Does united healthcare pay for therapy
Yes, United Healthcare (UHC) insurance may cover testing, therapy, and treatments depending on your insurance plan’s benefits and individual needs.
How to Verify United Healthcare Mental Health Benefits
Athena Care is in-network with most major insurance plans. The quickest and easiest way to find out if United Healthcare benefits cover your mental and behavioral health services is to fill in our free and confidential online insurance verification form.
Avoid the hassles, confusion, and wait times that come with contacting your insurance provider for health insurance coverage information and let us do it for you. We have years of experience working with insurance providers in the mental and behavioral health space. All information provided or discussed is kept confidential. After filling out the form, a care coordinator will go over your policy and thoroughly explain your options.
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Which Mental Health Services Are Covered by United Healthcare?
UHC mental health coverage encompasses a variety of programs and resources for mental and behavioral health. The following is a partial list of services that your United Healthcare mental health benefits may cover:
- Mental Health Testing, Assessments & Evaluations
- ADHD Testing & Treatment
- Dialectical Behavioral Therapy
- Cognitive Behavioral Therapy
- Emotional Support by Phone or Mobile App
- Family Counseling
- Medical Management Services & Medications
- Virtual Visits
Which Mental Health Disorders Are Covered by United Healthcare?
Mental and behavioral health conditions that your United Healthcare mental health coverage may cover include:
- Autism Spectrum Disorder
- Peripartum Depression3
- Substance Use Disorders
How To Find Mental Health Services Near Me in Tennessee
Finding mental health services near you in Tennessee has never been easier with Athena Care. A care coordinator at one of our various Tennessee locations, is there to help.
Consider the following factors when selecting a mental healthcare provider:
- Education, training, license, and years of experience
- Specialties and services offered
- Treatment methods and philosophies
- Which insurance companies they work with, as well as their office hours, prices, and session length
Furthermore, don’t hesitate to ask lots of questions.
Athena Care mental health clinics are open Monday – Friday, 7:00 a.m. to 6:00 p.m. You’ll find a list of practitioners by city, along with their background and specialties here.
About United Healthcare Plans & Behavioral Health Coverage
Founded in 1977, United Healthcare has since grown by providing a complete range of consumer-oriented health benefit plans and services to more than 26.5 million clients nationwide. This includes United Healthcare behavioral health coverage, which encompasses mental health and substance abuse therapy, emphasizing a person’s actions and habits.
As of 2021, statistics state that you’ll have access to an extensive provider network with over 1.44 million physicians and care staff, as well as 6,500 hospitals and care facilities around the country5.
A division of UnitedHealth Group, the largest single carrier in the United States6, United Healthcare offers a variety of plans in Tennessee7 which include individual and family plans, employee plans, as well as government and state funded options as well. United Healthcare offers several types of insurance:
- Medicaid: a federal and state-funded program that assists persons with low income and resources with healthcare costs. Medicaid also provides services not covered by Medicare, such as nursing home care and personal care.
- Medicare: a health insurance program in the United States for adults over 65 and those receiving Social Security disability benefits.
- Short-Term Health Insurance: A temporary medical insurance plan8 that provides the flexibility you need for life’s transitions. You can choose your length of coverage (up to 12 months in Tennessee). United Healthcare offers multiple short-term insurance plans, including:
- Basic: A just-in-case plan with max out-of-pocket costs of $10,000.
- Budget Benefits: Budget focused with discount prescription cards and discounts on large single payments
- Prescription Plus: $50 co-pay visits
- Balanced Cost & Coverage: Pay 20% of most covered costs after deductible
- Urgent Care & More: Pay $0 for a majority of covered expenses after deductible, urgent care visits are $50 co-pay, and some prescriptions cost $25
- Preventative Care & More: A predetermined amount of $50 co-pay visits to the doctor’s office, $50 co-pay urgent care visits, and some prescriptions cost $25
- TriTerm Medical Insurance: Preventive care, doctor visits, and medications are all covered by this short-term health insurance that covers you up to almost 36 months. There are four different plans to choose from with varying deductibles:
- Co-Pay Select: 30% is what you pay after deductible
- Plan 80: 20% is what you pay after deductible
- Plan 100: 0% is what you pay after deductible
- Value: 30 – 50% is what you pay after deductible
- Health ProtectorGuard Fixed Indemnity Insurance: With increasing benefits over time, you’ll pay cash for qualifying, covered medical services. There are no deductibles or co-pays, and benefits are paid regardless of whether or not you have other insurance. There are three different levels of coverage in addition to a select, preferred, or premier plan
Does United Healthcare Cover Online Therapy?
