Optum Insurance Detox & Rehab Benefits Guide

Optum Insurance Detox & Rehab Benefits Guide

Optum is a health information technology and services firm whose parent company is UnitedHealth Group. Located throughout the United States, they provide healthcare and consulting solutions and services to healthcare organizations, individuals, and pharmaceutical companies as well as the federal and state governments.1

Optum serves approximately 120 million people worldwide and 80% of health plans.2 Working across the country to serve its clients, Optum ensures you can get the care you need for whatever health issue you’re facing. This is particularly critical for those dealing with substance abuse and addiction.

Substance abuse and addiction in the United States has soared in the last couple of decades, with overdose deaths rising from 38,329 to 70,237.3 Getting treatment for substance addiction is essential before the problem escalates. If you’re one of the many people who are facing an addiction crisis in your life, then understanding your drug rehab insurance coverage options is essential. This guide will help you understand how Optum detox coverage works and how to access your Optum rehab insurance coverage to get addiction and detox services.

Does Optum Insurance Cover Detox?

When it comes to Optum drug rehab coverage, you may be asking, what does Optum cover, exactly? Optum takes substance use disorder and all behavioral health issues very seriously. Whether you are dealing with prescription drug use, opioids, cocaine, alcohol, or something else, you’re not alone during your journey to recovery. Optum offers a comprehensive behavioral health plan through their insurance coverage. The Optum plan covers many behavioral health issues, such as anxiety, depression, anger, marital problems, and more. Notably, it also covers addiction issues and medication management.9

 In addition, it specifically mentions that substance use disorder, including opioid use disorder, is covered by the health plan. As part of their coverage options, they provide access to community support groups and cognitive behavioral therapy .10,11

Other types of services you can expect under the Optum plan include:

  • Individual therapy.
  • Group therapy.
  • In-patient hospitalization.
  • Residential treatment.

These services are performed by licensed clinicians and are conducted in either a private office setting or at a facility such as a rehab clinic or hospital.9, Patients covered by the state Medicaid program also have coverage for behavioral health issues including substance abuse and addiction.12  If you’re concerned about getting help for a family member who is dealing with a substance abuse issue, Optum does provide coverage for all dependents under the age of 26.13 As with any healthcare plan, there may be deductibles and co-payments, so it is best to check with your provider about your plan’s details.

 

Types of Optum Insurance Plans

Optum works with a wide variety of health insurance solutions. Since they are affiliated with the UnitedHealth Group, they manage all the major health insurance plans. These include the following:

Pro-Health Insurance Plans. This plan provides several options, including:

  • Anthem Blue Cross.
  • Blue Shield.
  • Cigna.
  • United Healthcare.
  • Community Health Group.
  • TRICARE Select.
  • Health Net.

Medicare Advantage HMO Health Insurance Plans—With this Medicare option, you have the following plans:

  • United Healthcare.
  • Aetna.
  • Easy Choice Health Plan.
  • Health Net.
  • SCAN Health Plan.
  • Care 1st Health Plan.
  • Anthem Blue Cross (Medicare Advantage).
  • Blue Shield 65 Plus.
  • Humana
  • LA Care Health Plan.

HMO Health Insurance Plans—With an HMO plan, you’ll have access to a broad range of services within a network of providers, meaning you need to work with the facilities in that group. The plans within this group are:

  • Sharp Health Plan (this is for San Diego only).
  • Health Net.
  • Anthem Blue Cross.
  • TRICARE Prime.
  • CalOptima Medi-Cal.
  • Cigna.
  • Blue Shield.

Covered California—These plans, which are brand-name health insurance plans offered under the Patient Protection and Affordable Care Act are as follows: 5

  • Health Net (for San Diego only).
  • Anthem Blue Cross.
  • LA Care Health Plan.

Cal Mediconnect Plans—These healthcare plans are for people who have dual benefits of both Medicaid and Medicare.6  They are as follows:

  • LA Care Health Plan.
  • Care 1st Health Plan (San Diego offices).
  • OneCare (HMO SNP).
  • OneCare Connect CalMedi Connect Plan.
  • Health Net.

OptumCare Medical Group Network Choices—These plan options include:

  • AppleCare Medical Group.
  • Monarch HealthCare.
  • Primary Care Associates.

To know more about the specifics of your plan, you can select this link and sign in at the patient portal login.

You may be wondering about your insurance coverage for rehab if you have Medicare. Current Medicare patients have the Medicare Advantage plan. This plan includes OptumCare. Through the OptumCare solution, you’ll have access to a wide range of network providers and healthcare solutions.8

Detox at American Addiction Centers

Find hope and a new future if you’re struggling with an addiction problem by reaching out to American Addiction Centers. Our premier treatment centers are qualified to assist those with substance use disorders. Certified professionals will provide evidence-based treatment for drug and alcohol addiction. We work with a wide variety of substance use disorders, such as:

  • Alcohol addiction.
  • Cocaine addiction.
  • Fentanyl addiction.
  • Heroin addiction.
  • Meth addiction.
  • Opiate addiction.
  • Opioid addiction.

At American Addiction Centers, you can count on our staff to provide superior service. Our high staff-to-patient ratio ensures you receive a personalized experience. Additionally, we use a wide variety of professionals, such as physicians, psychiatrists, licensed social workers, registered nurses, and psychologists to meet the needs of our clients.

With centers throughout the United States, you can find a place conveniently located near you. We work with a wide variety of insurance providers, including Optum, so you are assured of easy access to the healthcare you need. Find out now about your insurance coverage with our safe and secure system.

Our compassionate staff is always on hand to guide you through this process. Whether you need help with the paperwork, the insurance process, finding the right facility, or setting up a treatment plan, we’re on hand 24/7. Your journey to healing is just a phone call away. Contact us today at 1-888-935-1318 for personalized, confidential help.

  1. Becker’s Hospital Review. (2014). 10 things to know about Optum.
  2. Becker’s Health IT. (2020). 10 numbers that show how big Optum is in healthcare.
  3. National Institute on Drug Abuse. (2020). Overdose death rates.
  4. (2020). Accepted health insurance plans.
  5. Covered California. (2020). What is Covered California?
  6. Fact Sheet. (2015). Low income assistance: Cal MediConnect.
  7. (2020). Patient portal login.
  8. (2020). Medicare with OptumCare.
  9. Optum’s behavioral health benefits.
  10. (2020). Substance use disorders.
  11. (2020). Substance use disorders (SUDs).
  12. (2020). Behavioral health.
  13. (2019). OptumCare benefits enrollment guide.
  14. (2020). Optum login.