Optum Drug and Alcohol Addiction Rehab Treatment Coverage in Massachusetts

What's on this page?

Serenity at Summit operates cutting-edge facilities in Massachusetts dedicated to providing comprehensive care for drug and alcohol addiction rehabilitation and mental health treatment. Committed to fostering a nurturing environment, our team of experienced professionals is driven by a passion for guiding individuals toward lasting recovery through personalized treatment plans and evidence-based practices.

Understanding the financial aspects of rehab is crucial, and at Serenity at Summit, we aim to make quality care accessible. We accept various health insurance plans, and for individuals considering rehab treatment through Optum, Serenity at Summit may be a viable option. We encourage you to contact us directly to inquire about insurance coverage levels and to engage in a confidential discussion about your specific treatment needs. Taking the first step towards recovery is a courageous decision, and at Serenity at Summit, we stand ready to support individuals on their transformative journey to a life of serenity and well-being.

Addiction and Mental Health Statistics in Massachusetts

In Massachusetts, opioid-related deaths have witnessed a staggering fourfold increase (450%) over the past 16 years. Notably, more than half of drug rehab admissions in the state are attributed to heroin abuse. According to the 2020 National Drug Threat Assessment, Massachusetts documented the fourth-highest number of fentanyl cases in the United States in 2019.

A study published in the American Journal of Public Health sheds light on opioid use disorder rates, with primarily rural counties such as Berkshire, Bristol, Hampden, Barnstable, and Worcester reporting some of the highest rates. Distressingly, over a quarter of Massachusetts residents have experienced the tragic loss of loved ones due to opioid overdose. Adding to the complexity, the state faces a unique challenge with xylazine, an animal tranquilizer, being mixed with opioids, intensifying concerns about the overdose epidemic. Massachusetts also contends with significant challenges in underage drinking, holding the fifth position nationally for underage binge drinking and ranking fourth for underage drinking overall.

Exploring Massachusetts and its Regional Cities

Massachusetts is located in the northeastern region of the United States and is known for its rich history, beautiful landscapes, and bustling cities. It shares borders with New Hampshire, Vermont, Connecticut, Rhode Island, and the Atlantic Ocean. The Bay State1 boasts a diverse geography, ranging from the rolling hills of Haverhill to the coastal charm of Quincy.

Boston, the capital and largest city, is a dynamic hub of culture and education. In the neighboring town of Cambridge, prestigious institutions like Harvard and MIT contribute to the intellectual vibrancy of the region. If you travel west, you will find Worcester, known for its artistic expression and cultural diversity, while Springfield is recognized for its industrial history and as the birthplace of basketball.2 Lowell honors its industrial legacy in the north, contributing to a captivating tapestry that enriches Massachusetts’ charm for residents and visitors.

Who is Optum?

Founded in April 2011, Optum stands as a leading health services and innovation company operating under the UnitedHealth Group umbrella. As a key subsidiary of UnitedHealth Group, Optum is instrumental in reshaping the healthcare landscape through various services and solutions.

Dedicated to enhancing accessibility, affordability, and effectiveness in healthcare, Optum utilizes data, technology, and expertise to drive industry advancements. Focusing on integrated components, Optum strives to elevate healthcare quality, improve patient outcomes, and foster a more efficient and sustainable healthcare system.

Headquartered in Eden Prairie, Minnesota, this global healthcare services provider boasts 310,000 employees worldwide and engages in technology, pharmacy care services, and various direct healthcare services. Committed to innovation and collaboration, Optum continues to shape the future of healthcare, addressing the evolving needs of individuals and organizations across the healthcare spectrum.3

Check Your Insurance by Phone

Call Now: (844) 326-4514

Some Optum Brands, Products, and Services in Massachusetts

As a prominent figure in the healthcare sector, Optum provides various brands, products, and services to elevate healthcare quality and accessibility. Together, these offerings align with Optum’s overarching mission to revolutionize healthcare delivery and enhance the health and well-being of individuals and communities. Here’s a brief overview of some of Optum’s notable offerings:

  • OptumHealth offers various health management services, including primary care, behavioral health, and care coordination. They aim to empower individuals to make informed healthcare decisions and enhance overall well-being.
  • OptumInsight focuses on data analytics and consulting services, assisting healthcare organizations in leveraging data-driven information to enhance operational efficiency, optimize financial performance, and improve the quality of patient care.4
  • OptumRx provides pharmacy benefit management, medication adherence programs, and specialty pharmacy services to streamline the drug process and improve affordability.5
  • Optum360 specializes in revenue cycle management services, helping healthcare providers navigate complex billing and coding processes and aiming to improve financial outcomes.
  • OptumCare delivers coordinated care through healthcare providers, emphasizing collaboration for patient-centered care.6
  • Optum Bank offers health savings accounts (HSAs), flexible spending accounts (FSAs), and other financial solutions for managing healthcare expenses.7
  • Optum Behavioral Health offers its insured mental health and substance abuse services, including Employee Assistance Programs (EAPs) and behavioral health management solutions.
  • OptumLabs is a collaborative research and innovation center focused on improving healthcare outcomes through data-driven analytics.8
  • OptumIQ leverages advanced technologies through innovation, such as artificial intelligence (AI) and machine learning, to develop solutions that enhance healthcare outcomes, improve patient experiences, and drive overall system efficiency.9
  • OptumServe provides services to government agencies, which are crucial in supporting public health initiatives. This encompasses services pertaining to the delivery of healthcare, management of data, and implementation of health programs.10

What is Optum Insurance Rehab Coverage?

Optum provides various resources and assistance, from inpatient care to outpatient care, counseling, detoxification, and beyond. These offerings are designed to assist individuals in stabilizing, developing resilience, and maintaining recovery. Optum’s rehabilitation services are integrated into its holistic health insurance plans, with details varying according to the specific plan and individual circumstances.

For those in search of rehabilitation services, particularly for drug and alcohol addiction treatment, check your insurance via our convenient online form or call (844) 326-4514. This facilitates a clear understanding of your Optum rehab coverage specifics, including potential co-pays, deductibles, limitations, or exclusions.

Check Your Insurance Coverage

Does Optum Cover Rehab in Massachusetts?

Optum provides some level of coverage for drug and alcohol rehab services in Massachusetts, although the amount of coverage may differ depending on the particular plan and additional factors. Optum recognizes the significance of tackling substance abuse problems and frequently incorporates some portion of behavioral health and rehabilitation services in its coverage.11

It’s highly recommended that you take a proactive approach and verify your insurance coverage levels. This will help you make informed decisions about your treatment options and enable you to consider factors like co-pays, deductibles, and other financial considerations associated with Optum alcohol rehab and Optum drug rehab services—call (844) 326-4514 today.

Does Optum Insurance Cover Medical Detox Treatment in Massachusetts?

Optum generally includes coverage for some expenses associated with medical detox treatment. However, the degree of coverage for medical detox varies depending on the specific plan and other factors. Medical detoxification is a vital initial phase in addressing substance abuse, enabling individuals to safely navigate withdrawal symptoms under the attentive care of medical professionals.

While Optum acknowledges the importance of covering such essential services, the actual levels of coverage may fluctuate based on factors like the insurance plan, network providers, and the terms outlined in your policy. For detailed information on the coverage of medical detox treatment, call (844) 326-4514. Understanding the specifics, including any associated co-pays, deductibles, or limitations, empowers you to make well-informed decisions about your treatment options.

Does Optum Insurance Cover Inpatient Treatment in Massachusetts?

Yes, Optum insurance does cover inpatient treatment in Massachusetts. Individuals seeking inpatient care for substance abuse or mental health treatment can benefit from some coverage for the associated costs. However, it’s essential to note that the extent of coverage varies depending on the specific Optum insurance plan and more.

