Most insurance plans will cover either all or a portion of the treatment.
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SUD treatment executive, national news contributor & keynote speaker.
Navigation:
- Overview
- What Models of Treatment Does My UMR Policy Cover?
- What Specific Therapies Does UMR Cover?
- UMR Coverage for Medication Management
- How Do I Find A Program or Therapist That Accepts My UMR Insurance Plan?
Overview
UMR is what is known as a Third-Party Administrator (TPA) for UnitedHealthcare. They work specifically with self-funded employer health plans and offer coverage options for a wide range of mental health conditions, including substance use disorder (SUD). Equipped with a broad network of providers who specialize in a wide array of clinical specialties in mental health, UMR helps members quickly and easily access medically appropriate care for addiction and other mental health challenges. If you or your loved one are battling alcohol or drug use disorder and are covered by UMR, you may be able to use your policy to help make treatment more affordable and accessible.
What Models of Treatment Does My UMR Policy Cover?
Each person’s scope of coverage will vary depending on their specific policy and plan type, but some of the main treatment services your UMR policy may cover include:
- Inpatient – Inpatient or residential treatment allows patients to stay at their care facility while they’re receiving treatment. It is often recommended for patients who have tried outpatient care but have found themselves unable to maintain their recovery. Inpatient treatment programs generally last an average of 28-30 days, but coverage length will vary by individual plan.
- Outpatient – Outpatient and intensive outpatient programs allow patients to attend daily treatment programs and return home after care. They provide flexibility, accountability, and independence while still getting the care they need. These programs vary in length but often last for four to six hours per day, with five days a week on site for treatment.
- Medically Supervised Detoxification – Withdrawal management overseen by trained doctors and nurses to help ease withdrawal symptoms and help patients battle cravings. Medical detox can be offered as a standalone service or as part of inpatient treatment, and generally lasts from around three to seven days, depending on patients’ progress and ongoing care needs.
- Virtual Treatment – Comfortable and convenient care from the privacy and safety of your own living space. Virtual treatment offers expert mental health professionals who specialize in a range of conditions and co-occurring disorders to meet your or your loved one’s specific care needs.
UMR policies may also cover partial hospitalization programs (PHPs) and other clinically appropriate treatment models.
What Specific Therapies Does UMR Cover?
As part of their overall coverage opinions, UMR policies guide patients toward a variety of evidence-based therapies, including but not limited to:
- Cognitive-Behavioral Therapy (CBT) – CBT is a type of talk therapy where you work one-on-one with an experienced and qualified mental health professional to address a specific issue or set of issues that have led to a serious disruption in your mental health or quality of life. It is often used for co-occurring disorders such as SUD and depression or SUD and anxiety. There are many different types of CBT, so it’s important to check and see what services the facility you’re considering provides.
- Dialectical Behavior Therapy (DBT) – DBT is an evidence-based therapy that’s rooted in the greater cognitive-behavioral paradigm. It’s specifically adapted for individuals who require assistance with emotional regulation. Its root word, “dialectical”, means opposing ideas or forces, which is indicative of the actual technique.
- Eye Movement Desensitization and Reprocessing (EMDR) – Eye Movement Desensitization and Reprocessing (EMDR) is an increasingly common therapy used in addiction treatment to help individuals safely and responsibly combat traumatic experiences that lead to substance abuse and eventual addiction.
Coverage may also extend to techniques such as family of origin therapy, rational emotive behavioral therapy, and many more.
UMR Coverage for Medication Management
Your or your loved one’s UMR policy may also help provide medication management services to help improve adherence and ensure responsible use. These include mental health meds, as well as certain FDA-approved medications to treat opioid use disorder.
Administration and management of medications for opioid use disorder is called medication-assisted therapy (MAT) and includes the following medications:
- Suboxone® (Buprenorphine and Naloxone)
- Sublocade® (Extended-Release Buprenorphine Injections)
- Vivitrol® (Monthly Injectable Naltrexone)
- Methadone
Eligibility for MAT depends on multiple criteria, including substance use and treatment history, tolerance, and others.
How Do I Find A Program or Therapist That Accepts My UMR Insurance Plan?
The quickest and most direct way to find treatment options that accept UMR insurance is to go to their provider directory. The UMR provider network offers specialists for both adults and adolescents. It’s made up of experienced psychiatrists and Master-level clinicians who can provide targeted and granular treatment for even the most unique substance use issues.
Use our nationwide directory and contact their admissions team and see what your options are for coverage. A representative will be able to provide a complete insurance verification to let you know what parts of your treatment are covered and which parts will have to be paid for by other means. The most important thing is to get the help you need today.
