Paying for Rehab with United Healthcare Insurance

The first thing most people worry about when thinking about seeking treatment for a mental disorder is how to pay for treatment. The financial stress that treatment can put on an individual and a family can be the reason a person does not seek help.

Our caring staff at Montare Behavioral Health can help you navigate the different insurance options available for the treatment you need.

An individual has two different options to pay for treatment. The first option is to pay out of pocket. This option takes away the stress of being denied for treatment but comes with its own set of worries. If an individual is already struggling with finances and does not have a family with extra funds to help, then paying out of pocket is not feasible.

The second option for payment is through your insurance company. You need to look at your insurance policy or call your insurance company for clarification of what your benefits are. If your insurance does cover the cost, it allows you to focus on the treatment of a mental disorder without financial stress.

Acceptance Into Our Treatment Center

Patients are accepted based on specific criteria. An individual’s needs and our facility’s ability to give the best form of treatment to meet those needs is the basis for approval. We also require that all individuals that enter our treatment center be at least 18 years old, allowing them complete control over their recovery journey.

Our treatment center does not accept patients who have a history of violent behaviors, have cognitive impairment or any medical conditions requiring around the clock assistance, or are at risk of hurting themselves or others.

Our focus is on mental disorder treatment, and our staff pride themselves on being mental disorder specialists. For this reason, we only accept individuals with substance abuse issues if a mental disorder is their primary disorder. We offer a dual-diagnosis program, but the main focus is on mental health recovery.

Before being accepted into Montare Behavioral Health, an individual will meet with a member of our staff. This meeting allows the individual to ask questions as well as our staff members to determine if the person will benefit from our facility. The information gathered during this meeting will be reviewed by our medical team and the admissions team to ensure that all admission criteria.

Once the individual is reis accepted into our treatment center, then payment plans and available treatment options will be discussed.

United Healthcare Insurance Information

United Healthcare was founded in 1977 as a parent company of Charter Med Incorporate. The company was founded on “using the best practices in medical care and best thinking in business management to improve the health of patients while strengthening the health care system.” This model serves as an integral part of the company’s heritage; it is committed to helping people live healthy lives.

In 2018, United Healthcare had nearly 49 million members, including Medicare Advantage plans. Based out of Minnetonka, Minnesota also offers coverage to over 6 million international members. Boasting more than 300,000 workers, more than 1.2 million physicians and medical professionals, and over 6,500 hospitals and care facilities across the nation.

At United Healthcare, we pride ourselves on inclusion and diversity. Embedded in our mission to help people are our five core values: integrity, compassion, relationships, innovation, and performance.

Integrity – Honor commitments. Never compromise ethics.

Compassion – Walk in the shoes of those we work with and serve.

Relationships – Building trust through collaboration.

Innovation – Learn from the past, invent the future.

Performance – Demonstrate excellence in everything we do.

Additional Health Benefits of United Healthcare

With United Healthcare, we offer additional programs that will be beneficial after treatment. We offer UnitedHealth Wellness, which is a group of services and programs that are designed to help promote healthy lifestyle habits. Members have full access to our online programs that give tools and guidance to live your best life.

Rally- a digital health and wellness program

Real Appeal – an evidence-based program that promotes weight loss

Motion – provides incentives for activity monitored on activity trackers for groups

SimplyEngaged Program

Fitness Reimbursement Program – money back for regular gym attendance

Health Discount Program – a discount program that can save 10-25% on non-covered purchases

All members have digital access to help better understand their coverage and choices for health care. Members can also be connected to nurse advocates who can answer your questions and guide you to make the most cost-effective choices.

Differentiating Between In-Network and Out-of-Network Policy

When paying for mental health treatment, there are two options for insurance companies to choose from: in-network and out-of-network. An in-network insurance company has a partnership with the treatment center and may offer discounts or cover the treatment entirely. If an out-of-network insurance company is selected, treatment may not be fully covered, and discounts will not be available.

