Alcohol and Drug Rehabs that Take Optum Insurance
Using Optum Coverage for Rehab at Icarus in Idaho
You have finally taken that important first step toward lasting recovery, and you know you need help to maintain sobriety moving forward. The problem is that you need to ensure that your health insurance will cover the cost of your care. Where can you find alcohol and drug rehabs that take Optum insurance?
Optum health insurance is required to cover mental health treatment and substance use disorders in the same way that they do medical issues. They are essential benefits under the Affordable Care Act, but it may still come with out-of-pocket expenses for you, like your deductible and coinsurance payment.
Icarus Behavioral Health in Boise, Idaho, is happy to help you navigate the labyrinth of the healthcare industry, giving you a clear idea of what care will cost in a quick and confidential call. We can help you get to the bottom of coverage and enroll in the right program.
Keep reading to learn more about how Optum health insurance will kick in to cover your care in the weeks and months ahead.
Does Optum Health Insurance Cover Drug and Alcohol Treatment?
When you feel ready to take those first steps toward your sobriety, you want to know that you won’t be burdening your family with massive debt. You pay a hefty premium to a health insurance company each and every month, but what will it cover?
It wasn’t all that long ago that people were denied access to expensive treatment services, even if they were proven avenues toward sobriety and healing from substance abuse. In 2010, the Affordable Care Act was passed into law, changing the entire addiction treatment landscape.
While drug and alcohol addiction used to be refused coverage, it’s now considered an essential health benefit alongside mental health, medical services, and surgical interventions. While this doesn’t mean that your insurance coverage will foot the bill for your entire stay, it’s a step in the right direction.
Here is what you need to know about coverage for these essential benefits and how they might impact your bottom line.
Parity Protection for Addiction and Mental Health Treatment
One clever way that the insurance companies used to get around paying for care was to demand a high rate compared to what they deemed “more important” issues. This meant that residential treatment was often off the table for someone who was barely scraping by. Otherwise, they might plunge their loved ones into massive debt.
Along with naming substance use disorders and their treatment as an essential health benefit, this act also granted parity protection. This means that your insurance coverage must kick in the same amount for medical issues as it does for substance abuse.
Think of it this way: you head to the emergency room because of the intense pain of a kidney stone. A doctor evaluates you, recommends treatment, you pay your coinsurance, and go home. Accessing care for drugs and alcohol is now just as cut and dry with parity protections.
Whatever your coinsurance is for medical issues, the same applies to your residential treatment or even an outpatient therapy program. If you have experience using your plan for other conditions, you may be well-prepared to navigate this front.
No Lifetime Limits for Substance Use Disorders
Another issue that many people faced when they were finally ready to enter into recovery was the lifetime limit of their plan. Optum insurance might have covered the first thirty days of an inpatient mental health stay. After that, they may have decided that you exhausted your resources for this issue, and they would not cover additional treatment services.
The Affordable Care Act also enabled clients to start seeking treatment without worrying about tapping out their resources.
Instead, you can spend as much as is necessary to heal from your drug and alcohol addiction. You will never reach a specific cap on healthcare services spending. Plus, you may be eligible for zero costs if you hit your out-of-pocket maximum for the year.
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Access to Behavioral Health Services without Pre-Existing Condition Limits
Of course, there was another major flaw in Optum’s health insurance coverage for behavioral health and addiction treatment services before the ACA. Under the old system, any insurance company was legally allowed to deny you coverage based on a pre-existing condition you may have had.
If they did cover you, this condition may have been excluded from your spending and coverage.
This meant that if you sought help for substance abuse, you might have found yourself out in the cold in the following year without coverage. This applied not only to behavioral health, addiction, and mental health issues. It also went for physical conditions like diabetes or heart disease.
Now, plans must cover you regardless of any conditions you bring with you to the underwriting process.
May Require a Deductible for Residential Treatment and Lower Levels of Care
No matter which direction you choose to go, Icarus Behavioral Health in Boise offers several treatment options, from inpatient to outpatient care. Insurance is mandated to help cover the cost, but it may not foot the bill entirely upfront. Instead, they may levy a few fees before coverage kicks in.
The first figure to know is your deductible or the amount of money you have to spend before insurance is going to start covering a percentage of your care. Higher monthly premiums with Optum insurance often indicate lower deductibles and vice versa.
Once the deductible has been hit, you may be responsible for a copayment (a set fee for a service) or a coinsurance payment (a percentage of your care). This applies until you hit that out-of-pocket maximum that will cover the remaining costs for the year.
Looking for In-Network Providers to Minimize Spending
Optum health insurance may give you lower rates on drug and alcohol addiction rehab centers if you choose to go with an in-network provider. This means that the rehab has negotiated a fair rate with Optum insurance companies and is willing to pass that savings along to you.
That’s not to say that you can’t go with an out-of-network provider; it just means that it may be more expensive initially compared to those who attend in-network rehabs for substance use disorders and mental health treatment.
Icarus Behavioral Health Boise is ready and waiting to help you navigate the complex system of your health insurance coverage. Our enrollment team can verify your benefits and provide you with a cost estimate in a quick, confidential, no-obligation call.
Paying with Health Savings Accounts
If you find that your plan has a high deductible, you may be eligible for health savings accounts that can offset the sticker price of your Optum behavioral health bill. Health savings accounts are a way for you to set aside tax-sheltered money that can be spent on any qualified medical expense.
You contribute on a pre-tax basis and spend tax-free on substance abuse treatment or mental health.
This is a great way to minimize the burden of your treatment on your bank account. Your HSA can be funded with automatic deductions from your paycheck each pay period, assuring you have funds when you need them without ever having to think twice about it.
