UnitedHealth Group, the parent company of UnitedHealthcare, is one of the 10 largest companies in the world and the largest health care insurance provider in the United States. If you’re one of the millions covered by this company’s policies, understanding UnitedHealthcare mental health coverage is essential to seeking quality care for you and your family.
Does UnitedHealthcare Cover Mental Health Care?
According to its 2023 results report, UnitedHealthcare pays claims on average within 48 days. You might wonder if that includes UnitedHealthcare therapy coverage and other mental health care benefits. In most cases, it does.
The Affordable Care Act actually requires health insurance policies in the marketplace to include behavioral health care coverage. The rule is basically that insurance companies must include this type of coverage and have a benefits policy that aligns with the level of coverage provided for physical health care. For instance, an insurance policy can’t provide therapy benefits but then ration that coverage in a way that’s substantially different from how coverage for doctor’s visits is handled.
To understand whether your UHC insurance plan covers mental health care and to what degree, you can check your benefits. Your plan administrator may have provided a benefits document — either in hard copy or digitally — that details your coverage. You might also be able to sign up for an online insurance portal with UHC and check your benefits there.
Using UnitedHealthcare Services to Find Health Care
If you have UHC and want to find options for covered UnitedHealthcare behavioral health services in your area, you can also turn to your benefits documents. If you were provided with a booklet listing in-network providers, start there.
UnitedHealthcare also provides an online customer portal. You may need to register for this service — many times, your insurance card comes with a removable sticker with instructions for signing up for portal access. Once you sign up, you may be able to review benefits, search the provider database and check claims status online.
When you search for mental health care providers via UHC tools, whether you’re looking for a psychiatrist, a therapist or an addiction recovery facility, pay attention to network designations. UHC typically covers a higher percentage of costs when you use in-network providers; if you opt for an out-of-network provider, your out-of-pocket costs may be higher.
How Mental Health Care Providers Check Your Insurance Coverage
Sorting through provider databases or benefits documents when you’re in the middle of a crisis isn’t always practical. If you feel overwhelmed by documents and decision-making, it may be best to take a further step toward help. You can contact a potential mental health provider for assistance, and they can verify your insurance so you understand if their services might be covered.
Verifying Benefits and Network Status
During the insurance verification process, a provider:
- Requests a copy of your insurance card. If you don’t have the card or it’s not practical to provide a copy, they may ask for information such as the name of the insurance, your group and member ID numbers and the phone number for your plan.
- Verifies you have coverage. Providers check that your coverage is in effect and hasn’t lapsed.
- Checks their network status. Providers find out if they’re in network with your plan. If they aren’t, it can have an impact on covered services and out-of-pocket expenses.
- Determines deductible and co-pay amounts. This knowledge helps providers ensure you understand the potential costs of care and can plan proactively.
Understanding Deductible Amounts
Providers will find out your deductible amount and whether it applies to mental health care coverage. They might also be able to find out how much of your deductible you’ve already met. Typically, you must meet your deductible before insurance will begin to pay your claims.
For example, if your deductible is $6,000 per calendar year and you’ve already had $3,000 in medical expenses during the year, you’d be responsible for the first $3,000 in mental health care expenses before insurance started to pay.
Checking Your Co-Pays
Depending on your plan, even after you meet your deductible, you might have to pay for some portion of treatment due to co-pay and coinsurance policies. For example, if your co-pay amount is 20% of services after meeting your deductible and you incur $2,000 in mental health care costs after that point, you might owe $400.
However, most UHC plans have an out-of-pocket maximum. This is the maximum amount you pay for covered physical and mental health care costs during each year. If you meet that amount, you would not owe any additional co-pay or coinsurance amounts that year for covered services.
Find Mental Health Care Resources Near You
As a UHC policyholder, you have numerous options for finding mental health care resources near you. You can check your benefits documents or use the online portal to search for providers in your network. You can reach out to mental health facilities in your area to find out about services and have them verify your insurance coverage.
You can also contact the Mental Health Hotline. Our free, confidential service connects you with a compassionate specialist who can help you locate relevant mental health resources in your area. Call us 24-7 to get assistance locating the resources you need.
