UMR is a unique type of insurance policy in that they are a Third-Party Administrator (TPA) on behalf of United Healthcare and not an insurance provider themselves.
However, UMR is associated with thousands of providers for both HMO and PPO benefits and dedicated to helping you find treatment at an affordable cost.
If you need help finding UMR-approved substance abuse treatment, contact our addiction specialists today.
While UMR does not directly offer treatment coverage as they are not an insurance company, their network of healthcare providers do.
UMR follows guidance under the Affordable Care Act which mandates coverage for mental health and substance abuse diagnoses. You can expect to see all levels of addiction treatment covered under UMR, including:
Because UMR helps you connect with a variety of healthcare providers, there are no set guidelines for who or how coverage can be delivered. However, the provider network you’re connected with is likely to follow the American Society of Addiction Medicine’s criteria for diagnosing alcohol use disorder and substance use disorder.
This criteria is typically discussed during your initial call with an addiction specialist and includes questions that help determine your insurance coverage:
Your UMR policy coverage and the provider network at your disposal will be the determining factor in what addictions are covered. However, as people have become more educated on what addiction looks like and the treatment necessary to establish long-term success, you can expect to see common addictions covered under almost every plan:
Yes. Inside UMR’s provider network you are likely to find common mental health services covered by a variety of providers. This may include: Cognitive Behavioral Therapy, Eye Movement Desensitization and Reprocessing, or even Biofeedback (depending on the plan).
UMR offers three tiers of medication coverage that may be available under your unique plan. They report covering both generic and brand-name medications approved by the FDA. In the case of Medication-Assisted Treatment (MAT) there are numerous FDA-approved medications proven to help with addiction when used alongside traditional treatments.
While medication-assisted treatment (MAT) is not necessary for all clients, many, especially those struggling with an opioid addiction can find lasting recovery with a program focused on the combination of prescription medications and behavioral therapy.
The exact amount your UMR insurance will cover for drug and alcohol rehab depends largely on your unique plan, the type of service you’ve elected, and how much of your deductible has been paid. Because of the large network available under UMR they estimate 20-30% reductions in your medical bill.
If your deductible has been met for the year it applies, you may be eligible for complete coverage of your treatment and be able to attend rehab with 100% coverage under UMR. However, if you’ve yet to meet your out-of-pocket maximum, there are numerous options available to afford treatment:
The Hope House is one of the few Arizona rehab centers to accept UMR and help clients obtain personalized treatment from masters-level clinicians.
As members of the United Healthcare PPO Network, The Hope House is dedicated to providing treatment for addiction and mental illness, offering FDA-approved medications to clients who wish to partake in MAT, and only employ trained and fully accredited behavioral health professionals.
UMR’s access to the United Healthcare PPO Network enables them to offer coverage across the United States. This means that you can seek treatment in a state other than where you’re insured. While out-of-state treatment is not ideal for everyone, it can be a chance to break out of the environment leading to addiction and help you reset.
UMR is one of many offering addiction treatment coverage. If you or your loved one are on a different insurance policy you can review their benefits specifically:
