Optum Coverage for Addiction & Mental Health Treatment
Federal parity law requires Optum and most other plans to cover substance use and mental health treatment on par with medical care. Verify your specific benefits — free, confidential, in about 15 minutes.
About Optum Behavioral Health Coverage
Optum is the behavioral-health and pharmacy-benefits arm of UnitedHealth Group, the parent company of UnitedHealthcare (UHC). Optum administers behavioral-health benefits for most UHC commercial plans and many third-party employer-sponsored plans. If your insurance card lists Optum, Optum Behavioral Health, or United Behavioral Health as your mental-health and substance-use carrier, this page applies to you.
What Optum Typically Covers
Under the Mental Health Parity and Addiction Equity Act (MHPAEA) and the Affordable Care Act (ACA), Optum must cover substance use and mental health services at parity with medical/surgical benefits. Specific covered levels of care include:
Medical Detox
24/7 medical supervision during withdrawal. Typically 3-10 days, usually fully covered when medically necessary.
Inpatient Hospitalization
Acute psychiatric or medical stabilization in a hospital setting. Pre-authorization required.
Residential Treatment
24-hour clinical care at a non-hospital facility. Coverage varies; often requires step-down from inpatient or PHP.
Partial Hospitalization (PHP)
5-6 hours/day, 5 days/week. Step-down from residential. Generally well-covered.
Intensive Outpatient (IOP)
3 hours/day, 3-5 days/week. Highly covered across plans.
Standard Outpatient
1-2 sessions per week with a therapist or psychiatrist.
Medication-Assisted Treatment
FDA-approved medications for opioid and alcohol use disorder.
Telehealth Therapy
Virtual psychiatry and counseling, typically covered at in-person rates.
Optum Plan Types and Network
Optum maintains the largest behavioral-health network in the US, with more than 350,000 contracted clinicians and thousands of inpatient, residential, and outpatient facilities. Optum administers benefits under whichever underlying medical plan you have — typically UHC commercial or employer self-funded plans.
Pre-Authorization for Optum
Optum requires pre-authorization for all levels of care above standard outpatient. Optum uses the Optum Level of Care Guidelines and ASAM criteria for substance-use admissions. Authorization is requested by the facility utilization-review department; concurrent reviews continue throughout the stay.
Frequently Asked Questions
What is the difference between Optum and UnitedHealthcare?
UnitedHealthcare administers your medical/surgical benefits; Optum administers your behavioral-health (mental health and substance use) benefits for most UHC plans. They are sister companies under UnitedHealth Group.
My card says United Behavioral Health — is that Optum?
Yes. United Behavioral Health (UBH) was rebranded as Optum Behavioral Health several years ago. Coverage and network are essentially the same.
Does Optum cover residential addiction treatment?
Yes. Optum covers residential treatment when medically necessary under ASAM criteria and the Optum Level of Care Guidelines. Pre-authorization is required.
How do I verify Optum behavioral-health benefits?
Call the behavioral-health number on the back of your medical insurance card (it may differ from your medical-benefits number), or let us run a free verification for you.
Find Out What Your Optum Plan Covers
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