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Drug and Alcohol Rehab Covered by UMR

Medically Reviewed By:

Dr. Vahid Osmanm, M.D.

Board-Certified Psychiatrist and Addictionologist
Clinically Reviewed By:

Josh Sprung, L.C.S.W.

Board Certified Clinical Social Worker

Your Insurance May Cover The Cost Of Detox and Rehab

Complete a free, confidential Verification of Benefits to learn more about what resources may be available to you.

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UMR is the largest TPA, or third-party administrator, in America, with more than 3,800 benefits plans and 6 million members to date. It isn’t an insurance plan itself, but it is attached to United Healthcare Group as their TPA.

A TPA is a company that processes medical claims and provides administrative services to self-insured companies. UMR helps employers manage their employee benefits packages, including health insurance, dental, disability, and pharmacy benefits. UMR members also have access to online benefits plans, directories, tools, and resources. These help make understanding their UMR insurance coverage for drug and alcohol rehab easier.

In addition to providing administrative services, UMR also offers resources for members to better understand their benefits and access quality healthcare. This includes tools for finding in-network providers, cost estimators for medical procedures, and educational materials on managing chronic conditions.

UMR plays a big role at Tulip Hill Healthcare. Our KY and TN admissions teams accept UnitedHealthcare insurance for drug and alcohol rehab. We also work closely with UMR to verify coverage and help individuals navigate the insurance process. If you’re a UMR member looking to start the process of healing from addiction, we’re here to help. This guide will walk you through the steps of using your UMR insurance to cover drug and alcohol rehab offered by Tulip Hill Healthcare.

Will UMR Cover Addiction Rehab?

UMR partners with several insurance providers with addiction coverage, including UHC. The good news is that UMR can help make the process of using your UHC insurance coverage for drug and alcohol rehab easier to understand and use.

In short, UMR does cover the cost of addiction treatment in TN and KY. That’s because as a partner of the nation’s largest health insurance provider, UHC, it is required to provide coverage for mental and behavioral health services. This is because the Affordable Care Act (ACA) mandates that all health insurance providers offer coverage for mental health and substance abuse treatment at the same level as physical health services.

UMR’s coverage for addiction treatment may vary depending on your specific plan. For example, some plans may require preauthorization or have limitations on the number of days covered for residential rehab programs. It’s important to reach out to UMR directly or speak with a representative from a treatment center to understand the details of your coverage.

UHC covers a wide range of addiction treatment options at Tulip Hill Healthcare, including our inpatient rehabilitation programs, outpatient programs, detoxification services, medication-assisted treatment (MAT), and more. Whether you need treatment for alcohol or substance use disorder, UMR can help you understand your insurance and simplify the process of using your benefits to cover the cost of your recovery.

How to Use Your UMR Insurance for Addiction Rehab

Using your UMR insurance to cover addiction rehab at Tulip Hill Healthcare is a straightforward process. Here’s how it works:

Verification of Benefits:

The first step is to verify your insurance benefits with both UMR and UHC. To do this, you’ll want to contact UHC’s customer service or reach out to UMR directly, since this TPA helps simplify the process of understanding your benefits. Their online portal helps you find forms, search for providers, and get access to tools and resources that can help you sign up for drug and alcohol rehab in TN.

Look for a provider:

If you’re already familiar with your coverage, you can start looking for a behavioral health provider using UHC’s online directory. Using the search feature, you can filter by location, type of provider, and other criteria to find a list of in-network providers near you.

Review your coverage:

Before signing up for drug and alcohol rehab in TN, it’s important to review your coverage with UHC. This will help you understand what services are covered under your plan and any potential out-of-pocket costs you may incur.

Get pre-authorization:

Some treatment programs may require pre-authorization from UHC before beginning treatment. This means that the insurance company needs to verify that the recommended treatment is medically necessary and covered under your plan.

Reach out to Tulip Hill Healthcare:

If you’re still unsure about your coverage or need assistance navigating the process, reach out to us at Tulip Hill Healthcare. Our team can help you understand your insurance benefits and work with UHC and UMR to get pre-authorization for treatment, help you understand out-of-pocket costs, or understand your payment options.

