Outpatient treatment covered by UMR insurance can help you balance recovery with work, family, and daily life. At The Hope House, we understand the unique challenges you face when seeking support for substance use disorder. In this guide, you’ll learn how your UMR-administered benefits work, what levels of outpatient care are available, and how to tap into comprehensive therapy and medication-assisted treatment—all while staying in-network.
Understand UMR coverage
When you enroll in a UMR-administered plan, you’re working with a third-party administrator (TPA) that partners with UnitedHealthcare and other providers to process your claims. UMR itself is not an insurance company, but it ensures your benefits for mental health and addiction treatment are handled correctly [1].
UMR as third-party administrator
- UMR manages benefits for over 6 million members nationwide.
- It works behind the scenes to process claims and verify coverage.
- Your actual benefits are determined by the UnitedHealthcare plan your employer selects.
Required coverage under ACA
Under the Affordable Care Act, health plans must cover substance use disorder treatment just as they cover medical and surgical care. As a result, your UMR-administered benefits include coverage for various levels of addiction care, from detox to outpatient services [1].
Network providers and PPOs
UMR contracts with more than 150 preferred provider organizations (PPOs) and physician hospital organizations (PHOs). This extensive network gives you access to:
- Hundreds of addiction specialists
- Mental health professionals
- Facilities offering PHP, IOP, outpatient, and MAT services
You can search for in-network providers on the UMR member portal or by calling the number on your insurance card.
| Coverage aspect | Details |
|---|---|
| UMR role | Third-party administrator for UnitedHealthcare |
| Mandated benefits | Substance use disorder treatment under ACA |
| Provider network | 150+ PPO and PHO networks |
| Member verification | Check your benefit plan document or call member services |
Explore outpatient care
Outpatient programs let you receive structured treatment while maintaining your daily responsibilities. As you step down from PHP or bridge to ongoing care, these outpatient levels offer flexibility and support.
Partial hospitalization program
- Typically 20 hours of therapy per week
- Daytime schedule allows you to return home each evening
- Combines individual counseling, group therapy, and skill-building workshops
Intensive outpatient program
- 9–15 hours of sessions per week, often in evenings or weekends
- Focus on coping strategies, relapse prevention, and peer support
- Ideal if you need more structure than standard outpatient but cannot pause work or family duties
Standard outpatient treatment
- One to three therapy sessions per week
- Individualized plans to address triggers and build resilience
- Telehealth options available for remote counseling
| Program type | Schedule | Intensity | Typical UMR coverage |
|---|---|---|---|
| Partial hospitalization program (PHP) | 4–5 days, 4–6 hours/day | High | Covered when medically necessary |
| Intensive outpatient program (IOP) | 3–5 evenings or weekends | Moderate | Covered per plan limits |
| Standard outpatient treatment | Flexible weekly hours | Low | Covered per session limits |
Access medication-assisted treatment
Medication-assisted treatment (MAT) combines FDA-approved medications with counseling to reduce cravings and support long-term recovery. UMR benefits often include MAT services such as Suboxone and Vivitrol [2].
Suboxone and other medications
- Suboxone (buprenorphine/naloxone) helps manage opioid withdrawal and cravings
- Vivitrol (naltrexone) blocks opioid effects and supports abstinence
- Medications are prescribed and monitored by a certified provider
Combining MAT with counseling
- MAT is most effective when paired with individual therapy and group sessions
- You’ll work with clinicians to adjust dosage and address co-occurring mental health issues
- The Hope House integrates MAT into a comprehensive, individualized plan
Engage therapy offerings
Therapy is a cornerstone of lasting recovery. Your UMR-administered plan typically covers outpatient therapy services, so you can access evidence-based treatments in a supportive setting [3].
Individual therapy sessions
- Cognitive behavioral therapy (CBT) to challenge unhelpful thought patterns
- Motivational interviewing to strengthen your commitment to change
- Personalized goal setting and progress tracking
Group and family counseling
- Peer support groups foster camaraderie and shared insight
- Family therapy sessions rebuild trust and improve communication
- Psychoeducational workshops teach coping strategies and relapse prevention
Choose The Hope House
At The Hope House, you’ll find a supportive environment and tailored treatment programs designed around your unique needs. Our continuum of care lets you transition smoothly from higher-intensity programs to ongoing support.
Tailored treatment programs
- Co-occurring disorder tracks for dual diagnosis
- Trauma-informed therapy and holistic modalities
- Gender-specific and peer support groups
Supportive recovery environment
- Compassionate staff available 24/7
- Secure, comfortable facility with private and communal spaces
- Emphasis on respect, trust, and mutual encouragement
Step-down care continuum
- Move from PHP to IOP to standard outpatient seamlessly
- Ongoing alumni programs and sober living referrals
- Access to aftercare planning and community resources
Take next steps
You don’t have to navigate insurance and treatment alone. Our team at The Hope House can help you verify benefits and start on your path to recovery.
Verify your insurance benefits
- Review your UMR benefit plan document for SUD coverage details
- Call the customer service number on your insurance card
- Ask about prior authorization requirements and co-payment amounts
Contact our admissions team
Reach out today for a free, no-obligation insurance verification. Our admissions specialists will guide you through the process and help you schedule an intake assessment. You deserve comprehensive care and the support necessary for lasting recovery.
