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UMR Health Insurance for Drug and Alcohol Rehabilitation in Texas

 

 

UMR health insurance for drug and alcohol rehab in Texas helps families through United Healthcare as UMR is not a traditional insurance agency. UMR is a third-party administrator that manages claims for companies to ensure they are handled properly. When someone has UMR health insurance coverage, it typically means that the health insurance is provided through a company that is self-insured. Moreover, they are contracted with this agency to administer policies and process all health insurance claims. United Healthcare is a branch of UMR that offers behavioral health services that cover drug and alcohol rehab in Texas. Members of UMR can use their health insurance plans to cover drug rehab, drug detox, and forms of counseling or therapy.

The drug rehabilitation process when using health insurance involves multiple steps. Most drug rehab centers evaluate the patient before treatment to determine what counseling and therapy methods are needed. The first step to treat drug addiction is a drug detox to manage withdrawal cravings and symptoms. Common drug detox options are medically supervised detox and standard drug detox. Drug detoxification should not be considered the only approach to treat drug addiction because it does not provide adequate counseling and therapy. The next phase of drug rehabilitation involves attending a residential or outpatient drug rehab center. UMR and its affiliates cover most outpatient and residential drug rehab programs in Texas. It is also important to consider aftercare support like 12-step meetings, peer support groups, and sober living homes.

 

How Does UMR Health Insurance Cover Drug Rehab in Texas?

UMR and United Healthcare cover different drug rehab options in Texas, but the extent of coverage and what is paid for depends on the health insurance plan. Typically, for inpatient drug rehab, for example, most plans would likely cover a percentage of these services with a copayment option. There are a variety of healthcare plans offered through United Healthcare and UMR. United Healthcare Choice offers in-network coverage but no coverage for out-of-network providers. United Healthcare Choice Plus offers savings for service providers within the network but less coverage for out-of-network drug rehab providers. United Healthcare Options PPO offers savings for out-of-pocket costs when using a member of the preferred provider network. Generally, location is not a barrier to seeking drug rehab as long as a provider is chosen within the network.

The most common healthcare plans are Health Maintenance Organization plans and Preferred Provider Organization plan. An HMO plan allows a patient to choose their primary care physician. However, when seeking treatment outside of the network, an individual would need a referral. HMO plans have lower or no deductibles, and overall coverage is a lower cost compared to a PPO. HMO plans are a good option for someone who is not seeking drug rehab outside of the provider network. PPO plans allow members to see providers within the network and out of network. However, PPO plans have higher deductibles than an HMO. Also, PPO plans have the option of accessing specialists and providers outside of the network without a referral.

 

What Type of Drug Rehab Does UMR Health Insurance Cover in Texas?

UMR and United Healthcare insurance for drug rehab in Texas covers drug and alcohol detox, residential or outpatient drug rehab, some counseling options, or therapy. The extent of coverage and what is covered depends on the plan type and whether the program is within the provider network. Most drug detoxification options are covered by United Healthcare. However, the insurance company may not extend coverage to drug detox if they do not feel the drug withdrawal could become dangerous. Residential drug rehab in Texas is generally covered with a coinsurance option. However, the insurance company may only cover certain aspects of residential care.

Outpatient drug rehab is generally covered by most health insurance, and it may often extend to long-term outpatient care. Outpatient drug rehab offers long-term and short-term programs for the patient to attend treatment daily. In-network providers for drug rehab have negotiated with UMR and United Healthcare to charge members lowered prices. An out-of-network provider has not reached an agreement with a drug rehab center that usually charges standard rates. Most health insurance plans cover counseling and therapy, but this is different for each health insurance plan. Common counseling for drug addiction includes individual therapy, group counseling, and family-based therapy.

 

Family Intervention for Drug Addiction in Texas

The first step that many families take is arranging drug rehab through their health insurance provider. Drug rehab programs in Texas manage all forms of drug and alcohol addiction. However, many families struggle to get their drug-addicted loved one committed to attending drug rehab. Family intervention in Texas motivates an addict to seek help for drug addiction. Unfortunately, someone struggling with drug addiction is often in denial about their situation and may not recognize the negative effects their behavior has on themselves and others. A family intervention presents the addict with a structured opportunity to make positive changes.

The best way to plan and organize a family intervention is to hire a professional interventionist. Family intervention is a carefully planned process done with family, friends, and an interventionist. A family intervention provides specific examples of the addict’s destructive behavior and offers prearrange treatment. With the help of the interventionist, the family sets clear boundaries and consequences if the addict refuses to accept help.  A carefully planned family intervention works, but a poorly planned intervention worsens the situation.

 

Health Insurance for Drug Rehab and Drug Addiction Trends in Texas

Health insurance plans through UMR and United Healthcare cover different drug rehab options in Texas. However, not every person has health insurance. According to the United States Census Bureau, in 2018, approximately 17.7% were without health insurance. Also, roughly 61.8% had private health insurance, while 29% had public health insurance. Illicit drug use impacts people from all age groups, but health insurance plans make it easier to access and pay for drug rehab in Texas. According to the Texas Behavioral Health Barometer, among people aged 12 or older, between 2015 and 2017, 2.3% had an illicit drug use disorder.

 

Sources-

https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/Texas-BH-BarometerVolume5.pdf

https://www.census.gov/library/stories/2019/11/state-by-state-health-insurance-coverage-2018.html