Maximizing Your Chances for Long-Term Recovery with UMR and Tulip Hill Healthcare

Achieving lasting recovery from SUD requires more than just medical treatment – it involves ongoing support, counseling, and lifestyle changes. With UMR insurance covering a wide range of services, Tulip Hill Healthcare offers everything you need to build a strong foundation for long-term sobriety.

Drug and Alcohol Rehab Services Covered by UMR

As one of the nation’s largest health insurance companies, UnitedHealthcare (UHC) and its subsidiary United Medical Resources (UMR) provide coverage for a wide range of healthcare services, including drug and alcohol rehab. Understanding what services are part of UMR’s extensive network and what costs are covered can help you or your loved ones get the treatment needed to overcome addiction.

Here’s a look at some of the many levels of care for addiction treatment in TN and KY that UMR’s network covers.

Comprehensive Detox

3 to 10 Days

The recovery process often begins with detoxification, which is a process designed to help your body rid itself of harmful substances. This is a vital first step, because your mind cannot receive the lessons of recovery until free from the compulsion to drink and use. 

At Tulip Hill Healthcare, we offer safe, effective detox programs tailored to your needs:

  • Medically-supervised detox offers 24-hour, around-the-clock clinical supervision by a team of doctors, nurses, and addiction specialists. If appropriate, medications can be administered to alleviate withdrawal symptoms.
  • Nonmedical detox utilizes both counseling and adopting lifestyle changes as preparation for an ongoing treatment program.

Residential Drug and Alcohol Treatment

30 Days
Best for someone who:
  • Is battling a moderate-to-severe addiction
  • Has a long history of drug or alcohol abuse
  • Is unable to quit on their own, even after several attempts
  • Has failed to complete a previous treatment program
  • Has relapsed multiple times
  • Has ever overdosed
  • Is a danger to themself or others
  • Does not have a stable, supportive, and sober home life

During residential drug/alcohol treatment, you receive services in a live-in setting, away from the challenges and temptations that could hinder your recovery. Services include counseling, medication management, group therapy, holistic care, life skills training, and 24/7 medical supervision.

After establishing a firm foundation upon which to build a sober, healthier, and happier life, most people who complete treatment at a residential facility continue their recovery journey by enrolling in an appropriate outpatient rehab program.

Partial Hospitalization Program (PHP)

30 Days

Best for: Individuals finishing inpatient rehab or who need a high level of structured support without needing round-the-clock monitoring.

  • 5–7 weekly sessions, 6–8 hours per session
  • Intensive individual counseling and peer group therapy
  • Medication support
  • Mental health treatment

UMR insurance coverage for drug and alcohol rehab also extends to inpatient programs that utilize PHP (Partial Hospitalization Program) services. This level of care is typically recommended for individuals who have completed residential treatment and are transitioning back into their everyday lives.

PHP offers a structured schedule of daily therapy sessions, group support, and medical monitoring, but allows participants to return home at night instead of staying on-site. This can be beneficial for those who need the flexibility to manage work or family responsibilities while still receiving intensive treatment.

If you are struggling every day to get or stay clean and sober, but you do not need round-the-clock, 24/7 supervision, then a PHP at a Tulip Hill Healthcare facility is the best drug rehab option for your needs.

A Tulip Hill Healthcare PHP is also the right choice if you have recently completed residential treatment and need continued services and support.

Intensive Outpatient Program (IOP)

1 to 2 Months

Best for: Anyone who still needs significant support during early recovery, but who also needs flexible drug rehab options. This is a step down from partial hospitalization – it offers the same services, treatments, and therapies, but there are fewer weekly sessions. 

IOP makes it much easier for you to go to work, attend school, spend time with your loved one, and fulfill other obligations

  • 3 to 5 days per week, 3 hours per session
  • Next step for anyone completing PHP
  • Focuses on coping skills, relapse prevention and response, and post-treatment aftercare planning

A step down from PHP is Intensive Outpatient Program (IOP). This level of care still provides a structured treatment schedule, but with fewer hours per week compared to PHP. IOP is often recommended for individuals who have completed residential or PHP treatment and are ready to continue their recovery journey while incorporating more independence.

Participants in IOP attend therapy sessions a few times a week, typically for half-day sessions. This allows them to maintain their daily responsibilities outside of treatment while still receiving support and guidance from their treatment team. IOP may also offer group therapy sessions and access to additional resources such as education on relapse prevention techniques.

