Summit Helps, a leading rehabilitation and mental health treatment service provider, operates cutting-edge facilities in New England. Our goal is to help you or your loved one overcome the obstacles associated with drug and alcohol addiction and other mental health issues, utilizing evidence-based practices and providing optimal support.

We prioritize service accessibility, believing that everyone should have the opportunity to receive the care they need. To enhance accessibility, we accept various health insurance plans, including the potential accommodation of your Optum plan. If you or a loved one is considering rehab treatment, call (888) 995-6311 to learn more about Optum rehab coverage and embark on a journey toward a future filled with vitality and well-being.

Addiction and Mental Health Statistics in New England

In New England, a complex tapestry of substance abuse issues unfolds. Vermont takes the lead in underage binge drinking rates across the U.S.,1 while Maine has seen a surge in overdose deaths.2 Connecticut witnessed a drastic rise in drug overdose deaths from 11.2 per 100,000 to 42.3 per 100,000.3 Drug abuse casts a vast shadow over the region.4

New Hampshire boasts the lowest percentage of children lacking private insurance and mental health coverage, an encouraging 2.0%, contrasting starkly with the national average of 8.1%.5 However, the state has witnessed a decline in substance use treatment enrollment6 and faces a significant barrier to mental health care due to cost, impacting 41.7% of adults.7 The landscape of substance abuse in New England remains intricate, demanding comprehensive strategies for intervention and support.

Exploring New England and its Regional States

Spanning along the northeastern coast of the United States, New England presents a diverse geographical tapestry that includes picturesque beaches, rolling hills, and vibrant urban centers. A standout feature is its proximity to the Atlantic Ocean, providing residents and visitors access to captivating shorelines.

The renowned New England coastline, adorned with beach towns and lively boardwalks, is a coveted destination for those seeking a coastal retreat. For urban enthusiasts, the dynamic cityscapes of Boston and Providence offer iconic skyscrapers that contribute to distinctive skylines, providing breathtaking views. Each city within New England boasts its unique charm and cultural offerings.

Nearby Cities

Situated in Princeton Junction, our facility is conveniently close to several renowned cities, including Princeton, known for its cultural richness and academic prestige. The dynamic cityscapes of Trenton, the state capital, combine history and modernity, and our location provides convenient access to the vibrant urban centers of Philadelphia and New York City, offering cultural attractions, entertainment, and employment opportunities.

Furthermore, our facility is close to other notable cities, including Boston, MA, known for its historical significance, and Portland, ME, with its picturesque coastal charm. Providence, RI, another city in proximity, adds to the diverse options for exploration and engagement. The strategic location ensures that individuals seeking rehabilitation can benefit from the supportive environment of our center while having easy access to these culturally rich cities.

Who is Optum?

Optum is a healthcare services and innovation company founded in April 2011. It operates as a subsidiary of the UnitedHealth Group and contributes significantly to transforming the healthcare landscape by offering various services and solutions. The company’s primary mission is to make healthcare more accessible, affordable, and effective. They achieve this by using data, technology, and expertise to drive industry advancements.

Headquartered in Eden Prairie, Minnesota, Optum has a global workforce of 310,000 employees. The company focuses on technology and related services, pharmacy care services, and various direct healthcare services. Optum is committed to innovation and collaboration and plays a crucial role in shaping the future of healthcare by addressing the evolving needs of individuals and organizations across the healthcare spectrum.[viii]

Some Optum Brands, Products, and Services in New England

As a prominent figure in the healthcare sector, Optum plays a pivotal role by offering a diverse range of brands, products, and services aimed at enhancing the quality and accessibility of healthcare. These comprehensive offerings align with Optum’s overarching objective of revolutionizing healthcare and promoting improved health and well-being. Below is an overview of notable offerings from Optum:

  • OptumHealth provides a comprehensive suite of health management services, including primary care, behavioral health, and care coordination. The goal is to empower the insured 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 improve operational efficiency, optimize financial performance, and enhance the quality of patient care.
  • OptumRx is a pharmacy care services provider offering solutions for pharmacy benefit management, medication adherence programs, and specialty pharmacy services. OptumRx works to streamline the prescription drug process and improve affordability.
  • Optum360 specializes in revenue cycle management services, aiding healthcare providers in navigating complex billing and coding processes to enhance financial outcomes.
  • OptumCare delivers integrated and coordinated care through a network of healthcare providers, emphasizing collaboration across different specialties to ensure a holistic approach to patient-centered healthcare.
  • Optum Bank offers health savings accounts (HSAs), flexible spending accounts (FSAs), and other financial solutions for managing healthcare costs.
  • Optum Behavioral Health provides various mental health and substance abuse services, including Employee Assistance Programs (EAPs) and management solutions.
  • OptumLabs is a research and innovation center advancing healthcare outcomes through collaborative data-driven research and analytics.
  • OptumIQ focuses on innovation, utilizing 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.
  • OptumServe provides services to government agencies, which are crucial in supporting public health initiatives. Services include healthcare delivery, data management, and health program implementation.

