Detoxificationâ€”detox for shortâ€”is the process of ridding the body of a harmful, addictive substance. It is almost always the first step in a longer journey to addiction recovery and overall wellness. Fortunately, most insurance plans with UnitedHealthcare partially or fully cover addiction treatment, including UHC-approved detox in Nashville, Tennessee.
Someone knowing precisely what their UHC plan covers allows for peace of mind in one area. This knowledge also helps them or their loved ones can get sober and think about the journey ahead without worrying about surprise fees or medical bills. For this reason, UHC members should contact their UHC representatives to discuss options.
What is UnitedHealthcare?
UnitedHealthcare is the health benefits business of UnitedHealth Group. Founded in 1974, UnitedHealth Group has grown up to become the world’s largest insurance company when measured by net premiums. UnitedHealthcareâ€”UHC for shortâ€”boasts revenues that make up more than three-quarters of the total revenue of UnitedHealth Group. UHC offers a wide range of healthcare benefits to fulfill its goal of delivering access to affordable, high-quality healthcare all over the U.S.
The Minnetonka, Minnesota-based organization periodically negotiates with healthcare providers like hospitals and physician groups to create provider â€œnetworksâ€ that lock in certain coverage and payment rates for healthcare services. Sometimes, these negotiations break down, discontinuing contracts.
The Affordable Care Act (ACA) requires health insurers to provide at least partial coverage for mental health treatment, including substance use disorder treatment. Thus, UHC covers substance abuse treatment, including some part of the cost of inpatient rehab. A subsidiary of UnitedHealth Group, QSSI, is a contractor with the U.S. Department of Health and Human Services to contribute to HealthCare.gov, the government-run online health insurance exchange.
Does UHC Insurance Cover Addiction Treatment?
UHC specializes in commercial group insurance plans, under different names and with differing coverages. Many if not most provide some level of coverage for addiction and mental health treatment. Among these plans are:
- UHC Select is an exclusive provider organization (EPO), meaning that services by healthcare providers not in the EPO are not covered.
- UHC Select Plus is the company’s preferred provider organization (PPO). Like a health maintenance organization (HMO), PPO plans have a network of providers that provide care to members under certain payment rates.
- UHC Choice is an HMO plan that offers access to specialists.
- UHC Choice Plus is an HMO allowing for coverage for healthcare providers not in its network.
- UHC Navigate, Charter, and Compass plans require a primary care physician’s referral to see any specialist.
To ensure members find help for substance use disorder and alcohol use disorder, UnitedHealthcare has its own division dedicated to addiction treatment: United Behavioral Health (UBH). This division provides confidential services for people to consult a substance abuse healthcare provider, and this includes UHC-approved detox in Nashville. Meanwhile, UHC’s yearly preventative care visits include drug screening and counseling.
Which Treatments Does UHC Insurance Cover?
Regarding substance use disorder and alcohol use disorder treatment services, UHC plans almost always include coverage of:
- Inpatient hospital detox
- Inpatient rehab
- Outpatient detox
- Outpatient alcohol and drug abuse rehab
UHC members’ coverage of inpatient rehab depends both on the type of plan they have as well as the state where they live. Along with individual and family plans, UHC offers short-term medical plans that can provide coverage for detox and addiction treatment. Some UHC plans have pre-certification requirements, depending on the services provided and whether the treatment program is inpatient or outpatient.
As part of UHC’s short-term medical plans, many individual policies offer partial coverage for addiction treatment programs. One exception is its Short-Term Medical Value plans, which do not cover addiction treatment costs.
Will I Have to Pay a Deductible for My UHC Coverage?
A deductible is the amount of money that UHC members must pay out-of-pocket for medical services before the plan â€œkicks inâ€ and begins covering medical services, either partly or fully. High-deductible health plans work well for those who are young and generally healthy, without dependents, and who can cover out-of-pocket costs for unexpected situations.
However, for those who anticipate significant medical expenses each year, low-deductible plans are recommended. Whether any given UHC plan requires a deductible for UHC detox in Nashville depends on the specific plan and whether the treatment provider involved is in-network or out-of-network.
Short-Term Medical Plus plans policies, as well as UHC’s more comprehensive plans, have a 20 to 30% deductible. After paying the deductibleâ€”which can range from $1,000 to as much as $10,000â€”UHC coverage kicks in. For outpatient treatment, UHC covers 20 to 30% of coinsurance after the deductible. For individual outpatient visits, patients are limited to $50 per visit.
Again, for more help in verifying a particular plan and finding the most affordable treatments, UHC members should speak with a UHC representative or their primary care provider.
Need Help with UHC for Detox in Nashville, TN? Contact Us Today
Finding the appropriate level of treatment for your alcohol use disorder or substance use disorder is a crucial step in overcoming addiction and finding recovery. At Brentwood Springs, our team of medical professionals strives to provide the resources needed for UHC-approved detox in Nashville, Tennnessee. If you are struggling, contact us today. We are happy to help you figure out your payment options for treatment.