer coverage for partial hospitalization programs (PHPs). This approach falls between inpatient and outpatient treatment. It allows you to participate in rehab throughout the day and return to your home environment in the evening.
Sober Living/Follow-Up Care
Optum Health may help pay for sober living following acute treatment and any follow-up care you might need to maintain sobriety. These programs allow you to maintain your recovery goals and avoid triggers that could cause a relapse.
If you’re struggling with behavioral health issues, including addiction, Behavioral Health Centers can help. We offer residential treatment options in a safe setting to help you begin your recovery journey. We accept many insurance options, including Optum rehab coverage. Reach out to Behavioral Health Centers today to learn more about how we can help you start the road to recovery.
Optum Behavioral Health Benefits
Behavioral Health Centers is a participating provider in the Optum network. Our experienced mental health caregivers make our facility one of the best for receiving behavioral health assistance.
Since the type of services you receive from Behavioral Health Centers vary depending on your health insurance plan, it’s crucial to understand what we offer as an Optum network provider.
What Is Optum Mental Health Coverage?
Optum is a company under the UnitedHealth Group that provides various medical services. Optum Health is the company’s branch that provides health plans to private and public employers.
The company’s behavioral health care solutions make it easier for employees to receive mental health services through the Employee Assistance Program.
Detox
According to the National Center for Drug Abuse Statistics, at least 50% of Americans experiment with illegal drugs once in their lifetime. Close to 60 million use restricted substances every year, most of whom become addicted.
Substance use is harmful. It disrupts your life, making it impossible for you to function without using drugs. Maintaining a drug habit can also be costly, depleting your and your loved ones’ resources. If you struggle with drug addiction issues, you must get help quickly. Once admitted to our Behavioral Health Centers, you’ll undergo detoxification to ensure the drugs completely leave your system.
Optum mental health benefits include coverage for substance use disorder services. Our experts will supervise you full-time, ensuring you undergo the difficult detoxification process comfortably and safely.
Inpatient
You can get residential behavioral health services at Behavioral Health Centers through your Optum plan. We provide a calm environment where you can fully focus on your treatment program. You’ll be surrounded by a nurturing community that supports you through all your treatment activities.
Some behavioral health benefits you’ll receive during your inpatient stay include a personalized treatment plan for therapy and medication. You can also fully participate in the various alternative therapies to promote holistic healing, including fishing, massage therapy, gym exercise and games.
If Optum covers your treatment costs, you may need prior authorization to receive residential treatment at our facility. However, most Optum plans allow hospitalization at the nearest emergency room if you pose a danger to yourself or others.
Aftercare
Treatment for mental health conditions doesn’t end when you finish your inpatient stay at Behavioral Health Centers. As the end of your inpatient stay nears, you’ll be assigned a case manager who will help you transition to the outside world.
Optum medical insurance can cover follow-up treatments to maximize your behavioral health benefits. The case manager will help you find outpatient treatment centers under the Optum provider network so you can sustain the beneficial behaviors you developed during treatment.
Behavioral Health Services Under Optum
When you stop using drugs or alcohol, your body goes through a detox process that may take several days. In some people, this process causes nausea, vomiting, headaches and other symptoms. It’s safer to go through withdrawal under the supervision of experienced mental health providers, so Behavioral Health Centers offers a drug and alcohol detox program. Thanks to the Affordable Care Act, detox is covered under all ACA-compliant health insurance plans. That means Aetna insurance provides at least some level of coverage for drug and alcohol detox.
Individual Therapy
Optum’s individual therapy coverage gives you the space to honestly look inward and identify the causes of your mental health conditions. You’ll attend sessions with qualified psychologists. These professionals employ different behavioral health therapies, such as cognitive behavioral therapy (CBT) and motivational Interviewing, to help you modify your negative habits.
During individual therapy, there’s no pressure to move at everyone else’s speed. You can heal on your own time and develop lasting changes that benefit your mental and behavioral health issues.
Group Therapy
While individual therapy provides confidentiality, group therapy promotes accountability during your mental health journey. Most substance use treatments Behavioral Health Centers offer include group therapy sessions.
Optum health plans can cover group session costs so you can freely interact with people dealing with behavioral health conditions like yours. A group leader guides discussions and helps members craft action plans to benefit their mental health.
Conditions Covered by Optum Behavioral Health Plan
Substance Use Disorder
Optum plans support anyone seeking care for substance use disorder. Drug addiction treatment is one of our specialties. We offer treatment services for alcohol, cocaine, heroin, meth and other drugs. Our in-house experts use CBT, dialectical behavior therapy (DBT), eye movement desensitization and reprocessing (EMDR) and neurobehavioral therapy.
Each form of therapy helps you look at contributors to your drug abuse. Some treatments include a family support program to help you make amends and build a support system to which you’ll be accountable once you leave Behavioral Health Centers.
Anxiety Disorders
Around 40 million Americans suffer from some type of anxiety disorder. The most common conditions under this umbrella include chronic anxiety, social anxiety and phobias.
Anxiety disorders disrupt your life, making it hard to perform regular life activities, including work or socializing with loved ones. If unaddressed, an anxiety disorder can lead to self-medication and eventually substance abuse.
You can get help managing anxiety disorders while you get treatment for substance use disorder at Behavioral Health Centers. Our experts use traditional psychotherapy approaches. You can also undertake alternative treatment options, such as yoga and exercise, to learn how to manage your anxiety. Optum covers these treatments, ensuring you get well-rounded care.
Depression
Optum Health Insurance Basics
Optum coverage varies depending on where you live. The company offers HMO and PPO plans, each with distinct features. Those with HMO plans can choose an in-network primary care physician who can refer them to other specialties. Optum’s HMO plans tend to have lower monthly premium payments, but coverage doesn’t extend outside the network. Comparatively, PPO plans allow you to see anyone you choose without needing a referral, but the cost of out-of-network care is much higher.
As with any insurance coverage for addiction and behavioral health services, it’s essential to know your out-of-pocket expenses. You’ll likely have to deal with deductibles, copays and coinsurance costs. The deductible is the amount you’re responsible for before insurance coverage kicks in.
So, if an Optum policy has a deductible of $500, this is the amount you must pay before your coverage takes over to pay the remainder.
Coinsurance is a percentage of covered services that varies depending on the plan. So, for instance, if your coinsurance rate is 30%, the insurance company will pay 70% of the cost of covered service and you’re responsible for the remaining 30%. A copay is a set amount you pay for covered services upon receiving them. So, for instance, if your copay is set at $25, then each time you see a provider, this is the amount you’re responsible for paying up front.
Behavior Health Centers Mental Health Services
Seeking help for your mental health is brave and commendable. However, if you’re unsure what therapy interventions your Optum mental health coverage includes, you may not receive the health you need.
Fortunately, our insurance experts at Behavioral Health Centers are always available to help you with your Optum plan. Call us today at 855-299-472 or visit our offices at 208 SW Port St. Lucie Boulevard in Port St. Lucie.
We’ll help you learn everything about your Optum mental health coverage. We’ll also provide you with educational material about our mental health services to help you make the right decisions about your mental well-being.
Get Help Today
Don’t let the cost of substance abuse treatment deter you from getting the help you need. Behavioral Health Centers is a treatment facility that is committed to taking every step necessary to ensure your treatment is accessible and affordable. If you or someone you love is struggling with an addiction to alcohol or drugs, reach out today and take the first step in your recovery journey.