Optum Drug and Alcohol Addiction Rehab Treatment Coverage

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Serenity at Summit is dedicated to providing comprehensive drug and alcohol addiction rehab and mental health treatment at our state-of-the-art facilities located in Massachusetts and New Jersey. Our team of professionals is committed to helping individuals overcome substance addiction challenges and achieve lasting recovery.

With a focus on personalized care and evidence-based therapies, we can guide you or your loved one toward healing and transformation. Serenity at Summit accepts health insurance, and we encourage anyone interested in our programs to call (844) 326-4514. Our dedicated team can check your insurance coverage levels and discuss your treatment needs. By taking this step, you can gain clarity on the available resources and embark on a journey toward recovery in a supportive environment at Serenity at Summit.

Who is Optum?

Founded in April 2011, Optum is a leading health services and innovation company that operates within the broader UnitedHealth Group. As a subsidiary of UnitedHealth Group, Optum plays a pivotal role in transforming the healthcare landscape by providing diverse services and solutions.

Established to make healthcare more accessible, affordable, and effective, Optum leverages data, technology, and expertise to drive advancements in the healthcare industry. Through integrated components, Optum aims to improve the overall quality of healthcare delivery, enhance patient outcomes, and promote a more efficient and sustainable healthcare system.

Based in Eden Prairie, Minnesota, this healthcare services provider has 310,000 employees globally with interests in technology and related services, pharmacy care services, and various direct healthcare services. Their commitment to innovation and collaboration continues to shape the future of healthcare by addressing the evolving needs of individuals and organizations across the healthcare spectrum.¹

Some of Optum Brands, Products and Services

Optum, as a key player in the healthcare industry, offers a diverse range of brands, products, and services to enhance the quality and accessibility of healthcare. Collectively, they contribute to Optum’s overarching mission of transforming healthcare delivery and improving the health and well-being of individuals and communities. Below, we’ve provided a snapshot of some of Optum’s notable offerings:

  • OptumHealth: OptumHealth provides a comprehensive suite of health management services, including primary care, behavioral health, and care coordination. Their goal is to empower individuals to make informed healthcare decisions and improve overall well-being.
  • OptumInsight: Focused on data analytics and consulting services, OptumInsight assists healthcare organizations in leveraging data-driven information to enhance operational efficiency, optimize financial performance, and improve the quality of patient care.²
  • OptumRx: As a pharmacy care services provider, OptumRx offers solutions for pharmacy benefit management, medication adherence programs, and specialty pharmacy services. They work to streamline the prescription drug process and improve affordability for individuals and healthcare organizations.³
  • Optum360: This segment specializes in revenue cycle management services, helping healthcare providers navigate complex billing and coding processes. Optum360 aims to improve financial outcomes for healthcare organizations.
  • OptumCare: OptumCare focuses on delivering integrated and coordinated care through a network of healthcare providers, emphasizing collaboration across different specialties to ensure a holistic, patient-centered healthcare experience.4
  • Optum Bank: Optum Bank offers health savings accounts (HSAs), flexible spending accounts (FSAs), and other financial solutions for managing healthcare costs.5
  • Optum Behavioral Health: Optum Behavioral Health provides various mental health and substance abuse services, including Employee Assistance Programs (EAPs) and behavioral health management solutions.
  • OptumLabs: OptumLabs is a research and innovation center that advances healthcare outcomes through collaborative data-driven research and analytics.6
  • OptumIQ: With a focus on innovation, OptumIQ leverages advanced technologies such as artificial intelligence (AI) and machine learning to develop solutions that enhance healthcare outcomes, improve patient experiences, and drive overall system efficiency.7
  • OptumServe: Dedicated to providing services to government agencies, OptumServe plays a crucial role in supporting public health initiatives. This includes services related to healthcare delivery, data management, and health program implementation.8

What is Optum Rehab Coverage?

Optum offers resources and support that may extend to inpatient care, outpatient care, counseling, detoxification, and more to help individuals achieve stabilization, build resiliency, and sustain recovery. Optum’s rehab services are part of its comprehensive health insurance plans that vary based on the specific plan and individual circumstances.9

Those seeking rehabilitation services, such as drug and alcohol addiction treatment, are encouraged to contact Optum directly or call us to understand coverage specifics, including any potential co-pays, deductibles, limitations, or exclusions.

Check Your Insurance Coverage

Does Optum Cover Rehab for Substance Addiction?

Yes, Optum covers drug and alcohol rehab services at some level. However, coverage levels will vary depending on the specific plan. Optum understands the importance of addressing substance abuse issues and often includes behavioral health and rehabilitation services in its coverage.10

While Optum contributes to some of the cost of drug and alcohol rehab, it’s advisable to check your insurance to gain a clearer understanding of the coverage specifics. This proactive approach allows you to make informed decisions about your treatment options, considering any potential co-pays, deductibles, or other financial considerations associated with Optum alcohol rehab and Optum drug rehab services.