Several online therapy programs are offered, including Telehealth Therapy and Talkspace.
The specifics of your United Healthcare mental health benefits will determine the extent of your coverage.
How Much Do Mental Health Services & Testing Cost?
Costs can vary depending on your specific United Healthcare mental health coverage and personalized treatment needs. The following are average costs for therapy, though they may vary by location and other variables and may not reflect the actual cost of treatment or what you may actually pay.
For example, In the United States, the typical cost of psychotherapy ranges from $100 to $2009 a session, dependent upon the state and the length of the session. With health insurance, you’ll most likely have a co-pay that can range from a few dollars to $50 or more a session.
Cognitive Behavioral Therapy (CBT) sessions are typically 45+ minutes long and cost between $100 and $200 per session, while Dialectical Behavioral Therapy (DBT) usually consists of a weekly individual therapy session, a weekly group therapy session, and weekly phone conversations. DBT costs vary depending on the type of services rendered.
Such factors, like whether the therapist is in-network or out of network, can influence this out-of-pocket cost.
Even with insurance, you will normally have to pay some or all of your medical expenditures until your total medical expenses for the year reach the deductible. Depending on your plan, you may be required to pay a co-pay or coinsurance for each treatment.
Some therapists will work with patients on a sliding scale for those who do not present insurance. If you find a therapist who offers a sliding scale payment plan, they will most likely base the cost of your sessions on your income. This sliding scale can also vary from therapist to therapist.
Do I Need a Referral To Use My United Healthcare Coverage?
No, you do not need a referral with United Healthcare insurance for outpatient mental health services.
- “Behavioral Health Resources.” United Healthcare, 2022, https://www.uhcprovider.com/en/resource-library/behavioral-health-resources.html
- “Understanding Mental Health.” United Healthcare Services, Inc., 2022, https://www.uhc.com/health-and-wellness/mental-health
- “Get Maternity Support, 24/7.” United Healthcare Services, Inc., 2022, https://www.uhc.com/health-and-wellness/health-topics/pregnancy/maternity-support
- “Health ProtectorGuard.” United Healthcare Services, Inc., 2021, https://www.uhone.com/api/supplysystem/?FileName=46034B-G202108.pdf
- “Find United Healthcare doctors and providers.” United Healthcare Services, Inc., 2022, https://www.uhc.com/find-a-doctor.
- “Largest Health Insurance Companies of 2022.” ValuePenguin, 2022. https://www.valuepenguin.com/largest-health-insurance-companies
- “Tennessee Health Insurance Options.” United Healthcare Services, Inc., 2022, https://www.uhc.com/health-insurance-plans/tennessee
- “Let’s find the right short-term health insurance plan for you.” United Healthcare Services, Inc., 2021, https://www.uhone.com/health-insurance/short-term-health-insurance
- Lauretta, Ashley. “How Much Does Therapy Cost?” edited by Alena Hall, Forbes Health, 2021, https://www.forbes.com/health/mind/how-much-does-therapy-cost/
One of our friendly associates will help you get the help you need. Take this first step to feel better and take control.
United is one of the largest health insurance companies in the world (and the biggest by revenue). United coverage includes mental health, behavioral health, and therapy services. This guide outlines the coverage that United typically provides for therapy services.
Does United Behavioral Health cover therapy?
Yes, nearly all United Behavioral Health plans cover therapy for mental and behavioral health conditions.
Health insurances offered through the health insurance Marketplace or through small employers are required by the Affordable Care Act to cover mental health services. While not required by federal law, the vast majority of large employers also cover mental health services.
While rare, your United plan may not cover therapy services if:
- You work for a large employer that does not include mental health benefits in its insurance coverage.
