Does UnitedHealthcare cover mental health treatment? Yes, many UnitedHealthcare plans cover mental health care such as therapy, psychiatric visits, virtual visits and more intensive programs like partial hospitalization (PHP) and intensive outpatient (IOP). Exactly what’s covered, and what you’ll pay, depends on your plan. The Ranch Pennsylvania Outpatient Services accepts many UnitedHealthcare plans for mental health treatment in Lancaster, PA.
Read on to learn how Optum fits into UnitedHealthcare’s behavioral health coverage, what levels of care to ask about for depression, anxiety, PTSD or bipolar disorder, and how to check your benefits.
How UnitedHealthcare Handles Behavioral Health
UnitedHealthcare works with Optum for behavioral health. UnitedHealthcare’s provider network page says Optum Behavioral Health Solutions handles credentialing and contracting for behavioral health providers on behalf of UnitedHealthcare. So when you look for a therapist, psychiatrist or mental health program in your network, you may see Optum’s name in the process.
On its mental health programs page, UnitedHealthcare notes that therapy or counseling can help on its own or as part of a larger care plan, and that coverage depends on your specific health plan. Members can find a network mental health provider and view benefits by signing in to their account or the UnitedHealthcare app.
UnitedHealthcare also highlights extras such as coaching, stress management resources and the Calm Health mindfulness app. Those tools can help with everyday stress, but they aren’t a substitute for professional treatment when symptoms are affecting your work, relationships or safety.
Does UnitedHealthcare Cover Mental Health Treatment at Every Level?
Many plans cover a range of mental health services, from a weekly therapy visit to a full-day program. Here’s what to ask about:
Therapy and virtual visits
UnitedHealthcare highlights virtual mental health visits, where you talk with a provider by phone or video. The National Institute of Mental Health explains that psychotherapy helps people identify and change troubling emotions, thoughts and behaviors, and that cognitive behavioral therapy (CBT) teaches people to question harmful automatic thoughts.
Psychiatric care
Psychiatric evaluation and medication management are often part of treatment for depression, bipolar disorder and anxiety disorders. Your pharmacy benefit affects medication costs.
Intensive outpatient (IOP)
Our mental health IOP meets for three-hour group sessions three days a week while you live at home, typically for about 5 to 6 weeks.
Partial hospitalization (PHP)
Our mental health PHP offers full-day programming five days a week at our Lancaster Outpatient Center; most clients complete it in about 8 to 12 weeks. PHP can also serve as a step down after a hospital stay. Learn more about step-down care after psychiatric hospitalization.
Your Rights Under the ACA and Parity Law
HealthCare.gov states that all Marketplace plans cover mental health and substance abuse services as essential health benefits, including psychotherapy, counseling and inpatient behavioral health care, and that they can’t deny coverage because of a pre-existing mental health condition.
For group health plans and insurers, the Mental Health Parity and Addiction Equity Act adds more protection. According to the U.S. Department of Labor, most plans can’t charge higher copays for mental health visits than for comparable medical visits, and a majority can’t require preauthorization for all mental health treatment if similar rules don’t apply to medical care. See our guide to mental health parity for details.
Prior Authorization and Level-of-Care Reviews
Optum’s prior authorization guidance says plans administered by Optum Behavioral Health require authorization or notification for specialty outpatient services and most inpatient services. Programs like PHP and IOP may fall under these rules, so confirm before you start.
When Optum reviews mental health care for adults, its clinical criteria list LOCUS, a level-of-care tool, for adults age 18 and older to help determine the appropriate level of care. In plain terms, reviewers use it to help decide whether weekly therapy, IOP or PHP fits your needs. Our admissions team can share clinical information with your plan to support that review.
How to Check Your UnitedHealthcare Coverage
- Sign in to your UnitedHealthcare account or app and look for mental health or behavioral health benefits.
- Call the member services number on your ID card and ask whether mental health PHP and IOP are covered, whether you need prior authorization, and what your costs will be.
- Check network status for any program or provider you’re considering.
- Ask our team. We can verify your insurance and walk you through your benefits.
Curious about costs? Our article on outpatient treatment costs explains deductibles, copays and coinsurance.
Frequently Asked Questions
Does UnitedHealthcare cover mental health treatment like therapy?
Many plans cover outpatient therapy, including virtual visits by phone or video. Your copay and any visit rules depend on your plan.
Why does Optum keep coming up?
Optum Behavioral Health Solutions contracts with behavioral health providers on behalf of UnitedHealthcare, and Optum rules may guide authorization for higher levels of care.
Can I get PHP or IOP for depression or anxiety?
Often, yes, if the care is medically necessary and your plan covers it. Our programs treat depression, anxiety, panic disorder, PTSD and bipolar disorder.
What if I’m also struggling with substance use?
We offer integrated dual diagnosis care. Read about UnitedHealthcare rehab coverage for addiction treatment.
Get Mental Health Help in Lancaster, PA
If you’re in crisis or thinking about suicide, call or text 988 to reach the 988 Suicide & Crisis Lifeline, or call 911 in an emergency. When you’re ready, The Ranch Pennsylvania Outpatient Services offers mental health treatment programs in Lancaster, PA, with therapies including CBT, DBT and cognitive processing therapy. We accept many UnitedHealthcare plans, and coverage varies by plan. Verify your insurance to get started. Our admissions team is available 24/7, and calls are free and confidential.