Does Optum Cover Medical Detox Treatment?

Yes, Optum typically covers some of the cost of medical detox treatment. However, the extent of coverage for medical detox can vary based on the specific plan. Medical detoxification is a crucial initial step in the treatment of substance abuse, helping individuals safely manage withdrawal symptoms under the close supervision of medical professionals.

While Optum recognizes the importance of providing coverage for such essential services, the actual coverage levels may differ depending on factors such as the insurance plan, network providers, and the terms outlined in your policy. To obtain detailed information about the coverage for medical detox treatment, contact us. Understanding coverage specifics, including any associated co-pays, deductibles, or limitations, enables you to make informed decisions about treatment options.

Does Optum Cover Residential Treatment?

Yes, Optum typically covers some of the costs associated with residential treatment for issues like drug and alcohol addiction. However, the extent of coverage varies based on the specific plan, factors such as in-network facilities, treatment duration, and associated costs. Check your insurance details to understand the particular coverage parameters, including co-pays, deductibles, and limitations related to residential treatment services.

Being well-informed about your insurance plan will help you make important decisions about suitable residential treatment options while managing finances effectively.

Does Optum Cover Mental Health Therapy Treatment?

Yes, Optum covers at least some mental health therapy treatment costs. Coverage levels vary based on your plan, including in-network providers, session limits, and potential co-pays or deductibles. Call (844) 326-4514 for plan details, or contact Optum directly to understand the specifics of your mental health therapy coverage.

Optum prioritizes mental and emotional well-being, offering a range of therapy options to support psychological health. From behavioral health solutions for Medicaid to employers, Optum is dedicated to providing some level of coverage for mental health.

Does Optum Cover EMDR Therapy?

Yes, Optum typically covers some of the cost of Eye Movement Desensitization and Reprocessing (EMDR). EMDR is a specialized form of psychotherapy commonly used to treat trauma and related mental health issues. The extent of coverage for EMDR therapy may vary based on the specific plan and can be influenced by factors such as the treatment provider and your location.

To understand the specifics of EMDR therapy coverage, it’s essential to review your Optum insurance plan details or call (844) 326-4514. This proactive step clarifies the coverage parameters so you can make informed decisions about pursuing EMDR therapy while considering the associated financial aspects.

Other Rehab Treatment Programs Covered by Optum

Optum’s coverage extends to various rehabilitation programs and specialized interventions. The specific coverage for each program varies based on your plan. The following will offer more insights into specific treatment programs typically covered by Optum, facilitating informed decisions about the services available for your overall well-being.

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Call Now: (844) 326-4514

Coverage for Partial Hospitalization Programs

Partial Hospitalization Programs (PHPs) are intensive, structured day programs that provide comprehensive mental health or substance abuse treatment without requiring overnight stays. Individuals in PHPs receive therapeutic services during the day and return home in the evenings. Optum typically covers some of the treatment costs, offering a valuable option for those requiring intensive treatment but who don’t need 24-hour care.

Coverage for Intensive Outpatient Programs

Intensive Outpatient Programs (IOP) are structured yet flexible programs offering a higher level of care than traditional outpatient programs. Individuals attending IOPs receive a comprehensive range of therapeutic services multiple times per week. Optum usually covers some of the costs associated with IOPs, providing access to a more intensive level of care while allowing time for daily routines and responsibilities.

Coverage for Evidence-Based Therapy Treatments

Optum recognizes the efficacy of evidence-based therapy treatments, which are therapeutic interventions grounded in scientific research and proven effective. These may include various modalities such as cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), motivational interviewing, and others tailored to address specific mental health or substance abuse concerns.

Optum typically covers some of the costs associated with evidence-based therapy treatments, acknowledging the importance of these well-established approaches in promoting positive outcomes for those seeking mental health and addiction recovery.

Coverage for Inpatient Rehab

Inpatient rehabilitation involves a 24-hour treatment setting for severe mental health or substance abuse issues. This level of care is suitable for those who require a highly structured and immersive environment. Optum typically covers some of the costs associated with inpatient rehab, recognizing the importance of this level of care for serious mental health or substance addiction challenges.

Rehab Center in Massachusetts That Takes Optum

At Serenity at Summit, we are dedicated to supporting your journey to recovery, guiding you through the initial detox phase to aftercare, and promoting a holistic approach to enduring sobriety and improved mental health. Our contemporary facility provides a tranquil, private setting for rehabilitation from drug abuse, alcoholism, and more, incorporating advanced clinical practices and evidence-based methods.

Furthermore, we accept insurance and may be able to accommodate your Optum plan. To begin this transformative path, we invite you to explore our nationally-recognized treatment center at the address below.

Rehab Center in New Jersey That Takes Optum

Situated in Union, New Jersey, our facility provides a wide range of treatment options, prioritizing individualized services, maintaining low staff-to-client ratios, and employing a team of master’s level therapists. Our comprehensive rehabilitation programs are carefully tailored to address the diverse needs of our patients.

For more information or to inquire about our New Jersey rehabilitation center, which may accept your Optum insurance plan, visit our facility at:

Check Your Insurance Coverage

How Much is Rehab with Optum Insurance?

Rehabilitation costs can significantly vary, influenced by factors such as the type of treatment, location, and insurance plan. Without insurance, psychotherapy sessions can cost $100-$200 per hour on average.11Additionally, the average cost for an individual seeking outpatient rehab in New Jersey and Massachusetts is around $1,700.12

We suggest carefully reviewing your policy documents to fully understand your healthcare coverage, as the above are only estimates. Speaking with one of our helpful staff members who can clarify cost details tailored to your specific treatment needs can provide confidence and security.

How To Check Optum Coverage Levels for Rehab Treatment

Please complete our online form to confirm your eligibility and the extent of coverage for rehab treatment under Optum. Our committed team will promptly speak with your insurance provider, ensuring a confidential process with no obligations. Upon verification, we will reach out to discuss your policy details and guide you through the next steps.

For a comprehensive understanding of your Optum insurance policy specifics and to discover rehab centers that take Optum, call (844) 326-4514 or complete our online form listed below.

How To Get Optum to Pay for Rehab Treatment

To understand your Optum insurance coverage thoroughly, we recommend carefully reviewing your benefits documentation summary or contacting us for up-to-date details and answers to any questions. Additionally, follow the steps below to maximize coverage with your Optum rehabilitation benefits:

  • Selecting Rehab Centers: Choose rehabilitation centers that are in-network with Optum and align with your preferences and requirements once you thoroughly understand your benefits.
  • Referral and Pre-Authorization: If necessary, secure a referral from your primary care physician, and if pre-authorization is required, provide Optum with your diagnosis and treatment strategy details.
  • Claims Handling: Ensure the rehabilitation facility you choose submits claims to Optum on your behalf.
  • Post-Treatment Follow-Up: After completing your treatment, follow up with Optum to verify claims processing and receive any owed reimbursements or coverage benefits.
  • Staying In-Network and Adhering to the Plan: Staying in-network with authorized providers and adhering to your recommended treatment plan can significantly enhance the chances of Optum covering your rehabilitation treatment.
Check Your Insurance by Phone

Call Now: (844) 326-4514

How Many Times Will Optum Pay for Rehab?

The extent of rehabilitation coverage provided by Optum depends on your specific policy, treatment type, medical necessity, and other factors. Typically, Optum offers coverage for services when deemed medically necessary, and the frequency and number of covered rehab sessions may be outlined in your insurance policy. For more information, call (844) 326-4514.

To comprehend your coverage details, including the frequency and number of covered rehabilitation sessions, it is crucial to understand your insurance benefits. Engaging in discussions with your healthcare and insurance providers can provide additional insights. Contact us for specific details about the scope of Optum’s rehabilitation coverage.

Addiction Statistics in Massachusetts

  • According to state reports, there has been a fourfold (450%) increase in opioid-related deaths in Massachusetts over the last 16 years.13
  • As per the National Drug Threat Assessment for 2020, Massachusetts documented the fourth-highest number of fentanyl cases in the United States in 2019.14
  • An American Journal of Public Health study revealed that counties with predominantly rural populations exhibited some of the highest rates of opioid use disorder, with Berkshire (6.06%), Bristol (5.81%), Hampden (5.34%), Barnstable (5.03%), and Worcester (4.38%). Suffolk County, which includes Boston, reported a lower prevalence at 3.36%.15
  • Approximately 260,000 adults in Massachusetts are affected by a serious mental illness.16
  • More than a quarter of Massachusetts residents have experienced the loss of a loved one due to opioid overdose.17

Addiction Statistics in New Jersey

  • The leading cause of accidental deaths in New Jersey is drug overdoses.18
  • Recent data indicates New Jersey ranks the 15th most cost-effective state for non-hospital residential drug rehab treatment.19
  • In 2019, a report on substance abuse in New Jersey identified the most commonly abused illicit drugs: heroin, other opiates, cocaine, and marijuana.20
  • Between 2016 and 2021, approximately 312,000 people in New Jersey sought treatment for substance abuse.21
  • In 2019, the New Jersey Department of Health allocated a $250,000 fund to enable paramedics to carry and administer buprenorphine during emergency calls.22

Sources

  1. “About Optum.” How We Are Creating a Healthier World, www.optum.com/about-us.html. Accessed 11 Nov. 2023.
  2. “Optum Insight.” UnitedHealthGroup, 2022, www.unitedhealthgroup.com/content/dam/UHG/PDF/investors/2022/conference/IC_22_OptumInsight_Overview_Highlights.pdf.
  3. “Optum RX | Fast, Free Prescription Delivery.” Optum RX, www.optumrx.com/public/landing. Accessed 11 Nov. 2023.
  4. “OptumCare.” OptumCare, secure.optumcare.com/Page/Content/LandingPage. Accessed 11 Nov. 2023.
  5. “Financial Products and Health Savings Accounts From Optum Bank.” Optum Bank, www.optumbank.com. Accessed 11 Nov. 2023.
  6. “OptumLabs Health Care Collaboration and Innovation.” OptumLabs, www.optumlabs.com. Accessed 11 Nov. 2023.
  7. “OptumIQ.” Optum, cdn-aem.optum.com/content/dam/optum3/optum/en/resources/fact-sheets/wf559688-iq-fact-sheet-2918.pdf. Accessed 11 Nov. 2023.
  8. “About Optum Serve.” Optum, www.optum.com/business/federal-government.html. Accessed 11 Nov. 2023.
  9. “Support for Individuals With Substance Use Disorders.” Optum, www.optum.com/business/employers/behavioral-health/substance-use-disorders.html. Accessed 11 Nov. 2023.
  10. “Behavioral Health Solutions for Health Plans.” Optum, www.optum.com/business/health-plans/behavioral-health.html. Accessed 11 Nov. 2023.
  11. Lauretta, Ashley. “How Much Does Therapy Cost in 2023?” Forbes Health, 14 Apr. 2023, www.forbes.com/health/mind/how-much-does-therapy-cost.
  12. Stilkind, Joseph. “Average Cost of Drug Rehab [2023]: By Type, State and More.” NCDAS, 1 Jan. 2023, drugabusestatistics.org/cost-of-rehab.
  13. “Massachusetts State Health Assessment.” Mass.gov, www.mass.gov/doc/chapter-6-addiction/download. Accessed 25 Oct. 2023.
  14. U.S. Department of Justice. “2020 DEA National Drug Threat Assessment.” Drug Enforcement Administration, Mar. 2021, www.dea.gov/sites/default/files/2021-02/DIR-008-21%202020%20National%20Drug%20Threat%20Assessment_WEB.pdf.
  15. Barocas, Joshua A. MD, et al. “Estimated Prevalence of Opioid Use Disorder in Massachusetts, 2011–2015: A Capture–Recapture Analysis.” American Journal of Public Health, vol. 108, no. 12, American Public Health Association, Dec. 2018, pp. 1675–81. https://doi.org/10.2105/ajph.2018.304673.
  16. “Mental Health in Massachusetts.” National Alliance on Mental Illness (NAMI), Feb. 2021, www.nami.org/NAMI/media/NAMI-Media/StateFactSheets/MassachusettsStateFactSheet.pdf.
  17. Crowe, Jack. “Poll: More Than One in Four Massachusetts Residents Have Lost Friend or Loved One to Opioid Overdose.” National Review, 12 Mar. 2018, www.nationalreview.com/2018/03/opioid-crisis-massachusetts-25-percent-overdose-victim.
  18. NJTV. “New Jersey’s Drug Addiction Crisis – NJ PBS and the Drug Addiction Crisis.” New Jersey’s Drug Addiction Crisis, www.njpbs.org/addiction.
  19. Stilkind, Joseph. “Average Cost of Drug Rehab [2023]: By Type, State and More.” NCDAS, 1 Jan. 2023, drugabusestatistics.org/cost-of-rehab.
  20. “New Jersey Drug and Alcohol Abuse Treatment: Substance Abuse Overview 2019 Statewide.” New Jersey Department of Human Services Division of Mental Health and Addiction Services, Oct. 2020, www.nj.gov/humanservices/dmhas/publications/statistical/Substance%20Abuse%20Overview/2019/Substance%20Abuse%20Overview%20Statewide%20Report%20-%20%202019.pdf.
  21. “New Jersey Drug and Alcohol Abuse Treatment: Substance Abuse Overview 2021 Statewide.” New Jersey Department of Human Services, July 2022, www.nj.gov/humanservices/dmhas/publications/statistical/Substance%20Abuse%20Overview/2021/statewide.pdf.
  22. Gounder, Dr. Céline, and Kerry Breen. “New Jersey County Uses Innovative Program to Treat and Prevent Drug Overdoses.” CBS News, 1 July 2023, www.cbsnews.com/news/new-jersey-county-uses-innovative-program-to-treat-and-prevent-drug-overdoses.

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