UMR Rehab Coverage for Drugs & Alcohol

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UMR Rehab Coverage

UMR, also known as United Medical Resources, doesn’t offer rehab coverage because UMR is not a health insurance plan. UMR is a third-party administrator, or TPA. TPAs work on behalf of employers and their employees to ensure the business’s self-funded insurance pays for the benefits you’re entitled to. UMR is part of UnitedHealth Group’s collection of healthcare companies.

These Frequently Asked Questions help explain in detail UMR’s role in the insurance industry. UnitedHealthcare Insurance (UHC), also part of UnitedHealth Group, however, provides varying levels of insurance coverage for rehab services. Zinnia Health, staffed with compassionate treatment specialists, is a substance use disorder (SUD) treatment facility that helps individuals with UnitedHealthcare insurance.

If you or a loved one need to find an insurance provider, insurance policy, or just need help understanding your insurance benefits, reach out to our team at Zinnia Health by calling (855) 430-9439. Our helpline is completely free and available 24 hours a day.

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Does UMR Insurance Cover Alcohol Rehab?

No, UMR does not cover alcohol rehab services or treatment programs.

UMR is not insurance, so it doesn’t cover any healthcare services. This TPA does, however, ensure that your employer-sponsored health insurance properly pays your claims. You and your employer are responsible for your respective shares of your policy premium. Your employer contracts with UMR to help keep all staff healthcare costs as low as possible.

The Affordable Care Act established certain essential benefits for insured individuals, and alcohol rehab, substance abuse treatment, and mental health services are considered essential care services. Health insurance carriers are required to cover at least a portion of the costs associated with rehab for substance abuse, alcohol abuse, substance use disorder, and other treatments. 

Alcohol addiction sometimes requires detox before beginning an outpatient program, in which case you may need to consider things like per-visit copays. There may also be a limit on the number of visits per policy period. Your policy details your coverage, deductible, co-insurance, and any other out-of-pocket expenses you might experience.

But remember: UMR is not healthcare insurance.  UMR is a TPA that helps insure employer-sponsored, self-funded health insurance correctly and timely pay insurance claims brought by UMR members.

UMR’s sister company, UnitedHealthcare, provides health insurance coverage for mental health, substance use, and alcohol addiction rehab treatment centers. Employers have multiple plan options to choose from.

Does UMR Insurance Cover Substance Abuse Treatment?

UMR is not insurance so it doesn’t cover drug rehab or any other healthcare services. Your UnitedHealthcare employer-sponsored policy may offer drug treatment.

UnitedHealthcare insurance offers multiple types of insurance for individuals and families, employer-sponsored plans, and resources for employers to share with employees. Some plans and policies may not fall under the scope of the Affordable Care Act, so some individuals opt for UnitedHealthcare’s Individual & Family ACA Marketplace plans.

Actual coverage for substance abuse treatment varies according to the level of care needed and other variables. For example, this Coverage Summary outlines in detail the alcohol and substance abuse detox and rehab coverage for an individual with a UnitedHealthcare Medicare Advantage policy.

Does UMR Cover Mental Health Treatment?

UMR doesn’t cover mental health treatment, but UnitedHealthcare typically does.

UMR does not offer insurance coverage for mental health treatment and UnitedHealthcare employer-sponsored policies may or may not offer mental health treatment coverage—however, if you purchase your own UnitedHealthcare plan through the Marketplace, mental health services are covered under all Marketplace plans.

UMR Inpatient Coverage

Neither UMR health insurance nor UMR insurance coverage exists. UMR does not provide inpatient coverage, as it’s not a health insurance company but rather a third-party administrator under the UnitedHealth Group umbrella.

UnitedHealthcare, also under this parent company, provides varying levels of inpatient treatment coverage. Covered treatment options vary according to type of plan and coverage level. For instance, a short-term policy might pay very little towards an inpatient treatment plan (and that’s if the policy covers inpatient treatment). If inpatient services are covered, it’s only partial coverage and your out-of-pocket expenses would be greater than those of an individual or family policy.

