Will Optum’s Health Insurance Cover My Rehabilitation?

Rehabilitation is not a pretty experience. So are the expenses behind it. Typical rehabilitation costs can range from $10,000 up to $50,000. $50,000 is just about the average annual household income. This makes actual, and potential addicts look away, risking their life and livelihood. Where will they go to if they can’t afford the healthcare they need?

In accordance with the Affordable Care Act, Optum Healthcare Insurance now covers rehab and detoxification. Optum is a part of the UnitedHealth Group, who caters to more than 80 million citizens across the nation.

Have a visit to the nearest treatment center in your area for more information.

What Program Will I Be In?

There are two kinds of rehab treatments: Inpatient and Outpatient programs. Both involve the twelve-step program, medications, counseling and group meetings. Your program will depend on the conditions of your addiction.

If your condition meets the criteria, you’ll opt for outpatient care:

  • You don’t have any other physical and mental conditions.
  • Withdrawal won’t have any complications other than what’s intended
  • Other substances or medication you take won’t affect the treatment
  • There’s low risk of exposing you to the abused substance
  • There are no inpatient facilities in your area

Otherwise, you’ll opt for inpatient care. In inpatient care, you’ll be admitted to a hospital for a week or so. Some inpatient care is residential, meaning you’ll live in a facility for a month or more. Some facilities offer luxury suites for rehab. This program offers extra amenities like swimming pools, sports facilities, gym equipment, and food prepared by chefs. Optum may not cover the luxury suite but they will cover the medical aspects.

What Programs Do They Cover?

Optum has coverage on nearly all rehabilitation programs, even alternative medicinal therapy. The following are examples of Optum’s coverage:

  • Outpatient and Inpatient Rehabilitation
  • Detoxification Treatments
  • 12-Step Programs and other structured rehab programs
  • Dual Diagnosis for addictions with underlying physical or mental conditions
  • Alternative and Holistic Treatments
  • Withdrawal Medication
  • Methadone Treatments
  • Partial Hospitalization Programs

Some of these treatments need pre-approval from Optum before they cover it. Once you have your doctor’s recommendation, always confirm with Optum if they will cover the treatment. If they don’t they can always work with your physician to get you a “win-win” program.

How Long am I Covered For?

Rehab lasts from a couple of weeks to half a year. If approved, Optum will cover for the program’s entire length. If your physician or addict specialist recommends an extension Optum has to approve it first before they cover it. In some inpatient programs, your physicians recommend a supplementing outpatient program. This is to ensure the smooth transition back to the world, along with monitoring and evaluation.

What if I Don’t Have Insurance But I Need Help Now!

It’s not too late. Contact Optum and see if you can find a compromise for pre-existing conditions. The amount they will cover may not be as much, but any discounts will help. There are also free government programs and nonprofit organizations that will help you cope, and eventually, cure your addiction.

Quality healthcare must be affordable, as healthy, hardworking people are the bread and butter of any good nation. It’s also our responsibility to take care of ourselves. Even if rehabilitation is within reach, it’s still better to be safe than sorry.

Check out this playlist from Detox of South Florida Miami to learn more about rehabilitation.

Will Optum’s Health Insurance Cover My Rehabilitation?
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