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Does Optum Cover Addiction Treatment?

Optum Insurance Rehab Center

Learn more about how Optum insurance can help cover most of the costs associated with addiction treatment at Indah Recovery.


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optum insurance coverage
optum insurance coverage

Optum Insurance Coverage

Optum Insurance

Getting help is never easy, but if you are struggling with addiction, don’t let the fear of how much treatment will cost stop you from getting the help you need. If you have Optum insurance, Orange County rehab treatment may not be as expensive as you think.

With addiction, remember that there isn’t a one-size-fits-all treatment plan. You might be surprised to find how much your health insurance coverage applies to the specific services or medications you need. You can choose which of the services that fall under the category of substance abuse treatment work best for your mental health, addiction, insurance plan, and personal finances.

It is important to note that with Optum insurance, where you live, and your plan will dictate much of what is covered and how much you have to pay out-of-pocket. You may or may not need a referral from your primary care physician to start an Optum insurance rehab in Orange County.

Contact the admissions team at Indah Recovery today for help verifying your insurance benefits and to learn more about our addiction treatment programs in Orange County.

What is Optum Insurance?

Optum Can Help Cover Rehab Costs

Optum insurance partners with over 125 customers to provide health insurance coverage at hospitals across the nation. They provide insurance coverage in 15 states, including:

  • California
  • Washington
  • Arizona
  • Nevada
  • Colorado
  • New Mexico
  • Utah
  • Texas
  • Ohio
  • Indiana
  • Connecticut
  • New York
  • New Jersey
  • Massachusetts
  • Florida

Coexisting Mental Health

Federal requirements extend to Optum health care plans, including annual checkups and other preventative services at no cost to you and coverage for mental health services.

So, suppose you are struggling with an addiction and a coexisting mental health disorder. In that case, you might have complete coverage for things like therapy sessions and medication to manage your mental health disorder and partial coverage for your drug addiction.

Indah Recovery can help you check your Optum in-network rehab options today and provide dual diagnosis programs in Southern California. 

It is very likely, but your policy will provide Optum addiction treatment, at least partially. However, the type of health care plan, the rehab center you choose, and your location are all carefully considered when determining how much coverage you get for Optum addiction treatment.

Types of Optum Insurance Rehab Plans

Your rehab coverage is determined mainly by the state in which you live. Other services included in your plan may or may not extend to hospitalization for partial hospitalization rehab or pharmacy costs for drugs associated with your recovery or ongoing treatment.


Your state will dictate the plans available to you, like an HMO or PPO. Both kinds cover basic medical, dental, and vision care, but with an HMO, the out-of-pocket expenses you are required to pay for rehab are generally lower. With an HMO, you probably have no co-pay, or if you do, you have a minimal co-pay. 

However, you will also need a referral from your primary care physician for rehab, and you will have to use an Optum in-network rehab center. 


With a PPO, you typically have higher co-pays and higher out-of-pocket costs. However, you don’t need a referral from your primary care physician to go to rehab, and you can choose whichever provider you want regardless of whether they are an Optum in-network rehab facility. 

Medicaid and Medicare

Medicare and Medicaid options are offered through Optum for those over the age of 65. Under Medicaid, your rehab treatment services are likely covered, but it comes down to the state where you live. 

Inpatient Treatment

Optima insurance plans usually cover inpatient treatment where you have to remain full-time at a rehab facility. This process usually starts with detox. Detoxification programs often use medications to help manage your withdrawal symptoms. You are generally under the direct supervision of medical staff. Your detox might even take place in a hospital.

After that, your inpatient treatment provides you with 24-hour supervision while you reside at a rehab facility and undergo medical and behavioral care. The type of inpatient services you receive usually include individual and group therapy and possibly medication management.

Exactly how many therapy sessions, what types of medications, and which services are covered is based on your plan. This is why it’s important to reach out to Indah Recovery to verify your benefits.

Outpatient Treatment

Outpatient treatment usually takes place after detox and involves more individual and group therapy, sometimes including family therapy options. Depending on your plan, outpatient treatment might be covered to a certain extent.

Your plan will also dictate what you have to pay out-of-pocket in terms of a deductible before your insurance policy covers the remaining costs.

Medication-Assisted Treatment

Medication-assisted treatment and detoxification services might also be covered under your insurance policy. Some rehab facilities rely on medication-assisted treatment for opioid addiction or alcoholism. 

In these cases, you remain under direct supervision at a facility or hospital while being given FDA-approved medications. These help ease your withdrawal symptoms and make you more comfortable during detox.

Contact Indah Recovery for questions about your Optum insurance rehab in Orange County.

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What is an In-Network Rehab Center for Optum?

When comparing Orange County Optum insurance rehab centers, you should look for Optum in-network rehab. Optum in-network rehab means that the facility in question has already come to a pre-determined arrangement with Optum about the costs for Optum addiction treatment. 

So, if you are ready to get help, your insurance provider has an estimate for how much treatment costs. This helps them budget accordingly for your Optum insurance rehab in Orange County. 

If, on the other hand, you find a rehab center that is out of network, that might mean a location near you, but not with a pre-determined arrangement. In these cases, insurance providers like Optum are less likely to provide comprehensive coverage because they do not have an estimate for what your treatment will be. 

You are certainly allowed to use an out-of-network provider, but depending on your Optum insurance rehab treatment plan, your health insurance may or may not cover any of the services you receive. If they do, they will typically cover a much smaller percentage leaving you with higher out-of-pocket requirements. 

If you are ready to take the next step, let Indah Recovery start you on your rehab journey.