Every policy is different, and coverage depends on multiple variables, not the least of which is where you obtained your policy. UnitedHealthcare offers seven handy tips to help you choose the best coverage for your unique healthcare needs.

UMR Outpatient Coverage

UnitedHealthcare covers outpatient treatment services. For instance, Washington state resident policyholders requiring emergency substance abuse, mental health, or behavioral health services:

  • Can visit any emergency mental health provider.
  • Do not require prior authorization.
  • Benefits cover both in-network and out-of-network providers.

Most of UnitedHealthcare’s plans cover unlimited primary care visits, but again, when this coverage kicks in, your deductibles, coinsurance, and any other variables unique to you all influence your plan’s out-of-pocket costs.

If you need assistance finding your insurance coverage information, reach out to a compassionate admissions specialist at Zinnia Health by calling (855) 430-9439. With your permission, we can contact your insurance company on your behalf and find out your exact levels of coverage.

Rehabs That Accept UMR Insurance Near You

UMR isn’t insurance. But UnitedHealthcare Marketplace plans cover you in all 50 states. Zinnia Health works with UMR and UnitedHealthcare.

Our treatment facilities offer the highest quality standards for substance abuse treatment, and mental and behavioral health programs.

Zinnia Health is certified compliant with:

  • CARF
  • ASAM

Our convenient Zinnia Health locations may work with UMR coverage.

Our nationwide locations include:

If you would like to speak with a treatment specialist who can help you find in-network drug and alcohol rehab programs in your area, reach out to Zinnia Health at (855) 430-9439 to learn more.

How to Check Your UMR Coverage

Call Zinnia Health at (855) 430-9439. With your permission, we can contact UnitedHealthcare to discover the benefits of your policy.

Types of UMR Plans That Cover Addiction Treatment

Almost all health insurance plans cover addiction treatment, but the coverage amount varies depending on the type of plan and where you obtained your policy. UnitedHealthcare offers a variety of employer-sponsored healthcare plans.

These plan tiers may or may not align with the standards set by the Affordable Care Act. However, your UnitedHealthcare employer-sponsored plan may cover substantially more, depending on variables unique to you as well as UMR’s third-party administrator status with your organization.

Frequently Asked Questions

What Length of Stay Will UMR/UnitedHealthcare Cover?

Coverage caps on stays depend on your plan’s coverage level.

How to Pay for Costs UMR and UnitedHealthcare Doesn’t Cover?

Insurance rarely covers 100% of treatment costs for drug and alcohol abuse or any other type of treatment. If you’re concerned about how you’ll cover the out-of-pocket expenses like copays, deductibles, and treatments that these healthcare organizations may not cover, the best thing to do is speak to the treatment facility directly.

Many offer payment plans and some can eliminate your out-of-pocket expenses with grants and other programs.

What to Do If UMR Doesn’t Cover Rehab?

UnitedHealthcare covers some of the costs of rehab treatment in most cases, but certain facilities may not be covered, especially facilities that use nontraditional methods for treatment.

If you have chosen a treatment provider but are worried about the cost of drug or alcohol recovery, speak to the treatment center. Substance abuse treatment facilities can give you information about grants, payment options, and other alternatives to ensure you get the care you need.

Do Rehab Facilities Need to Be In-Network?

The type of health insurance plan you have will determine whether an inpatient rehab center needs to be in-network. If you need emergency mental health or substance abuse treatment, the good news is that UnitedHealthcare requires no prior authorization and covers services in- and out-of-network for most plans. Check with your employer to learn more.

Do you have questions about your insurance coverage? Get in touch with the specialists at Zinnia Health by calling our free 24-hour helpline at (855) 430-9439 to get answers.

Call us
Ready to get help?
(855) 430-9439
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