If you are newly sober and need extra support without daily supervision, or if you need a flexible treatment option that lets you hold a job, then a Tulip Hill Healthcare IOP is your best path to recovery.

Outpatient Drug and Alcohol Rehab Ongoing as Needed

Best for: Anyone who needs support as they prepare to leave treatment soon. OP rehab gives you the tools, skills, and resources to build and maintain a happy, healthy life free of alcohol and drugs.

  • Individual counseling
  • Group and family therapy
  • Preventing and responding to relapse
  • Peer support
  • Local resources

Outpatient drug treatment at Tulip Hill Healthcare is the least-intensive level of care, typically meeting only one or two times a week and continuing until you leave structured rehab services.

If you are nearly ready to transition to living a life of recovery on your own, but want to continue practicing the skills you have acquired, Tulip Hill Healthcare offers the top outpatient drug rehab programs in Kentucky and Tennessee.


Dual Diagnosis Treatment

Many individuals with substance use disorder also struggle with underlying mental health issues, such as anxiety, depression, or PTSD. These conditions often complicate the recovery process, making it necessary to address both issues simultaneously.

At Tulip Hill Healthcare, we offer dual diagnosis treatment to help clients address all aspects of their well-being. This holistic approach to treatment helps to provide the best chance for long-term sobriety.

Because it is the best way to meet all of your recovery needs, all of our facilities provide services for co-occurring disorders as a standard treatment.


Medication-Assisted Treatment (MAT)

Mental health experts call the combination of anti-addiction medications and psychotherapy the “gold standard” of substance abuse treatment.

How big is the problem locally, within our own communities?

In 2023, overdoses killed over 3600 Tennesseans – 75% of those deaths involved fentanyl, the powerful opioid called the “deadliest drug in America”. That same year, overdoses claimed the lives of nearly 2000 Kentuckians – almost 80% involved fentanyl.

The Substance Abuse and Mental Health Services Administration says that MAT cuts drug deaths by at least 25%. That’s a lot of lives that could be saved by timely treatment.

MAT combines behavioral treatment with anti-addiction medications. It’s effective because the medications diminish cravings that drive compulsive use and that trigger relapses.

If you find it hard to stay sober on your own, Tulip Hill Healthcare’s UMR-approved Medication-Assisted Treatment in Tennessee and Kentucky is the proven resource you need that just may save your life.

Holistic and Therapeutic Support

In addition to traditional therapies like individual counseling and group therapy, Tulip Hill Healthcare incorporates a range of holistic therapies designed to address the mind, body, and spirit. These include mindfulness practices, nutrition counseling, art therapy, and more. These holistic methods, combined with traditional approaches, help to support overall healing and well-being.

UMR’s coverage for behavioral health services includes not only medical treatments but also access to these essential therapeutic practices that can provide long-term healing and stability.

Ongoing Aftercare and Alumni Support

Recovery does not end when you leave the treatment facility. At Tulip Hill Healthcare, we understand that maintaining sobriety after treatment can be challenging. That’s why we offer comprehensive aftercare services, including case management, therapy sessions, and alumni programs that connect you with ongoing support from peers and counselors who understand the challenges of staying sober.

UMR’s coverage for aftercare services ensures that you have access to the resources you need to maintain your recovery. Whether it’s continuing therapy or participating in recovery support groups, you’ll have the support you need to stay sober and build a fulfilling life.

Using Your UMR Insurance for Drug and Alcohol Rehab

If you see the UMR or PHCS logo on your insurance card, you may have access to UMR’s network of healthcare providers, including addiction treatment centers. To confirm your benefits and understand your coverage for drug and alcohol rehab:

✅ Call the customer service number on the back of your UMR insurance card. A representative can explain your plan details, including in-network providers and out-of-pocket costs for treatment.

✅ Check UMR’s online provider directory to search for in-network facilities and verify that Tulip Hill Healthcare is included in your plan.

For questions about PHCS’s network specifically, you can also reach out to:

  • PHCS Network – 1-800-922-4362
  • PHCS Healthy Directions – 1-800-678-7427

By using an in-network provider like Tulip Hill Healthcare, you can take advantage of lower costs and comprehensive coverage for addiction treatment.

