Medically Reviewed by Dr P. E. Pancoast, MD
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Like all U.S. healthcare insurers, United Healthcare is required to cover addiction treatment under the Affordable Care Act (ACA). This includes treatment for alcohol use disorder (AUD), as well as mental health care.
The extent to which United Healthcare will cover care depends on several factors, including:
The most significant factor influencing coverage is your United Healthcare plan.
While most plans cover substance abuse treatment, you might still have some out-of-pocket expenses. These will vary according to your plan type and tier of coverage you have.
It’s essential to check the details of your plan when considering treatment.
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The cost of alcohol addiction treatment varies widely based on two main factors:
An alcohol rehab facility can be either for-profit or non-profit. A for-profit treatment facility is generally more expensive.
Here’s why:
For-profit rehab centers usually have more amenities, like pools or saunas. They also are often in nicer locations, like in the mountains or on a beach. For that reason, they tend to market themselves as “luxury” rehabs for wealthier clients.
Non-profit rehab facilities usually only offer the basics: a room with a bed, a bathroom, a place to store your possessions, and sometimes a television. Insurance providers are more likely to approve coverage for these facilities.
A for-profit treatment facility might cost up to twice as much as a non-profit facility. One study of residential treatment programs found the average difference in monthly fees between the two to be $17,434 to $5,712.1
Aside from choosing a non-profit treatment facility that’s in your provider network, another way to minimize costs is choosing a program with a large enrollment. Studies show treatment centers with large enrollment numbers charge less per person.4
Note: Treatment success is not dependent on whether you attend a ‘luxury’ or less expensive facility. Both treatments have been shown to be effective.
Treatment type has a significant impact on cost:
Inpatient treatment involves 24/7 medical support, so it tends to be more expensive than outpatient treatment.
Medication will also increase treatment cost. For example, medication-assisted treatment (MAT) with naltrexone can cost up to $14,000 per year.3
United Healthcare covers a variety of treatments for alcohol addiction and other substance abuse issues.
Treatments include:
Detoxification is the first step in alcohol rehab. Also known as detoxing, the process involves stopping all drinking so your body can return to normal.
When the body becomes dependent on alcohol, brain and body chemistry change. The body depends on alcohol to keep some body systems running. Stopping alcohol suddenly without medical support can result in brain and body malfunction, fluid balance upset, and even seizures and death.
Since alcohol withdrawal can be deadly, the best way to detox is with professional help, known as medical detox.
The initial assessment in a treatment program will determine the level of medical support needed during withdrawal. This varies from person to person.
Inpatient alcohol rehabs provide around-the-clock care and support for people struggling with alcoholism in a residential or hospital-type setting. Those who suffer from severe alcoholism usually begin their treatment here. They may move into outpatient care later.
Outpatient treatment is less intensive than inpatient treatment. It consists of scheduled therapy sessions during parts of the day and unsupervised activities between each session.
Treatment may involve just a few sessions a week. People who attend return home when their sessions are done.
Those with mild alcohol use disorders (AUDs) benefit from outpatient treatment.
Medication-assisted treatment (MAT) involves taking medication to manage withdrawal symptoms during detox. It’s usually combined with counseling to reduce cravings and prevent relapse.
Three drugs are FDA-approved for MAT to treat alcohol abuse:
Substance abuse and mental illness often exist in a complex relationship known as a dual diagnosis. A mental health problem can lead to substance abuse. However, it can also result from an addiction.
United Healthcare plans cover mental illness linked to substance abuse.
Some mental health disorders linked to alcoholism include:
It’s essential to treat any dual-diagnosis with addiction and mental illness at the same time. This is known as integrated treatment.
Integrated treatment combines counseling with medications.
Mental health treatment approaches for alcohol addiction include:
Keep in mind: The cost of addiction is often many times that of a successful treatment program.
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You can check your United Healthcare coverage by calling the Substance Use Helpline at 1-855-780-5955. A representative can answer questions regarding the extent of your substance abuse coverage.
For mental health benefits, sign in to your health plan on the United Healthcare website or call the number on the back of your member ID card.
Knowing the cost of treatment before starting treatment is important. This way, you won’t be caught off guard with any unexpected charges.
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