UMR is a unique type of insurance policy, functioning as a Third-Party Administrator (TPA) for UnitedHealthcare rather than a direct insurance provider.
UMR partners with thousands of healthcare providers nationwide, offering both HMO and PPO benefits to help members access quality treatment at an affordable cost.
If you need assistance finding UMR-approved substance abuse treatment, contact our addiction specialists today.
While UMR itself does not directly provide treatment coverage, its extensive network of healthcare providers does.
UMR operates under the guidelines of the Affordable Care Act, which requires coverage for mental health and substance use disorders. As a result, you can typically expect coverage for all levels of addiction treatment through UMR, including:
Since UMR connects members with a wide range of healthcare providers, there are no universal guidelines for how coverage is applied. However, most providers within the UMR network follow the American Society of Addiction Medicine (ASAM) criteria for diagnosing alcohol and substance use disorders.
These criteria are typically reviewed during your initial consultation with an addiction specialist and include questions designed to assess your needs and determine your insurance coverage eligibility:
Your UMR policy details and provider network will ultimately determine which addictions are covered. However, as awareness and understanding of addiction have grown, most UMR plans now include coverage for a wide range of substance use disorders. Commonly covered addictions include:
Yes, within UMR’s provider network, you’ll likely find coverage for a range of mental health services offered by various providers. Depending on your specific plan, this may include Cognitive Behavioral Therapy (CBT), Eye Movement Desensitization and Reprocessing (EMDR), and even Biofeedback therapy.
UMR provides three tiers of prescription drug coverage that may apply under your specific plan, including both generic and brand-name medications approved by the FDA. For Medication-Assisted Treatment (MAT), UMR typically covers several FDA-approved medications proven effective when combined with traditional therapies.
While MAT isn’t necessary for every client, it can be especially beneficial for those recovering from opioid addiction. A treatment plan that integrates prescription medications with behavioral therapy can greatly improve the chances of lasting recovery.
The amount your UMR insurance covers for drug and alcohol rehab depends on your specific plan, the services you choose, and how much of your deductible has been met. Thanks to UMR’s extensive provider network, members often experience an estimated 20–30% reduction in overall medical costs.
If you’ve already met your deductible for the year, you may qualify for full coverage of your treatment and attend rehab with 100% coverage under UMR. However, if you haven’t yet reached your out-of-pocket maximum, there are several options available to help you manage the cost of treatment:
Arizona IOP is one of the few rehab centers in Arizona that accepts UMR and helps clients access personalized treatment from masters-level clinicians.
As part of the UnitedHealthcare PPO Network, Arizona IOP is committed to providing comprehensive care for addiction and mental health. Our programs incorporate FDA-approved medications for clients pursuing Medication-Assisted Treatment (MAT) and are staffed exclusively by licensed, fully accredited behavioral health professionals.
Through the UnitedHealthcare PPO Network, UMR provides coverage for treatment across the United States. This means you can access rehab services in a state other than where you’re insured. While out-of-state treatment isn’t the right fit for everyone, it can offer a valuable opportunity to step away from triggering environments and focus fully on recovery.
UMR is one of several insurance providers that offer coverage for addiction treatment. If you or a loved one are covered under a different policy, be sure to review that provider’s specific benefits and coverage details:
