Optum Health Insurance Coverage for Drug and Alcohol Rehab

Coverage for drug and alcohol rehab treatment varies depending on your insurance plan, and the type of treatment you are accessing. Be sure to check with your insurance plan to determine which services and healthcare providers are covered by your plan.

Optum offers members resources and support to help achieve stability, resilience, and sustained recovery from a substance use disorder (SUD).⁸ Optum provides immediate assistance and provider referrals to members through their Substance Use Disorder Helpline.⁹

Several treatment types may be covered by your Optum Health insurance plan, including:

• Medical detox: Medical detox helps patients withdraw from drugs and alcohol comfortably and safely to help facilitate the transition to ongoing addiction treatments, such as inpatient or outpatient rehab.
• Inpatient programs: Inpatient rehab provides intensive, structured care. You will live at the center for the duration of the program, attending individual and group therapy sessions with around-the-clock medical care.
• Outpatient programs: Outpatient rehab allow you to live at home while attending treatment. With outpatient rehab, you will attend individual and group counseling to learn about addiction, how to control it, and strategies for ongoing recovery and sobriety.
• Intensive outpatient programs: Intensive outpatient programs (IOPs) involve attending treatment several days a week for a few hours at a time. This is more time-intensive than a typical outpatient program, but you can still live at home.
• Partial hospitalization programs: Partial hospitalization programs (PHPs) offer a treatment structure like inpatient treatment, where you attend around 4 to 6 hours a day for approximately 5 days a week, but you can still live at home.
• Aftercare: Aftercare programs provide ongoing counseling or treatment after attending inpatient or outpatient rehab. Aftercare programs are designed to help you maintain recovery, find ways to prevent relapse, and achieve a fulfilling, rewarding life free from substance use.

Knowing exactly what is covered regarding addiction treatment can provide you peace of mind so you can focus on what matters: getting and staying sober. To learn more about what your insurance plan covers, you can call the number on the back of your insurance card, verify your insurance online, or fill out the form below.

Finding a rehab center that takes your insurance policy is important. This can make it easier for your insurance coverage to begin when accessing treatment and provide comfort knowing that you are financially taken care of while you focus on your recovery.

AAC has  rehab centers across the U.S. that accept Optum, including:

• AdCare Rhode Island: With various locations in the state, AdCare Rhode Island offers high-quality addiction treatment in a secure environment.
• Recovery First Treatment Center: Located in Hollywood, Florida, Recovery First Treatment Center is a leading alcohol and drug rehabilitation center offering high-quality addiction treatment.
• Laguna Treatment Center: Located in Laguna Beach, California, this rehab facility provides drug and alcohol treatment in a secure, supportive environment. 
• Oxford Treatment Center: Located in Etta, Mississippi, Oxford Treatment Center is a drug and alcohol rehab facility that provides high-quality addiction treatment in a natural, serene environment 
• River Oaks Treatment Center: River Oaks Treatment Center is in Riverview, Florida, and provides high-quality drug and alcohol addiction treatment including detox, inpatient and outpatient therapy, telehealth, and more.

To ensure that your insurance policy at least partially covers your addiction treatment, choose a rehab facility that is in-network with your insurance company. In-network means that your insurance company has an agreement with the rehab center to provide services at a discounted rate.

Out-of-network means that the rehab center does not have an agreement with the insurance company to provide treatment at a discounted rate. While some insurance companies will provide some coverage for out-of-network providers, others will not. This means you will end up paying more out-of-pocket for treatment or potentially be responsible for all the costs.

Whenever possible, it’s important to choose a rehab center that takes your health insurance, to keep your out-of-pocket costs down.

Optum Health provides some level of coverage for mental health disorders.¹¹ The Affordable Care Act (ACA) states that insurance companies must provide coverage for 10 essential health benefits, which include mental health and substance use disorder treatment.¹⁰ This law ensures that everyone who needs access to mental health care can access it when they need it.

If you struggling with a substance use disorder and a mental health condition such as anxiety or depression, this is known as a co-occurring disorder or dual diagnosis. Many rehab facilities throughout the country offer dual diagnosis treatment.

Mental health treatments that may be covered by Optum Health include:

• Group counseling.
• Inpatient/outpatient rehab.
• Medication.
• Talk therapy/psychotherapy.
• Virtual counseling (telehealth).

There are times when private rehab or luxury rehab might be the best option for your needs. These programs may come at a higher cost, but your Optum insurance may provide some coverage. Whatever rehab you choose, verifying your benefits ahead of time can help you know what to expect in terms of coverage.

Optum Health coverage will vary depending on the specific plan you have. The percentage of treatment costs covered depends on your plan and the treatments you receive. For the most part, health insurance provides you with financial protection when you need to access healthcare, including addiction treatment.

Beyond the monthly premium you pay to maintain your health insurance coverage, you are also responsible for paying:¹²

• Deductible: The amount you must spend before health insurance coverage kicks in (e.g., $1,800).
• Copayments/coinsurance: Payments you make each time you receive a medical service
• Out-of-pocket maximum: The highest amount you have to pay for covered services in a calendar year. After you reach this amount, your insurance coverage will pay 100% for covered services.

While the cost of rehab is often a deterrent for accessing treatment, it doesn’t need to be. There are several options to help pay for your out-of-pocket expenses for treatment, including:

• Loans or lines of credit: Many banks and credit unions offer loans or lines of credit to individuals to help them pay the costs of healthcare (e.g., rehab).
• Payment plans. Treatment facilities often allow you to pay back your out-of-pocket costs over time.
• Fundraising and crowdfunding: Family members and friends may be able to help you cover the costs of rehab. You can also raise money through crowdfunding websites, such as GoFundMe.
• SAMHSA grants: The government offers grants to individuals who are low-income or belong to specific populations (e.g., veterans).

AAC is dedicated to helping individuals struggling with addiction achieve and maintain sobriety. If you are looking to learn more about addiction treatment or have questions about your Optum Health coverage, you can contact us at

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