Currently, Montare Behavioral Health has not partnered with any in-network insurance companies. For this reason, it is essential to call your United Healthcare representative to get the cost of treatment at our facility and how much they will cover. United Healthcare covers a wide range of mental health treatment options to help you receive the care needed.

Review Your Policy

Once the decision to seek help for your mental health disorder is clear, it is vital to review your insurance policy to see what is covered. Our dedicated staff will work with your UnitedHealthcare representative to get all the benefits you are eligible for in your insurance policy.

At Montare Behavioral Health, a review of your policy will determine:

  • The programs you are eligible for
  • The length of time you are covered for (30,60,90 days)
  • Type of care covered (inpatient or outpatient)

We at Montare, understand the importance of saving money without sacrificing treatment options, and strive to help you pay the least out-of-pocket as possible.

Mental Health Treatment Coverage

What will ultimately determine how much money you have to pay will be how much your insurance covers. The type of treatment you need, the length of time you will be in therapy, and the medicines recommended for you are all factors in what is covered by your insurance company.

United Healthcare coverage plans are based on a standpoint of 80/60, and most plans offer a Behavioral Health benefit. These plans cover a large portion of your treatment but require a co-payment upfront that runs anywhere between 20 percent and 25 percent.

Dual-Diagnosis Coverage

Because substance abuse is an accompanying disease to mental disorders, Montare offers a dual-diagnosis program. Since you will be receiving treatment for both issues at the same time, the cost is more significantly higher than if you are treated for a mental disorder only.

We urge you to disclose all this to your United Healthcare representative when exploring all your financial options. Our staff will do all they can to make your treatment as affordable as possible.

Coverage for Inpatient and Outpatient Treatment

The two different types of treatment for addiction and mental health disorders are inpatient treatment and outpatient treatment. The most common type of treatment is inpatient treatment. An individual lives in the facility 24/7 while in recovery. Outpatient treatment is the second type of treatment available. This treatment allows the individual to continue with daily life and attend school or work and still be heavily involved in treatment.

United Healthcare is committed to helping each member receive the healthcare they need. Once all the criteria under your policy’s guidelines are met, coverage for inpatient and outpatient mental health treatments will be available by United Healthcare.

Process of Insurance Authorization

After the initial face-to-face evaluation, the insurance authorization process begins. Our staff at Montare will send the results of the assessment to United Healthcare to show proof of the services needed. In most cases, insurance will give approval or denial of services quickly. But in some cases, the insurance company may need more information from the doctors before a decision is determined. If your insurance company denies inpatient treatment, they may approve therapy in an outpatient capacity.

Even if you have been accepted into our treatment facility, treatment can not begin until the insurance company has given approval or payment has been made in full.

Typically, insurance providers will approve treatment in 5-7 day time frames. Treatment can be denied at any point between these intervals if the insurance company finds that the criteria for treatment were are not met.

We recommend a minimum 28-day stay at Montare Behavioral Health, but, we do not determine the length of stay that United Healthcare approves. Unfortunately, denial can happen at any point in your treatment, so it is good to have a backup plan in the event this happens.

Montare Behavioral Health financial counselor will meet with you to discuss all financial options available. We dedicate our lives to helping people with mental health issues and will do everything in our power to help make sure that treatment can happen.

Montare is Here to Help

Our team works with healthcare representatives to ensure that each individual is getting the financial help they are entitled to through UnitedHealthcare. A treatment center must focus not only on a person’s mental health but also on the person’s financial situation.

If you or a loved one is seeking treatment in our facility and not sure if it is financially feasible, please contact us today. Our caring staff is available 24 hours a day, 7 days a week to help you start the road to recovery.

References

https://www.healthcaredive.com/news/unitedhealth-optum-q1-2018/521523/

https://www.unitedhealthgroup.com/

https://www.uhcprovider.com/content/dam/provider/docs/public/policies/medadv-coverage-sum/mental-health-services-procedures.pdf