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If you’ve made the decision to seek out rehab, insurance is an important part of ensuring that your drug rehab remains affordable and achievable. If your employer provides UMR Insurance as part of healthcare coverage, you probably want to know if it offers drug and alcohol treatment coverage. If you have UMR, chances are, you’ll have a large portion of your health costs covered by your employee insurance.
With the help of our experts at Asana Recovery, we can guide you through UMR’s drug and alcohol treatment offerings to help you get the most out of your health insurance when you look for treatment.
While many people receive UMR through their workplace, it is not an insurance policy. Instead, it is a third-party administrator, known as a Third Party Administrator (TPA). Here, a TPA ensures your claims are paid correctly and that healthcare costs are kept to a minimum.
Essentially, this means UMR does not help you pay for rehab. In fact, any portion of your healthcare costs not covered by your employer and insurance will be paid by you.
However, UMR will help you to ensure you are paying a fair rate, that your insurance pays your claim, and that everything is handled without you having to intervene, so you can focus on recovery.
In addition, UMR is a UnitedHealthcare company, which is an insurance provider. However, the TPA covers and helps with insurance policies from most providers – meaning that if your employer offers UMR coverage, UMR will help with your drug or alcohol treatment.
UMR’s provider network includes a diverse range of behavioral health services across multiple levels of care — including detox, residential rehabilitation, inpatient treatment, and outpatient treatment. The Patient Protection and Affordable Care Act, commonly known as the ACA or Obamacare, mandates that all insurance providers must cover at least a portion of drug and alcohol treatment. Therefore, it doesn’t matter which insurance provider you have in addition to UMR — your drug and alcohol treatment is required to be included in the plan.
Asana Recovery delivers the outpatient phase of your recovery — including PHP, IOP, Virtual IOP, and MAT. For clients who need detox, residential, or inpatient care first, our admissions team coordinates placement through trusted UMR-network partner facilities, then transitions you seamlessly into our outpatient programs.
However, the scope and extent of treatment varies per provider. This means that while UMR offers support across all benefit categories, your specific employer plan may have different coverage limits. UMR will work to ensure you get the maximum amount of coverage available from your plan for the type of treatment you choose.
Most insurance plans offer better coverage for outpatient care, making it a cost-effective option for many clients. Asana Recovery delivers the outpatient phase of your recovery — PHP, IOP, Virtual IOP, and MAT. Call (949) 763-3440 to verify your specific UMR benefits with our admissions team.
UMR covers behavioral and mental healthcare including substance abuse treatment. Here, UMR substance abuse rehab policies extend to cover inpatient and outpatient for the recommended duration of treatment, as confirmed by your healthcare provider. This means that your provider will cover the full amount agreed for the full duration of treatment, whether your treatment is 30 days or 6 months.
If you’d like to see more about UMR policy, log in via the portal here.
However, coverage varies significantly per plan and per option. For example, if you choose the UMR Tier Two Choice Plus Network and got to a preferred network provider you can expect:
If you look for the same services from an out of network provider, you’ll likely have a 50% coinsurance policy. However, these rates are for the state of Arizona and may not apply everywhere.
UMR offers significant mental health coverage including behavioral treatment like cognitive behavioral therapy and eye movement desensitization and reprocessing (EMDR). With over 3,000 health care providers in the UMR network, you have access to a significant number of mental healthcare providers in the network. In addition, you may have access to out of network providers as well.
While UMR doesn’t require pre-approval for behavioral health treatment, your insurance provider may. Make sure you check with your provider before moving forward with treatment.
UMR is a preferred provider organization, also known as PPO. This means that the organization operates with a network of pre-approved hospitals, doctors, pharmacies, and care providers. This offers numerous advantages to users in that you can often go to treatment without a referral, the network includes a large range of providers and clinics, and services through a preferred provider are often up to 30% discounted over going to the same facility without UMR membership.
However, UMR also offers full coverage for an out of network provider. However, UMR does have specific requirements for this:
At the same time, it’s also important to check with your insurance provider to see if they offer the same coverage. UMR insurance is not traditional insurance, so you’ll have to check both. In addition, UMR Out of Network Coverage is not always available with every UMR plan. Check your plan to be sure. Normally you need a Tier 3 plan to have out of network coverage.
UMR covers generic and brand-name FDA-approved medications used in Medication-Assisted Treatment (MAT). In practice, this means you will get coverage for any MAT program provided by a licensed treatment facility and recommended by a doctor. This includes coverage for both short and long-term prescriptions.
UMR covers Vivitrol (naltrexone extended-release injection), a monthly medication used to treat both opioid and alcohol use disorders. Vivitrol blocks the euphoric effects of opioids and reduces alcohol cravings — a key option in Asana Recovery’s outpatient MAT program.
UMR covers Suboxone (buprenorphine/naloxone) treatment when recommended by your doctor and provided by a licensed treatment facility. Suboxone is one of the primary MAT medications used at Asana Recovery for opioid use disorder, helping reduce cravings and withdrawal symptoms during outpatient recovery.
At Asana Recovery, our medical team determines the best MAT option for your situation based on substance use history, medical considerations, and recovery goals.
Call (949) 763-3440 to learn how UMR covers your MAT medication.
If your insurance provider and UMR are not providing enough coverage for your chosen drug and alcohol treatment provider, the best alternative may be to look for another rehab center. However, you may also look into:
If you’re unsure if UMR or your insurance plan cover the drug treatment center you’re looking into, contact them to ask. Most insurance providers maintain a list of covered treatment centers. However, most will offer at least partial coverage for most treatment centers.
Asana Recovery works with and accepts UMR insurance for our outpatient drug and alcohol treatment programs — including PHP, IOP, Virtual IOP, and MAT. For clients who need detox, residential, or inpatient care first, our admissions team coordinates placement through trusted UMR-network partner facilities, then transitions you seamlessly into our outpatient programs.
To learn more about how your UMR policy works with our treatment plans, contact us at (949) 763-3440. Our team of experienced addiction experts is available to help now.
Our goal is to help you to get affordable and accessible mental and physical healthcare to treat substance use disorder and that starts with good advice and helping you to understand what your insurance policies offer.
Free, confidential, and no obligation. Get your insurance verified by our admissions team.