Are you ready to seek help for a substance abuse issue that has gotten out of hand? If so, then it may be time to explore a drug and alcohol rehab covered by UMR insurance. Finding a program that accepts your coverage is crucial to minimize out-of-pocket costs at the end of the day.
Under the Affordable Care Act, substance use and mental health are considered essential benefits. They must be covered by UMR to the same extent that medical services are covered, with no lifetime limits placed upon clients. This doesn’t necessarily mean no out-of-pocket costs, but it does limit them.
Changes Healing Center offers you the help you need when you’re ready to move forward. From support groups to individual counseling, we offer every service needed to kick drug and alcohol addiction from your life. Keep reading to learn more about what UMR covers.
For many people who struggle with a drug or alcohol addiction, the cost of receiving care can feel like an insurmountable hurdle. The good news is that UMR insurance may cover your stay in an inpatient rehab. Your access to substance abuse treatment services is protected by the Mental Health Parity and Addiction Equity Act (MHPAEA).
Passed in 2008, the MHPAEA mandates that your insurance company must cover substance use disorders and mental health disorders to the same extent that they cover medical services.
This means that your UMR rehab coverage must extend the same degree of benefits for your drug and alcohol rehab as they do for appendicitis or a kidney stone. This type of protection allows you to seek help without bankrupting your family, but it isn’t the only protection afforded by the government.
The Affordable Care Act did more than place parity protections in stone. In the past, United Healthcare could stipulate that they didn’t want to cover treatment options for mental health services or drug and alcohol rehab. They could get away with refusing to cover treatment for any service they wanted.
Now, substance abuse and mental health services are considered essential benefits. This means that your insurance company, no matter which one, must cover these services to some extent. They can’t deny you these services, no matter what.
Once upon a time, your insurance coverage could tell you that you had spent too much on any particular service. After they deemed your alcohol rehab treatment sufficient, they could stipulate that you had no more money to spend on care for this issue. They could impose a lifetime limit that would exclude care.
Will UMR insurance cover drug and alcohol rehab indefinitely?
The good news is that you can never spend too much on mental health or substance use disorders, with no more lifetime limits. This is great because it can take several tries at inpatient rehab before someone is able to turn away from an addiction.
Your UMR rehab coverage will continue to help cover costs at the same rate, no matter how many times you return.
With all of these great benefits on the table, you need to ensure that you’re choosing a program that will be cost-effective. The best way to do this is to select a drug or alcohol rehab that is in network with the UMR insurance company. Why is this so important?
In-network providers offer discounted rates to those who are enrolled in UMR insurance plans. Not only will they help to cover the cost of care, but your overall cost burden will be lessened by UMR coverage. This is significant for anyone who allows cost to exclude them from residential treatment when they do need it.
At Changes Healing Center, we prioritize helping you maximize your UMR benefits. We’re in network with many health insurance plans to make the cost of care more affordable. Our enrollment team can verify your insurance benefits in a quick fifteen-minute call so that you can pursue substance use disorder treatment at a reasonable rate.
Of course, residential treatment programs are the most expensive options for dealing with a drug or alcohol addiction. They require board payments, meals, and around-the-clock supervision by our team of medical professionals and clinicians. If this is too expensive for you, you can pursue outpatient.
Outpatient programs allow you to receive many of the same services you would have received during inpatient treatment. However, you’re free to leave the treatment center when not in appointments and can return home to sleep in your own bed at night.
Without board payments, outpatient treatment may be more affordable, but you lose access to our support team 24/7. Take some time to weigh whether you can be successful in outpatient programs based on your current substance use issues.
Despite the fact that UMR covers drug and alcohol rehab under every policy, that doesn’t necessarily mean that it will be covered in full. Rehabilitation services may still require some money upfront before your insurance company will kick in. This is known as your deductible.
A deductible is the set amount of money you must pay before your UMR insurance policy will start to offer help. After you reach this set amount for the year, they will charge you a coinsurance rate, which they calculate based on percentages. For example, they may cover 60 percent of your rehab services.
The exact value of your coinsurance payment will vary depending on your individual plan and policy. Bronze plans through the Health Insurance Marketplace cover the least, while platinum plans will cover the most. That being said, bronze plans are less expensive than platinum.
If you think that you will pursue rehab services, it may be worth the increase in monthly premiums to get lower coinsurance rates that require fewer out-of-pocket payments.
Healthcare providers have a wide array of prescription medications they can offer to clients to help with detox and any ongoing support necessary for mental health. Prescription medications may be covered by UMR depending on what tier they are placed in.
Tier 1 drugs are the least expensive options and are usually the ones available in generic forms. These medications are typically the first choice for someone who wants insurance coverage to kick in the most.
On the other hand, Tier 3 drugs are the most expensive and may be newer to market. These drugs may be the best fit for you, but your healthcare provider should consider looking for Tier 1 drugs initially and rule them out before moving to a higher tiered prescription.
If a third-party administrator deems that you must pay something before rehab coverage kicks in, you might initially panic. Seeking treatment to kickstart the healing process is an important first step, but it can feel daunting when you consider the cost.
Even if you choose to work with out-of-network providers, you may have access to a payment plan to make care more accessible. At Changes Healing Center, we can help you cover the rehab process in a way that feels comfortable for your budget and lifestyle. We may even offer a self-pay discount for those who aren’t covered by their UMR policy.
You’ll gain access to our holistic practices and group therapy now, and can worry about paying later. Our approach to personalized treatment plans for drug and alcohol use disorder can benefit anyone who is interested in relapse prevention.
Are you ready to see what your health insurance coverage will contribute toward our inpatient or outpatient programs? You may be surprised by what UMR insurance coverage will help with when it comes to your addiction treatment. Take advantage of the full benefits afforded to you and get help from us today.
Our enrollment team is happy to answer all of your questions, verify your UMR insurance benefits, and reserve your spot in our treatment program. Reach out to us today to learn more about your options!