Check With Your Insurance Provider Directly

If you find that your UMR insurance plan offers limited or no coverage for drug and alcohol rehab, it’s a good idea to contact UMR directly. Their representatives can provide detailed information about your specific plan and help you identify additional resources or options that may not be immediately visible in your benefits summary.

Out-of-pocket costs, prior authorizations, and even telehealth or virtual therapy options may be available under your UMR plan. In some cases, UMR also partners with specific rehabilitation centers that offer discounted rates or enhanced coverage for members.

By reaching out to UMR’s customer service team or using their online tools, you can get a clear understanding of your benefits and explore all possible treatment options—including care at in-network facilities like Tulip Hill Healthcare.

  • Insurance Verification
    Complete a free, confidential Verification of Benefits to learn more about what resources may be available to you.

    We strive to make high-quality treatment accessible. Tulip Hill Healthcare accepts most PPO/EPO employer-sponsored insurance plans. Our admissions team can provide a free, confidential verification of your benefits.

Take the First Step Toward Recovery Today

If you or a loved one is struggling with addiction, help is available. UMR insurance can help make the recovery process more affordable and accessible, and Tulip Hill Healthcare is here to guide you every step of the way. To learn more about how UMR can help you access addiction treatment at any Tulip Hill Healthcare facility in Kentucky or Tennessee, please reach out to us today. Disclaimer: Insurance coverage varies based on individual plans. Please verify your benefits with UMR directly or contact our admissions team for assistance.

FAQ

What types of addiction treatment does UMR cover?

UMR works with many insurance providers with addiction coverage, meaning you’ll need to check with your specific employer or benefits package to determine what addiction treatment services are covered. However, most insurance providers will cover medical detox, inpatient treatment, partial hospitalization programs (PHP), intensive outpatient programs (IOP), and outpatient treatment.

Does UMR cover inpatient vs. outpatient rehab?

Your UMR insurance coverage for drug and alcohol rehab may include both inpatient and outpatient treatment. Inpatient rehab typically involves staying at a facility for a set period of time, while outpatient treatment involves attending sessions and receiving support without living at the facility. Some UMR networks may include both types of treatment, while others may only cover one or the other. It’s important to check with your specific plan to determine what type of addiction treatment services are covered.

How do I verify UMR insurance benefits?

UMR isn’t an insurance carrier, but rather a third-party administrator that manages health plans for employers and individuals, mainly UHC. Contact UHC or your insurance or other Insurance providers with addiction coverage to determine your benefits.

Does my insurance cover out-of-network drug rehab?

If your insurance is partnered with UMR, chances are you have access to a wide range of in-network providers for addiction treatment services. However, if you prefer an out-of-network facility or the in-network providers are not able to accommodate your specific needs, it’s important to verify your insurance coverage before starting treatment.

To do so, reach out to UMR or your insurance provider and ask about their out-of-network coverage for drug rehab. This may include questions about deductibles, coinsurance, and any pre-authorization requirements. Some plans may have limited coverage for out-of-network services, while others may cover a portion of the costs or require a higher co-pay.

How much does out-of-network rehab cost?

If you’re planning on paying for Substance abuse treatment without insurance, be aware that out-of-network rehab services can be quite expensive. The exact cost will depend on the type of treatment, length of stay, and location. In general, luxury addiction facilities and specialized programs tend to have higher costs, ranging in the thousands of dollars per month. Call different treatment centers to get a better understanding of the costs involved and how they compare.

Which rehab centers accept out-of-network insurance?

Every drug and alcohol rehab is different, and not all will have the same payment options. Some will only accept certain insurance plans, while others may not accept any at all. Others might allow you to enroll by creating a payment plan. Again, you’ll need to do your research and contact individual treatment centers to find out their insurance policies.

Can I go to rehab if my insurance is out of network?

For those who have out-of-network insurance, it’s important to inquire about coverage at different treatment centers. Many rehab facilities may accept out-of-network insurance, but the amount of coverage may vary depending on the specific plan. It’s also important to note that with out-of-network insurance, you may be responsible for paying a portion of the costs through deductibles or coinsurance payments.

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