UMR Insurance

UMR Rehab Coverage Accepted at Live Oaks Wellness in Novato, California

UMR Insurance Coverage

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 is dedicated to helping you find treatment at an affordable cost. Contact our addiction specialists today if you need help finding UMR-approved substance abuse treatment.

Questions Answered in This Article

  • Does UMR cover inpatient rehab?
  • Does UMR cover mental health services?
  • What length of treatment does UMR cover?
  • Will my UMR monthly premium go up after rehab?
  • What states are covered by UMR insurance?

UMR Addiction Treatment Options

While UMR does not directly offer treatment coverage as it is not an insurance company, its network of healthcare providers does. 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:

  • Detox
  • Inpatient/Residential Rehab
  • Outpatient Rehab
  • Prescription Medications
  • Behavioral Therapy

Substance Abuse Guidelines Under UMR

Because UMR helps you connect with various healthcare providers, there are no 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 and substance use disorders. This criteria is typically discussed during your initial call with an addiction specialist and includes questions that help determine your insurance coverage:

  • How long have you been using the substance?
  • When was the last time you drank or used drugs?
  • Have you sought treatment previously?
  • Are you looking for long-term sobriety/recovery?

UMR Insurance Coverage by Addiction

Your UMR policy coverage and the provider network at your disposal will determine 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:

  • Alcohol Abuse Treatment
  • Prescription Medication Addiction Treatment
  • Cocaine Addiction Treatment
  • Methamphetamine Addiction Treatment
    and more

Does UMR cover mental health services?

Yes. Inside UMR’s provider network, you will likely find common mental health services covered by various providers. This may include:

  • Cognitive Behavioral Therapy
  • Eye Movement Desensitization and Reprocessing
  • Biofeedback (depending on the plan)

UMR Medication-Assisted Treatment

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), numerous FDA-approved medications are 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.

For help understanding your unique UMR benefits
Call our addiction specialists today.

Paying for Rehab with UMR Insurance

The 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 extensive network available under UMR, they estimate 20-30% reductions in your medical bill.

What length of treatment does UMR cover?

UMR health insurance companies are not required to deliver treatment for a specific period of time. Instead, UMR encourages its network to make a unique recommendation based on the patient’s needs.

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:

  • Personal Loan
  • Credit Card
  • Payment Plan

Will my UMR monthly premium go up after rehab?

No. It is illegal for any insurance company to increase its rates after using its benefits.

What states are covered by UMR insurance?

UMR’s access to the United Healthcare PPO Network enables them to offer coverage across the United States. This means 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.

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