What is Optum Rehab Coverage?

Optum offers a variety of resources and aid that cover inpatient care, outpatient care, counseling, detoxification, and additional support services, aiming to facilitate stabilization, nurture resilience, and sustain recovery. These rehabilitation services are seamlessly incorporated into Optum’s extensive health insurance plans, with adjustments based on the particular plan and individual circumstances.

For comprehensive information on Optum’s rehab coverage, including potential co-pays, deductibles, limitations, or exclusions, it is recommended to reach out directly to Optum or call (888) 995-6311. Establishing this connection will enable you to thoroughly understand the specific details tailored to your situation.

Does Optum Cover Rehab in New England?

Optum covers drug abuse and alcoholism rehabilitation services in their plans, but the extent of coverage varies based on each individual plan. Optum recognizes the importance of treating substance addiction problems and usually includes rehabilitation and behavioral health services in their.8
Although Optum’s rehab coverage assists with some of the costs associated with substance addiction rehabilitation, you should check your insurance to better understand the details. Adopting this proactive approach empowers you to make well-informed decisions about your treatment options, taking into account potential co-pays, deductibles, and other financial aspects related to Optum alcohol rehab and Optum drug rehab services.

Does Optum Cover Medical Detox Treatment in New England?

Optum generally aids in covering a portion of the costs associated with medical detoxification treatment. However, the extent of coverage for this crucial initial step in substance abuse treatment varies depending on the specific plan. Medical detox treatment plays a vital role in safely managing withdrawal symptoms under the careful supervision of medical professionals.

While Optum acknowledges the importance of providing coverage for these essential services, the actual levels of coverage can vary based on factors such as the insurance plan, network providers, and the terms outlined in your policy. For detailed information, please reach out to us. Understanding the specifics of your coverage, including co-pays, deductibles, or limitations, empowers you to make well-informed decisions about your treatment options.

Does Optum Insurance Cover Inpatient Residential Treatment in New England?

Yes, Optum provides some coverage for expenses related to residential treatment in New England. The extent of this coverage depends on the specifics of your plan, including factors such as in-network facility usage, treatment duration, and associated costs. Review your insurance details to clarify the specific coverage parameters, encompassing co-pays, deductibles, and limitations related to inpatient care.

Arming yourself with comprehensive knowledge about your insurance plan enables you to make informed decisions regarding suitable residential treatment options while effectively managing your finances.

Does Optum Cover Mental Health Therapy Treatment in New England?

Yes, Optum does offer coverage for certain expenses related to mental health therapy treatment in New England. The extent of this coverage depends on your specific plan, considering factors such as in-network providers, session limits, and potential co-pays or deductibles. For a detailed understanding of your plan and to clarify the specifics of your mental health therapy coverage, contact us.

The Mental Health Parity and Addiction Equity Act guarantees a level of coverage for mental health therapy treatment.9 Optum and Summit Helps promote psychological and behavioral health by offering various treatment options and programs.

Other Options for Rehab Treatment Programs Covered by Optum

Optum provides coverage for a variety of rehabilitation programs and specialized interventions, but the specifics of this coverage vary from plan to plan. To help you make informed decisions about the services available, we have provided additional information about the specific treatment programs usually covered by Optum’s plans.

Optum Coverage for PHP – Partial Hospitalization Programs

Partial Hospitalization Programs (PHPs) are organized day programs that provide intensive mental health or substance abuse treatment without overnight stays. Optum typically contributes to a portion of the treatment costs, providing a valuable choice for individuals in need of intensive care without the necessity for 24-hour supervision.

Optum Coverage for IOP – Intensive Outpatient Program

Intensive Outpatient Programs (IOPs) provide a heightened level of structured care compared to traditional outpatient programs. An IOP delivers a comprehensive array of therapeutic services multiple times per week. Optum usually assists in covering some of the costs related to IOPs, allowing access to a more intensive level of care while accommodating daily routines and responsibilities.

