UnitedHealthcare Rhode Island: Rehabs in RI that Take UHC

UnitedHealthcare (UHC) is a nationwide company that provides a variety of health benefits to millions of people across the country.⁶ Specifically, UHC, which is UnitedHealth Group’s health benefits business, provides individuals and families, employers, and Medicare and Medicaid beneficiaries with health benefit programs.⁷ UHC works with Optum to deliver benefits and care to covered members. In Rhode Island, there isn’t one specific plan, but rather many different types of UnitedHealthcare (UHC) plans that may be available to Rhode Island residents.

Here’s an overview of the main markets and the number of lives served in each:⁶

• UHC Employer and Individual Market: About 26.5 million members are covered by a plan from this market
• UHC Medicare and Retirement Market: About 13 million U.S. seniors are covered by a plan from this market.
• UHC Community and State Market: About 7.7 million Americans who are medically underserved, poor, or unable to enroll in an employer plan are covered by a plan from this market.

To learn more about the plan you have and what it covers, call the number on the back of your insurance card. Plan details will vary greatly depending on the type of plan that you have.

Because of the Affordable Care Act (ACA), almost all U.S. health plans, including those offered by UHC in Rhode Island, must provide coverage in some capacity for 10 essential health benefits, one of which is mental and behavioral health services.⁸ This means that, specifically, your plan must, at some level, provide coverage for inpatient and residential mental health treatment, behavioral health services, and substance use disorder treatment in Rhode Island.⁹ Please note that all plan details vary, and your coverage may be subject to network requirements as well as cost-sharing requirements like copays and deductibles, depending on the plan that you have.

What exactly is covered by your UHC Rhode Island plan will vary depending on the specific policy that you have. Despite this, your UHC Rhode Island plan is federally mandated to provide coverage in some capacity for substance addiction for substances such as alcohol, marijuana, opioids, heroin, cocaine, crystal meth, and prescription drugs.

What Rehab Programs Does United Healthcare of Rhode Island Cover?

There are many types of rehab programs and services that UnitedHealthcare of Rhode Island may cover. Some common types of addiction treatment that may be covered include:^10-12

• Detox. The medically supervised process in which you rid the body of substances (e.g., alcohol or drugs) is often referred to as medical detox.
• Inpatient. Inpatient programs involve 24-hour intensive, structured care that includes drug-free housing and around-the-clock medical attention.
• Outpatient. This type of rehab program is less intensive than inpatient care, as it does not involve 24-hour supervision. An outpatient program often involves a variety of programs which can include individual or group drug counseling.
• Intensive outpatient programs (IOPs). As the name suggests, an IOP is a more intensive outpatient program, as it requires patients to attend a minimum number of hours of sessions in an outpatient format every week.
• Partial hospitalization programs (PHPs). Often called a day program, PHPs, involve patients attending sessions for 4-8 hours each day, multiple days per week, but do not have to stay overnight.
• Any type of care that is administered after rehab is completed is referred to as continuing care or aftercare.

Under the ACA, UHC in Rhode Island plans must provide some level of coverage for mental health and dual diagnosis (also known as co-occurring disorder treatment).⁹ A co-occurring disorder, or dual diagnosis, is what it’s called when someone experiences a mental health disorder or illness and an SUD simultaneously.¹³ Co-occurring disorders are common, as researchers believe that about half of those with a mental health disorder or substance use disorder will experience the other at some point in their lifetime.¹⁴ Common examples include SUDs, attention deficit hyperactivity disorder (ADHD), post-traumatic stress disorder (PTSD), anxiety or mood disorders, and depression.¹⁴ Treatment often involves an integrated approach, where each condition is treated at the same time to improve the outcomes of treatment.¹³

1. RhodeIsland.gov. (n.d.). Historical information.
2. RhodeIsland.gov. (n.d.). Fun facts & trivia.
3. United States Census Bureau. (2021). QuickFacts: Rhode Island.
4. National Center for Drug Abuse Statistics. (n.d.). Opioid epidemic: addiction statistics.
5. Substance Abuse and Mental Health Services Administration. (2020). Behavioral health barometer Rhode Island, volume 6.
6. UnitedHealth Group. (n.d.). UnitedHealthcare.
7. UnitedHealthcare. (n.d.). About us.
8. Healthcare.gov. (n.d.). Essential health benefits.
9. Healthcare.gov. (n.d.). Mental health & substance abuse coverage.
10. Substance Abuse and Mental Health Services Administration. (2015). TIP 45: Detoxification and substance abuse treatment. (Original work published 2006).
11. National Institute on Drug Abuse. (2019). Treatment approaches for drug addiction DrugFacts.
12. Substance Abuse and Mental Health Services Administration. (2014). What is substance abuse treatment? (Original work published 2004).
13. National Alliance on Mental Illness. (2020). Substance use disorders.
14. National Institute on Drug Abuse. (2020). Common comorbidities with substance use disorders research report.