Guide to UMR Insurance Coverage for Addiction Treatment Centers

Last Edited: December 29, 2023

Author
Matt Esaena
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Clinically Reviewed
Jim Brown, CDCA
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All of the information on this page has been reviewed and certified by an addiction professional.

Substance Abuse Treatment Coverage With UMR Health Insurance

Click Here for a confidential benefits check or call (866) 578-7471 to speak to a addiction specialist.

Whether you are looking for drug or alcohol rehab treatment for yourself or for a friend, it can be a difficult, confusing and frightening time. If you have UMR insurance coverage, you will need to find a rehab center that accepts it, while at the same time offering you the type of treatment that you feel you need. This can be somewhat restrictive. However, help is out there and both UMR and treatment centers will be more than happy to help you find out just how much you will be covered for, how you can maximize the coverage you have and how to lower your out of pocket costs.

UMR Coverage for Drug and Alcohol Treatment

If you are covered under UMR insurance, you are likely to also have some benefits for drug and alcohol treatment. There are several factors that that will determine what the insurance company will cover and at the rehab centers that will be allowed, but nevertheless, there are many rehab centers that are within the UMR network. The insurance company may also be able to cover you for out of network providers depending on your plan.

The best way to find out what kind of substance abuse and mental health benefits are included in your plan is by contacting UMR and discussing your options, with no worries as every call and discussion you make with them is completely confidential. If you have identified a treatment center of interest, they will be able to perform the check for you.

Working with UMR to Get Help for Drug or Alcohol Abuse

The first step you need to make is determine the insurance benefits you have. As stated, both UMR and a treatment center will be able to check this for you. Once you have done this, you will have an exact overview of what will be covered. If you have not yet identified a treatment center, then do contact UMR directly and ask them for an overview of what you will and will not have covered, making it easier for you to find a center that can help you.

Once you have a few options available to you, you can start considering which center is best for your needs. This will help you to compare your options and come to a decision on which center to go to. It is important that you have an idea of the timeline of treatment you are likely to go through. Do make sure that the center you choose will meet your most important specifications.

Does UMR Cover Detox Services?

As UMR isn’t a health insurance provider itself but rather a third-party administrator, it doesn’t directly provide coverage for any health services, including detox. If you have UMR as your insurance claims processor, you are most likely covered for drug and alcohol rehab. Depending on your insurance policy, your benefits may cover all or a portion of the cost of treatment.

Does UMR Cover Rehab Services?

With over 3,000 health care providers within the UMR third-party network. MR specializes in working with each provider to expand the variety of mental health opportunities available to clients, including rehabilitation for drug and alcohol. UMR recognizes the effectiveness of rehabilitation and encourages providers to offer fair coverage. For more information on getting rehab coverage, call your insurance provider.

How Long Will UMR Cover My Treatment?

Exactly how much coverage you will receive and for how long, will depend largely on the plan that you have; it’s common for UMR to cover you for a duration that is based on need. The insurance company understands that every addiction story is different, and this also means that the length of time people need to stay in rehab will vary. The way to determine how long you will need treatment is by going to a rehab center, where professionals like insurance providers, treatment personnel and medical experts will work together.

It can happen that you have enrolled in a rehab center and require further treatment according to your medical professionals, only for UMR to refuse further coverage. In that case, you may be able to stay on in the center on a scholarship basis, which means that you will still be able to complete your treatment. This is one of the greatest indicators that what matters is not so much your insurance plan, but rather that you get help for your addiction. It should be noted that inpatient addiction treatment will usually last between 30 and 90 days.

Am I Covered for Inpatient and Outpatient Rehab?

UMR is likely to cover you for both inpatient and outpatient rehab treatment. Recovering from drug addiction is beneficial not just for yourself, but also for your insurance company, so it is likely that they will cover you for whatever you need. After all, the company will benefit from your recovery as it’s more likely that you will once again start contributing to society. They are likely to cover at least some of your inpatient and outpatient treatment, as well as sober living facilities. If you are interested in inpatient or outpatient facilities, and want to learn more about them give us a call at: (866) 578-7471.

Luxury Treatment

Luxury rehab facilities appeal to many people; they are generally a more comfortable setting with additional services that you would not find in public centers. While UMR might cover some of your treatment in a luxury facility, it is unlikely that they will cover much of it. Luxury facilities are very expensive and the possibility of paying out of pocket is much higher than going to a public one. It is also unlikely that UMR will cover you for complementary therapies such as massage and yoga, as there will not be a clear medical necessity for such treatments.

UMR and Out of State Rehab

Going to an out of state provider is generally very complicated, but also understandable, as many who are going through rehabilitation may want to leave the environment they were in. It’s very rare for insurance companies, including UMR, to agree to cover you for an out of state facility and are more likely to point you in the direction of centers that are within your geographical area that you may not have been aware of.

Deciding to go to rehab is one of the most difficult decisions you will ever make, but it is also the first step towards achieving a life of sobriety. If you find that your coverage is insufficient, you should not despair. There are many other options out there for you, including treatment loans, grants, and payment arrangements with the rehab facility that you want to go to. Rehab facilities have a singular goal in life, and that is to make sure you get the treatment that you need. While finances are often important barriers, they should not stop you from going for treatment. By calling (866) 578-7471 you can determine what your insurance plan covers to make a decision on how you will proceed with your rehabilitation.