Optum Coverage for Evidence-Based Therapy Treatments

Optum recognizes the efficacy of evidence-based therapy treatments, which are interventions grounded in scientific research and validated for success. These treatments include 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.

Typically, Optum offers coverage for certain costs associated with evidence-based therapy treatments, acknowledging the importance of these established approaches in promoting positive outcomes for individuals undergoing mental health and addiction recovery.

Optum Coverage for Inpatient Rehab

Inpatient rehabilitation involves a 24-hour treatment setting specifically crafted for severe mental health or substance abuse issues. This intensive level of care is ideal for individuals requiring a highly structured, immersive environment. Optum typically extends coverage for specific costs related to this program, recognizing the importance of inpatient care in addressing challenges associated with severe mental health or substance addiction.

Rehab Center in New England That Accepts Optum

We are dedicated to guiding and supporting you toward lasting sobriety and overall well-being. Our treatment programs, based in New England, offer comprehensive care, starting from the initial stages of detoxification through aftercare. Our goal is to empower you to achieve holistic well-being by recognizing the interconnected nature of substance addiction and mental health concerns.

Located in a state-of-the-art facility, our tranquil setting provides a confident and private environment to commence your recovery journey. We not only address substance addiction but also delve into the complexities of various mental health disorders. Our approach is rooted in a comprehensive strategy incorporating cutting-edge clinical practices and evidence-based methods, ensuring a thorough and practical treatment experience.

Our treatment center is accredited and accepts insurance. Contact us at (888) 995-6311 or visit our New England rehab facility:

How Much is Rehab with Optum Insurance?

The costs covered by Optum Insurance for rehabilitation can vary significantly, influenced by factors such as your policy details and the duration of required treatment. On average, psychotherapy sessions without insurance usually fall within the range of $100 to $200 per hour,10 while a three-month outpatient rehabilitation program costs, on average, $5,000.11

The above figures are estimates and subject to change. While Optum benefits generally cover some rehabilitation costs, financial responsibilities, like copayments and deductibles, may still apply. The primary objective is to ensure that you or your loved one can access necessary care, and our team is available to assist you in securing that care. Check your insurance details today for peace of mind and personalized support.

How To Check My Optum Insurance Coverage for Rehab Treatment

To assess your Optum insurance coverage, we encourage you to thoroughly review your insurance details by calling (888) 995-6311. Our dedicated team is prepared to contact your insurance provider on your behalf, ensuring a confidential and obligation-free process. After the verification process, we will reach out to discuss your policy details and offer guidance on the next steps.

For a more in-depth understanding of the specifics of your Optum insurance policy and to explore rehab centers that take Optum, contact us. We are here to assist you in navigating insurance coverage details and identifying the appropriate resources for your or your loved one’s rehabilitation needs.

How To Get Optum to Pay for Rehab Treatment in New England

Embark on the process by thoroughly examining your benefits documentation. For the most current information, call (888) 995-6311. When opting for a rehabilitation center affiliated with the Optum network, carefully consider your preferences to optimize your Optum benefits. If needed, secure a referral from your primary care physician and provide Optum with pre-authorization details.

To ensure that your rehab treatment costs in New England are covered by Optum, a facility that can submit claims on your behalf. Post-treatment, follow up with Optum to verify claims processing and receive any owed reimbursements or coverage benefits. Enhance the likelihood of Optum covering your rehabilitation treatment costs by choosing approved providers within the network and adhering to your prescribed treatment plan.

Key Points:

  • Thoroughly review benefits documentation for accurate information.
  • Call (888) 995-6311 for the latest details.
  • When selecting a rehab center within the Optum network, consider personal preferences.
  • Obtain a referral from your primary care doctor if necessary.
  • Provide Optum with pre-authorization details.
  • Choose a facility that submits claims to Optum on your behalf.
  • Follow up with Optum post-treatment to confirm claims processing and receive owed reimbursements.
  • Increase the likelihood of coverage by selecting approved providers within the network and adhering to your treatment plan.

How Many Times Will Optum Insurance Pay for Rehab Services?

The extent of rehabilitation coverage Optum provides depends on your individual policy, the type of treatment, medical necessity, and various other factors. Typically, Optum covers services considered medically necessary, and your insurance policy may outline the frequency and number of covered rehab sessions. For more information, call (888) 995-6311.

Having open conversations with your healthcare and insurance providers can provide further insights. Feel free to contact us for specific details regarding the scope and frequency of Optum’s rehabilitation coverage.

Related Optum Pages

Related New England Pages

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