Optum Health is a major health care conglomerate offering members a wide array of services worldwide. The company provides group and individual health plans and Medicare and Medicaid options. Behavioral Health Centers, based in Florida, accepts Optum rehab coverage for some of its addiction and mental health treatment programs. This is an affordable way for you to get help without paying entirely out of pocket.
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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.
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.
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Types of Addiction and Mental Health Services That May Be Covered by Optum
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.
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.
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.