Prior Authorization May Be Required
While emergency services are often funded without question, it may be a different situation with your treatment for mental health conditions or substance abuse. In some cases, you may need to get the prior authorization of your doctor, proving that you need this level of care from detox down to intensive outpatient programs.
Icarus Behavioral Health can help you navigate this stipulation for your care and get the paperwork you need to get help.
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Choosing Icarus Behavioral Health Boise for Your Addiction and Mental Health
With all of the rehabs available today, why should you entrust Icarus in Boise with your care? We offer a robust clinical program that offers sub-acute addiction treatment services in a variety of formats. This enables us to tailor your treatment options specifically to you for the best outcomes.
Here’s what you need to know about services at Icarus Behavioral Health.
Experience Providing Personalized Treatment Plans
Upon intake into one of our programs, our clinicians will give you a comprehensive assessment to see what areas you need help in. This includes mental health assessments as well as substance use, which enables us to provide you with a plan that is tailor-made for you.
We know that cookie-cutter approaches often fail because each client is unique. With our individualized treatment plans, our team leverages your strengths and assets. For example, we may take your extrinsic motivation for getting clean or a strong, supportive environment at home into account when coming up with goals.
As you move through each piece of your treatment plan, we can reassess and determine the next right steps–just for you.
Dual Diagnosis Treatment for Substance Abuse and Mental Health
Icarus Behavioral Health knows that there is often a link between your substance use and your mental health. In fact, the Substance Abuse and Mental Health Services Administration states that roughly one in four adults with a mental health issue will also abuse substances.
We employ a wide variety of behavioral health services under the Optum insurance umbrella so that you get the treatment options necessary for long-term sobriety.
Inpatient mental health treatment at our facility is robust and provides each client with comprehensive support in the early days of recovery. We’ll use cognitive and dialectical behavioral therapies alongside complementary therapies to give you the robust treatment you require to heal with new coping skills.
Medication-Assisted Treatment Options
In addition to offering individual, tailored treatment plans, we also offer medication-assisted treatment. As you work through our residential treatment program and transition to outpatient care, we will monitor you for common mental health issues that could be resolved with a non-addictive prescription.
For example, we may be able to prescribe something for anxiety disorders or mood disorders that won’t impact your recovery. It lessens the likelihood that you will try to self-medicate for these issues and turn back to drug and alcohol use.
We may also be able to help you taper from certain prescription drugs that you have been misusing, but this is more often the purview of our accredited partners who manage medical detox centers.
Continuum of Care for Addiction and Mental Health Support
No matter which substance you use or what your mental health conditions may be, we have a program that will suit your needs. Your insurance coverage may allow you to start with more intensive programs such as inpatient rehab, where you reside with us for a period.
After you no longer need this level of intensive care, you can graduate to less restrictive options such as our partial hospitalization programs or intensive outpatient programs. Both allow you to take part in your individual and group therapy during the day while returning home at night to transition to your routines.
Acute medical detox is handled by partner facilities for a seamless transition to Icarus Behavioral Health Boise.
Accredited Care for Healthcare Services
If you want to rest easy knowing that your upcoming inpatient or outpatient treatment stay will be safe and comfortable, you need an accredited facility. Icarus Behavioral Health Boise is proud to be a Joint Commission-accredited option for your care. This means that we meet all of the rigorous standards of OSHA and CMS.
In addition, we go a step further and uphold the stringent requirements of the Joint Commission itself.
Whether you come to us for inpatient or intensive outpatient treatment, the quality of your care will never be called into question.
Help from Peer Support Specialists in Group Therapy
We believe in the power of community to help you find your way through life sober. This is why we also offer group therapy with peer support specialists who can offer you guidance and real-life insight into new ways to cope with your lifestyle change. The connections you make here will be vital.
It’s also a lovely transition to outpatient programs such as Twelve Step meetings such as Alcoholics and Narcotics Anonymous. If these Twelve Step meetings don’t fit your needs, you can try other peer-based models like SMART Recovery meetings.
Up To 100% of Rehab Costs Covered By Insurance
Get Help at Icarus in Idaho Using Optum Insurance Today
While you could contact Optum directly, this is often a frustrating and time-consuming endeavor. The insurance agent you receive on the hotline may not have answers for you regarding your care or the potential cost of your treatment. The most they can often do is refer you to treatment providers.
Icarus Behavioral Health in Idaho wants to take the guesswork out of your treatment. That’s why our enrollment team is here to answer any of your questions about our compassionate team, intensive programs, and insurance coverage with Optum health insurance.
It takes just fifteen minutes of your time and comes with no obligation, so reach out to us directly. Don’t you owe it to yourself to see what recovery could hold?
References
- Abraham, A. J., Andrews, C. M., Grogan, C. M., D’Aunno, T., Humphreys, K. N., Pollack, H. A., & Friedmann, P. D. (2017). The Affordable Care Act Transformation of Substance Use Disorder Treatment. American journal of public health, 107(1), 31–32.
- Centers for Medicare and Medicaid Services. (n.d.-b). The Mental Health Parity and Addiction Equity Act (MHPAEA).
- U.S. Department of Health and Human Services. (2022a, March 16). Lifetime & Annual Limits.
- Marketplace health plans cover pre-existing conditions. HealthCare.gov. (n.d.-e). https://www.healthcare.gov/coverage/pre-existing-conditions/
- Deductible – glossary. HealthCare.gov. (n.d.-c). https://www.healthcare.gov/glossary/deductible/
- Copayment – Glossary. HealthCare.gov. (n.d.-b). https://www.healthcare.gov/glossary/co-payment/
- Coinsurance – glossary. HealthCare.gov. (n.d.-a). https://www.healthcare.gov/glossary/co-insurance/
- Mental health and substance use co-occurring disorders. SAMHSA. (n.d.).
