UnitedHealthcare Coverage for Rehab & Mental Health Treatment
Here's the thing about finding treatment with UnitedHealthcare coverage: every plan is different. But if a facility is in-network with UnitedHealthcare, you're usually looking at lower costs than going out-of-network. This page helps you find those in-network options in your area, so you can spend less time searching and more time getting the help you need.
How UnitedHealthcare Coverage Works for Treatment
What in-network means and why it matters for your costs
Think of UnitedHealthcare's network like a group of providers who've agreed to play by certain rules—including what they charge. When you go to an in-network facility, you're protected from surprise bills and inflated charges. You'll generally pay your copay or coinsurance, and that's it. Out-of-network? That's where costs can get unpredictable.
About UnitedHealthcare Networks
UnitedHealthcare is one of the largest insurers in the country. Your behavioral health benefits are managed through Optum Behavioral Health (you might also see it called United Behavioral Health on older materials). UHC has different plan types with different networks—employer plans, individual plans, and Medicare/Medicaid plans all work differently.
In-Network Benefits
- ✓Lower copays and coinsurance rates
- ✓Pre-negotiated service rates
- ✓Counts toward in-network deductible
- ✓Streamlined billing process
Out-of-Network Considerations
- •Higher out-of-pocket costs
- •Separate deductible may apply
- •Balance billing possible
- •May require single case agreement
Prior Authorization Requirements
Here's something important to know: most UnitedHealthcare plans require what's called "prior authorization" before you can start intensive treatment. Basically, the insurance company wants to review whether the treatment is medically necessary before they agree to cover it. The good news? Most treatment facilities handle this process for you—just expect it to take anywhere from 24 to 72 hours.
Residential, PHP, and IOP generally require precertification through Optum. The facility handles this process, but coverage is reviewed ongoing—meaning Optum may reassess whether you need to continue at your current level of care. This is called concurrent review.
Types of Treatment Available in the United States
Understanding your treatment options
Medical Detoxification(Detox)
24/7 Medical CareDetox is usually where treatment starts if you have a physical dependence on alcohol, opioids, benzodiazepines, or other substances. You'll have 24/7 medical supervision as your body clears the substances from your system. This can be uncomfortable—withdrawal symptoms range from mild to severe—but medical staff can provide medications and support to keep you safe and as comfortable as possible. Detox typically lasts 3-10 days, depending on the substance and severity of dependence.
3-10 days
24/7 supervision
- People who experience withdrawal symptoms when they stop using
- Those with physical dependence on alcohol, opioids, or benzos
- Individuals who need medical monitoring during early recovery
- People with health conditions that require medical supervision
Residential Treatment(Residential)
Residential SettingIn residential treatment (also called inpatient rehab), you live at the facility full-time—usually for 30, 60, or 90 days. You'll have a structured schedule with individual therapy, group sessions, and activities designed to help you build coping skills and understand your addiction. Being away from your usual environment means fewer triggers and more time to focus completely on recovery. It's intensive, but for many people, this level of support makes the difference.
30-90 days
24/7 on-site
- People who need to step away from their environment to focus on recovery
- Those who've tried outpatient treatment and it wasn't enough
- Individuals dealing with both mental health and substance use issues
- People who don't have a safe, stable place to live during recovery
Partial Hospitalization Program(PHP)
Outpatient ProgramPHP is like residential treatment in terms of intensity, but you go home at night. You'll spend most of the day at the facility—typically 5-6 hours, 5 days a week—in therapy sessions, groups, and skill-building activities. It's a good option if you've completed detox or residential and need to step down, or if you need intensive support but have stable housing and can maintain sobriety outside of treatment hours.
2-4 weeks
20-30 hours
- People transitioning from residential treatment who aren't ready for less support
- Those who need intensive help but have a stable, safe home
- Individuals who can stay sober overnight without 24/7 supervision
- People with family responsibilities who need to be home in the evenings
Intensive Outpatient Program(IOP)
Outpatient ProgramIOP gives you structure and support while letting you keep up with work, school, or family life. You'll typically attend 3-4 sessions per week, 3-4 hours each—usually in the morning or evening. Sessions include group therapy, individual counseling, and education about recovery. It's more than regular therapy but less than PHP, making it a practical choice for people who need consistent support without full-day programming.
6-12 weeks
9-15 hours
- People stepping down from PHP or residential treatment
- Those who need more than weekly therapy but can manage daily life
- Individuals who can't leave work or family for full-time treatment
- People with strong support at home who are committed to recovery
Outpatient Treatment(Outpatient)
Outpatient ProgramStandard outpatient treatment means you're meeting with a therapist or counselor once or twice a week while living your regular life. It's the least intensive level of care, but that doesn't mean it's less important—for many people, this is what helps them maintain long-term recovery. It works best when you have a solid foundation and are looking for ongoing support rather than crisis-level help.
Ongoing
1-4 hours
- People who've completed more intensive treatment and are stepping down
- Those with stable lives who need ongoing accountability
- Individuals managing recovery while working or going to school
- People with strong support systems already in place
Who decides what level of care is right?
When you call a treatment facility, they'll do an assessment to understand your situation— things like what substances you're using, how long, medical history, mental health, and your support system. Based on that, they'll recommend a level of care. Your insurance company also has a say—they use clinical criteria (like ASAM for substance use) to decide what they'll cover. Sometimes there's back-and-forth between the facility and insurance to find the right fit.
Find UnitedHealthcare In-Network Programs by State
UnitedHealthcare networks can vary by state—a facility that's in-network in one state might not be in another. Pick your state to see options near you.
What to Ask When Contacting a Program
Be prepared with the right questions
That first phone call to a treatment facility can feel intimidating. Here's the thing: the people answering are usually experienced at helping nervous callers navigate this process. You don't need to have all the answers—just your insurance card and a basic idea of what's going on. But it helps to know what questions to ask them:
- 1Are you currently in-network with my UnitedHealthcare plan? (Give them your insurance ID and group number)
- 2Can you verify my benefits and tell me roughly what my out-of-pocket costs would be?
- 3Do you handle the prior authorization process, or do I need to call my insurance first?
- 4Do you have availability right now? How long is the wait for admission?
- 5What does a typical day look like in your program?
- 6What credentials do your therapists and counselors have?
- 7Do you offer medication-assisted treatment (like Suboxone or Vivitrol) if that's appropriate for me?
- 8What happens after I complete your program? Do you help with aftercare planning?
- 9Can my family be involved in my treatment?
- 10What happens if my insurance stops approving coverage before I'm clinically ready to leave?
- 11Do you treat people with both addiction and mental health issues at the same time?
- 12How do you customize treatment plans for each person?
Before You Call
- Have your insurance card ready
- Know your policy number and group number
- Be ready to briefly describe the situation
- Have pen and paper for notes
What Intake May Ask You
- What substances or symptoms are involved
- History of prior treatment attempts
- Current medications
- Timeline for when help is needed
Here's something important to remember: calling a facility doesn't commit you to anything. You can (and should) call multiple places to compare options. The intake team is there to help you figure out if their program is right for your situation. If it's not the right fit, a good facility will tell you honestly and may even suggest alternatives.
"The only person you are destined to become is the person you decide to be."