Using Optum Insurance to pay for Rehab  


Optum Insurance Logo

Do you have behavioral health benefits administered by Optum? If so, you may qualify for partial or full coverage of your rehab stay at Hotel California by the Sea. Through Optum health insurance, various plans can help cover the costs for drug and alcohol treatment at Hotel California by the Sea.

Optum plans can provide coverage for those struggling with substance abuse and co-occurring mental health disorders in the United States. Oftentimes utilizing Optum insurance to receive help can be the best option for clients experiencing the symptoms of substance addiction. However, the amount that your Optum insurance plan will cover for substance abuse treatment varies depending on multiple factors.

The amount of coverage provided by your Optum plan is contingent upon your home state (and the state of your plan), terms and conditions of your specific plan, and the specific therapeutic offerings of your chosen rehab center. Optum reserves the right to make decisions concerning coverage on a case-by-case basis, factoring in each member’s circumstances and the specific type of treatment(s) the member receives.

There are a couple of steps that a member must take to discern whether their Optum health insurance will pay for the treatment of addiction. This also affects any financial responsibilities on the part of the member. With the help of your insurance company, seeking either inpatient treatment or outpatient treatment for substance abuse disorders can be the first step on the road to long-term sobriety.

With Optum, you can initiate your rehab journey from the comfort of your own home. Start immediately.

What is Optum Health Insurance?

Optum is a health insurance company that offers insurance benefits to its members for services such as primary care visits, hospital stays, surgery, and treatment for substance abuse and mental health disorders. Optum’s parent company is United Healthcare, though it operates as its own autonomous health insurance carrier.

Optum offers multiple different types of plans to fit the needs of its members. The types of programs available through Optum include PPO plans, HMO plans and many others.

Optum health insurance can cover various services, from family practitioner visits to specialist appointments, emergency room visits, and substance abuse treatment. Optum care managers help their members by managing their substance abuse rehabilitation benefits.

How much coverage does Optum offer for addiction treatment?

Much like any type of healthcare, substance abuse and mental health care treatment come in many shapes and forms. Luckily, insurance companies typically account for this variance in services. Therefore, Optum usually provides its members’ coverage for the following treatments:

What to consider when paying for rehab with Optum

Before deciding to utilize your Optum plan to help pay for addiction treatment, we suggest you take the steps described below:

Call the phone number on the back of your Optum insurance card to speak to an insurance representative. When you or a loved one decides to seek addiction treatment services, speaking to a representative from your insurance plan is a great first step. When calling your healthcare insurance provider, they can help you find in-network facilities in your area, as well as any treatment facilities that provide specific therapy modalities for which you may be searching.

Do your research to find the best treatment center for you. There are many accreditations and treatment methods that can set any treatment facility apart from the others. Some of the most reputable treatment centers utilize evidence-based treatments; individualized treatment plans based on each client’s needs, and offers long-term aftercare planning services for their clients. Be sure that the treatment facility you choose has the best possible program to serve your needs.

Call the treatment center you’d like to attend (you can also do this first). If you find a treatment center you are interested in the treatment facility can call your insurance company and obtain all the necessary information about your plan specifics. Once the substance addiction treatment program talks to your insurance company, they will report back to you with details of your rehab coverage. After this, you can begin working out a financial plan so that you can start treatment as soon as possible – with little to no stress.

What are my Out-Of-Pocket responsibilities for Rehab with Optum?

One of the biggest questions most people have regarding their insurance coverage is their financial obligation. Your financial responsibility will depend on several factors. But most importantly, it depends on which treatment program you choose. Whether you choose an in-network or out-of-network treatment program is essential. Your financial responsibility and all other policy details are made available to you and whichever provider you choose.

Reach out to our admissions team to start sorting out exactly what your insurance plan covers.

Verifying your insurance benefits with Optum 

The first and most crucial step to utilizing your coverage through Optum to pay for treatment is figuring out whether your policy is currently effective. This information and more is available through a quick process of verification with your insurance plan. To help us verify your benefits with Optum, just fill out the quick 60-second verification of benefits (VOB) form below. 

Finding treatment providers that accept Optum

If you’re looking to find out where you may be able to use your behavioral health coverage through Optum, look no further. You have multiple options at your disposal. You can log on to Optum’s member portal to find a list of providers that are in-network. You can always call and speak directly to an Optum representative as well. And more conveniently, just give us a call at Hotel California by The Sea. Our admissions team can get the ball rolling to help you figure out what benefits you have available and what your coinsurance or deductible may be.

Hotel California by The Sea is one of the preferred treatment programs in Orange County, California. However, selecting the right treatment program for you is important to us. We’re here to help you whether your journey begins with us or with another treatment program. 

Recovering from Substance Use Disorders at Hotel California by the Sea

Hotel California by the Sea’s inpatient and outpatient programs provide effective substance treatment methods, safe and supportive environments and a staff of certified medical physicians, psychologists and clinical professionals. Most of those who find themselves struggling with alcoholism or drug addiction also experience co-occurring mental health conditions. Everyone’s road to recovery is different. We’ve kept this in mind while designing our programs to meet the needs of each client. 

We have multiple inpatient and outpatient treatment centers around the country in California, Washington, and Ohio that offer the following addiction treatments:

At our facilities, we also offer counseling and services for more specific areas of focus. With our Career Resources Program, this service assists clients looking to pursue higher education or are in need career counseling. For those looking to involve their family relationships in their recovery journey, we offer a monthly Family Program where patients and their loved ones participate in various therapies and activities to promote family healing. 

If you or your loved one has behavioral health benefits administered by Optum and are looking for treatment, please do not hesitate to give us a call. Our admission specialists are ready and waiting to help you take the first steps towards the journey to recovery. 

Request a Call

The road to recovery is full of uncertainty, leave your worries behind…
Our compassionate staff will answer all of your questions without any pressure. Learn about our evidence-based drug addiction treatment and rehab, the ease of entering our program, and the benefits of getting help from a reputable addiction treatment facility like Hotel California by the Sea.

Every member of our admissions team has been where you are today – be sure to ask them about their journey!