Optum recognizes the significance of inpatient treatment as a crucial component of comprehensive care. While some costs will be covered, the precise coverage levels, including details on co-pays, deductibles, and any potential limitations, are contingent on the particulars of your insurance plan. To obtain detailed information about the coverage for inpatient treatment in Massachusetts and how it applies to your specific situation, call (844) 326-4514.

Does Optum Insurance Cover Mental Health and Therapy Treatment?

Optum provides coverage for at least some of the costs associated with mental health therapy treatment as mandated by The Mental Health Parity and Addiction Equity Act.12 The specific coverage details, including co-pays, deductibles, or limitations, may vary depending on the individual’s Optum insurance plan. For detailed information about your plan, including mental health therapy coverage, call (844) 326-4514.

Check Your Insurance by Phone

Call Now: (844) 326-4514

Other Options for Rehab Treatment Programs Covered by Optum

Optum’s coverage spans various rehabilitation programs and specialized interventions, with specific coverage for each program depending on your plan. For a thorough understanding of your coverage, please call (844) 326-4514. The details below will provide further insights into specific treatment programs typically supported by Optum, helping you make informed decisions about the available services for your overall well-being.

Optum Coverage for PHP – Partial Hospitalization Programs

Partial Hospitalization Programs (PHPs) offer an immersive, well-organized approach to mental health or substance abuse treatment. These day programs provide comprehensive services without needing overnight stays, allowing participants to receive therapeutic support during the day and return to their homes in the evenings.

Optum commonly includes coverage for a portion of PHP treatment costs, presenting a beneficial choice for those seeking intensive treatment without requiring round-the-clock care.

Optum Coverage for IOP – Intensive Outpatient Program

Structured yet adaptable, Intensive Outpatient Programs (IOPs) provide a heightened level of care. Participants in IOPs receive a comprehensive array of therapeutic services multiple times weekly. Typically, Optum covers a portion of the costs associated with IOPs, granting access to a more intensive level of care while maintaining the flexibility to manage daily routines and responsibilities.

Optum Coverage for Evidence-Based Therapy Treatments

Optum acknowledges the effectiveness of evidence-based therapy treatments, which are therapeutic interventions rooted in scientific research with proven efficacy. These treatments encompass various modalities like cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), motivational interviewing, and others tailored to address specific mental health or substance abuse concerns.

Optum typically provides coverage for some of the costs associated with evidence-based therapy treatments, recognizing the significance of these well-established approaches in fostering positive outcomes for those seeking recovery from drug abuse, alcoholism, or other mental health-related challenges.

Optum Coverage for Inpatient Rehab

Inpatient rehabilitation encompasses a continuous 24-hour treatment environment designed for individuals facing severe mental health or substance abuse issues. Inpatient care is ideal for those needing a highly structured, immersive therapeutic setting. Optum commonly includes coverage for some of the costs associated with inpatient rehab.

Rehab Centers That Take Optum in Massachusetts

Dedicated to guiding you on a transformative path toward lasting sobriety and overall well-being, we provide seamless support in our Massachusetts-based treatment programs, from initial detoxification to comprehensive aftercare. Our commitment is rooted in empowering you to achieve holistic well-being, recognizing the interconnected nature of substance addiction and mental health concerns.

Nestled within our state-of-the-art facility, you’ll experience a serene setting crafted to launch your recovery journey with confidence and privacy. Here, we not only address substance addiction but also explore the complexities of various mental health disorders. Our holistic approach integrates cutting-edge clinical practices and evidence-based methods, ensuring a thorough and practical treatment experience.

For those searching for an accredited treatment center that accepts insurance, we encourage you to connect with us by calling (844) 326-4514. Alternatively, you can visit our Massachusetts location:

Check Your Insurance Coverage

How Much is Rehab with Optum Insurance?

The expenses associated with rehabilitation can exhibit significant variability, shaped by factors like the treatment type, location, and insurance coverage. In the absence of insurance, psychotherapy sessions typically range from $100 to $200 per hour, on average.12Additionally, the average cost for an individual enrolled in outpatient care in Massachusetts is $1,703.13

We highly recommend that you carefully review your policy documents or call us at (844) 326-4514 to understand your healthcare coverage completely, as the figures provided above are just estimates. Speaking to one of our friendly staff members who can explain the cost details specific to your treatment needs will provide you with confidence and security.

How To Check My Optum Insurance Coverage for Rehab Treatment

To confirm your eligibility and assess the extent of Optum’s coverage for rehab treatment, kindly fill out our online form linked below. Our dedicated team will promptly engage with your insurance provider, ensuring a confidential process without any obligations. Upon verification, we will reach out to discuss your policy details and guide you through the following steps.

For a comprehensive understanding of your Optum insurance policy and coverage for rehab treatment in Massachusetts and to find rehab centers that take Optum, please call us at (844) 326-4514 or complete our online form below.

Check Your Insurance by Phone

Call Now: (844) 326-4514

How To Get Optum Insurance to Pay for Rehab Treatment

It’s essential to understand your Optum insurance coverage when deciding on rehabilitation. To get the latest information and answers to any questions, call (844) 326-4514 or carefully review your benefits documentation summary. Sticking to in-network providers and adhering to the recommended treatment plan can significantly increase the likelihood of Optum covering your rehabilitation treatment.

Additionally, consider the following to maximize your Optum rehabilitation benefits: choose in-network rehabilitation centers that align with your preferences, get referrals, and provide Optum with the pre-authorization details, if necessary. Make sure that the facility you choose submits claims on your behalf, and after the treatment, follow up with Optum to confirm claims processing and receive any owed reimbursements.

How Many Times Will Optum Insurance Pay for Rehab Services?

The extent of rehabilitation coverage offered by Optum is contingent on various factors, including your specific policy, treatment type, and medical necessity. Generally, Optum provides coverage for medically necessary services, with details on the frequency and number of covered rehab sessions outlined in your insurance policy. For a more comprehensive understanding, call (844) 326-4514.

To grasp the details of your coverage, especially regarding the frequency and number of covered rehabilitation sessions, it’s essential to familiarize yourself with your insurance benefits. Engaging in conversations with your healthcare and insurance providers can offer additional insights. Contact us directly for specific details concerning Optum’s rehabilitation coverage scope.

Addiction Statistics in Massachusetts

  • A significant number of women of reproductive age in Massachusetts require but don’t receive sufficient substance use disorder (SUD) treatment. Providing continuous services beyond detoxification and stabilization could potentially help with relapse prevention post-treatment and reduce dependence on emergency departments for subsequent medical care.15
  • According to state reports, there has been a fourfold (450%) increase in opioid-related deaths in Massachusetts over the last 16 years.16
  • More than half of drug rehab admissions in Massachusetts are for heroin abuse.17
  • As per the National Drug Threat Assessment for 2020, Massachusetts documented the fourth-highest number of fentanyl cases in the United States in 2019.18
  • It is estimated that around 260,000 adults residing in Massachusetts have a severe mental illness.19
  • According to a study published in the American Journal of Public Health, counties with mostly rural populations had some of the highest rates of opioid use disorder. Berkshire (6.06%), Bristol (5.81%), Hampden (5.34%), Barnstable (5.03%), and Worcester (4.38%) were among the counties with the highest rates. However, Suffolk County, which includes Boston, reported a lower prevalence at 3.36%.20
  • Over a quarter of Massachusetts residents lost loved ones to opioid overdose.21
  • In Massachusetts, xylazine – an animal tranquilizer – is being mixed with opioids, intensifying concerns about the overdose epidemic.22
  • Massachusetts holds the fifth position nationally for underage binge drinking and ranks fourth for underage drinking overall.23

Related Optum Pages

Related Massachusetts Insurance Pages

Tap to GET HELP NOW: (844) 326-4514