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
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:
Because UMR helps you connect with various healthcare providers, there must be guidelines for who or how coverage can be delivered. However, the provider network you’re connected with will likely 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:
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:
Yes. Inside UMR’s provider network, you will likely find standard mental health services covered by various providers. This may include:
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 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.
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 your deductible has been paid. Because of the extensive network available under UMR, they estimate 20-30% reductions in your medical bill.
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 recommendations 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:
No. It is illegal for any insurance company to increase its rates after using its benefits.
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.
Located in Marin County, the recovery community is strong and tight-knit. Many people have attempted recovery in other parts of California but found a new sense of family and accountability here, leaving Marin County with its reputation. Golden Gate Recovery’s mission is to provide men with the responsibility, structure, and community necessary to produce long-standing recovery. We want our clients to improve their lives and the lives of those they surround themselves with.
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Dr. Small’s professional experience encompasses General Psychiatry, Addiction Psychiatry and Family Medicine. As the founder of Headlands Addiction Treatment Services, Dr. Small and his team have become leaders in the delivery of addiction medicine and psychiatry to treatment programs throughout California and beyond. These compassionate services are reliable, responsive, personable, and evidenced based. Most of the team providers carry multiple board certifications in psychiatry, addiction medicine and family medicine. They recruit the best and brightest addiction medicine professionals to deliver the highest level of treatment.
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