Does Optum Cover Teen Rehab?

Using Optum Rehab Coverage for Teen Treatment Programs

Are you concerned that your child may be abusing drugs and alcohol, or struggling with mental health concerns that require support, but you aren’t sure where you can turn for help, even with health coverage? If you have a form of Optum insurance, and your child is struggling, you want answers.

You need to know: Does Optum cover teen rehab?

The Affordable Care Act and the Mental Health Parity and Addiction Equity Act ensure that all health insurance companies must offer coverage for substance use disorders and mental health, even among teens. However, your unique Optum plan may require copayments and deductibles before it kicks in to cover care.

Artemis Adolescent Healing Center provides a safe space for your teen to land with Optum insurance. Our enrollment team can help verify your benefits and save you hours of time on the phone with your insurance company’s benefits department.

Here is what you need to know about Optum coverage for your teen’s withdrawal symptoms, addiction, and mental health needs, and for confidential verification we are only a phone call away.

Can You Use Optum Health Insurance Plans for Teen Drug and Alcohol Rehab?

Worried parents want the best treatment services for their teens and young adults who are abusing drugs and alcohol. One of the factors that may deter them from seeking care services right away is a lack of understanding of exactly what their health insurance plan covers.

The good news is that Optum insurance plans often cover substance use disorders in teens. Under the Affordable Care Act of 2010, drug and alcohol addiction must be covered to the same extent as other medical issues. It’s considered one of your essential health benefits, no matter who your insurance provider might be.

There are no caveats for pre-existing conditions, and insurance plans have no caps on what they cover. This means that your child can seek treatment at all levels for as long as their recovery journey takes. It also ensures that they can seek lower levels of care to help them transition through the various stages of healing.

What are the Out-of-Pocket Costs for Substance Use Disorders?

While it’s true that substance abuse is covered by Optum, that doesn’t necessarily mean that parents won’t have any out-of-pocket costs. Optum insurance plans vary, which means your coverage depends on the plan you select.

Covering the cost of addiction treatment means that you may have to shell out for copayments. This can be a set payment based on the daily rate of inpatient treatment centers, or you may pay a certain percentage until you reach your deductible.

Once you hit your out-of-pocket maximum for the year, a residential treatment stay or even lower levels of care may be covered in full. Many people are surprised by just how much Optum coverage will help in these scenarios.

In-network providers are often less expensive than out-of-network care because they have negotiated lower rates for customers. This means that you may need to check with your specific plan to see which facilities are included in your benefits and healthcare services. Artemis can help you pinpoint whether our facility is in-network for your plan, all it takes is a quick and completely confidential phone call.

Optum Rehab Coverage and Levels of Care

Not every teen will require the same level of intensive services as another. While many parents want to start with inpatient treatment, this is often not the final step in recovery. Residential treatment centers are often covered by Optum insurance, though it depends on policy type and your exact details.

The best thing to do is call Artemis Adolescent Healing Center and allow us to verify your benefits in a quick and confidential phone call. We can inform you of what will be covered and what you can expect to pay.

Does Optum Cover Inpatient Rehab for Teens? What About Partial Hospitalization and IOP Coverage?

Most teens will need to transition out of inpatient care and into a partial hospitalization or an intensive outpatient treatment program. These allow teens to practice what they learned in inpatient while providing a support system for their early days of sobriety.

In these instances, they may spend all day in treatment but still return to you, their friends, and their own bed at night. It can be a way to ease the transition back to regular life without the structure of a hospital setting. All of these should also be covered by Optum.

Is Medication-Assisted Treatment for Teens Covered by Optum?

For many teens, there might be a rough transition period from using drugs and alcohol as they move into sobriety. Substance use disorders could be masking other conditions, or withdrawal could be an excruciatingly uncomfortable experience for them. Either way, medication-assisted treatment might help.

At Artemis Adolescent Healing Center, we offer the expertise of a medical team that can help identify what your teen needs. We can offer medications on an as-needed basis and monitor the transition to medication.

Fortunately, most medications are covered by Optum. Generic medications are often less expensive than name-brand ones, and we can help you select effective medications that will be covered under your insurance provider’s umbrella.

Is Evidence-Based Mental Health Treatment for Teens Covered by Optum?

There is often an overlap between substance abuse issues and mental health issues. In order to treat one, you must also address the needs of the other. Artemis Adolescent Healing Center will provide a comprehensive workup of your teen’s mental health needs and suggest treatment options for them.

From group therapy to individual therapy, we offer a range of evidence-based therapies that are typically covered by your insurance company. Optum plans will permit a primary care physician to recommend mental health treatment alongside substance use disorders.

Under the Mental Health Parity and Addiction Equity Act, insurance providers must cover mental health issues to the same degree that they would cover medical issues. If they would cover 75 percent of the treatment for appendicitis, they must usually cover 75 percent of your mental health treatment.

Behavioral therapy is often the first line of treatment for mental health, followed by holistic therapies like art and music therapy. Artemis can help you access these resources under your health insurance coverage while your child attends our programs at all levels.

Artemis Offers Programs for Teens That Accept Optum Insurance

Your Optum health insurance plan might offer more coverage than you think it will for your teen to get the help they need for substance abuse or mental health. Teen rehab can be expensive out-of-pocket, but Artemis will accept many insurance plans, including Optum, to help offset the costs.

The best thing you can do to ensure that your child’s addiction treatment is covered is to reach out to our enrollment team today. We can collect your insurance information and verify your benefits, letting you know what to expect with our comprehensive treatment program.

Our JCAHO-accredited facility ensures that your teen’s needs are met according to their symptoms and unique developmental stage. From group therapy to holistic treatment, we offer personalized treatment for dual diagnosis clients in both inpatient rehab and outpatient programs.

Don’t wait another day to talk with our expert staff, call Artemis confidentially now to learn more about our programs!

References

1. Find out what Marketplace Health Insurance Plans cover. HealthCare.gov. (n.d.). https://www.healthcare.gov/coverage/what-marketplace-plans-cover/
2. Copayment – Glossary. HealthCare.gov. (n.d.-a). https://www.healthcare.gov/glossary/co-payment/
3. Deductible – Glossary. HealthCare.gov. (n.d.-b). https://www.healthcare.gov/glossary/deductible/
4. Centers for Medicare and Medicaid Services. (n.d.). The Mental Health Parity and Addiction Equity Act (MHPAEA).