- Your health insurance plan was created before 2014, when the ACA’s requirement that health insurance plans cover mental health services was enacted.There are other situations in which your United plan may not cover the specific type of therapy service you are seeking, or where your coverage may not apply until you spend a certain amount on medical services first. Learn more about these cases below.
How do I check if my United plan covers therapy?
To check whether your United plan covers therapy, look for the “Outpatient Mental Health” line item on your Summary of Benefits.
Therapy is considered a type of outpatient mental health service. You can find your Summary of Benefits by logging into your United Member Services portal (called “myUnited”), calling member services, or checking your employer’s benefits portal.
Here is an example of what your United Summary of Benefits may look like, and where to find the Outpatient Mental Health line item:
If the Outpatient Mental Health line item indicates that these services are not covered, then your health insurance plan does not cover therapy services.
If you cannot find coverage information for Outpatient Mental Health, you can contact United for assistance. If you receive health insurance through your employer, reach out to your employer’s human resources department.
While your United plan likely covers therapy, the extent of coverage and requirements for coverage depend on your particular plan. Read on to learn more.
How much does therapy cost with an United Behavioral Health plan?
The cost of therapy sessions with United depends on your plan’s coverage: in the best case scenario, your therapy sessions may be fully covered, meaning you don’t pay anything at the time of session; most likely, the cost ranges from $15 to $50 per session. In the worst case scenario, you need to pay the full fee that the therapist charges at the time of the session, which generally ranges from $80 – $200 per session. Find the scenario that applies to you below:
If you choose a therapist who is in-network with United, your therapy sessions likely cost between $15 – $50 per session, after you meet your deductible. The $15 – $50 amount is your copay, or the fixed amount that you owe at each therapy visit. The deductible is the total amount you need to spend in medical costs in any given year before your health insurance begins to cover the cost of services. Here are examples you may see on your Summary of Benefits under the “In-network Outpatient Mental Health” category and what they mean:
- $15 copay, after $5,000 deductible → After you spend $5,000 in medical costs this year, your therapy sessions will cost $15 per session.
- $15 copay, after $1,000 deductible → After you spend $1,000 in medical costs this year, your therapy sessions will cost $15 per session.
- $15 copay, deductible does not apply → Your therapy sessions will cost $15 per session regardless of your deductible amount (ie. even if this is your first medical visit of the year, you will only pay $15 at the time of your therapy session).
If you choose a therapist who is not in-network with United and you have a United PPO Plan, your therapy session will likely cost between $50 – $100 per session, or 20% – 50% of the full amount that your therapist charges per session. This percentage is called a coinsurance: you pay the therapist’s full fee at the time of the session, send a claim to your health insurance company, and receive a check or direct deposit for the remaining percentage that your plan covers. PPO plans typically only cover out-of-network services after you meet your deductible. Here are examples you may see on your Summary of Benefits under the “Out-of-Network Outpatient Mental Health” category and what they mean:
- 20% coinsurance, after $5,000 deductible, therapist charges $100/session → After you spend $5,000 in medical costs this year, your plan will reimburse you $80 of your therapy session fee; your effective therapy cost is $20/session.
- 20% coinsurance, after $1,000 deductible, therapist charges $150/session → After you spend $1,000 in medical costs this year, your plan will reimburse you $120 of your therapy fee each time you submit a claim; your effective therapy cost is $24/session.
If you choose a therapist who is not in-network with United and you have a United HMO or EPO Plan, your plan will likely not reimburse you for sessions with a therapist who is not in-network with United. You would owe the therapist’s full fee at the time of session and not receive reimbursement from your plan. If cost is a barrier to seeking therapy, you can look for a therapist who offers a sliding scale, or lower session fees based on financial need.
What types of therapy does United cover?
The modalities that United Behavioral Health covers may include, but are not limited to, the following:
Any therapy type that is evidence-based and utilized for the purposes of diagnosis and treatment of mental health conditions should be covered by United plans.
What kinds of therapy does United not cover?
Like most insurances, it is not typical for United to cover services unrelated to a diagnosable mental health condition, such as:
- Couples counseling – Couples counseling is typically not covered by insurance, because relationship issues, while a significant source of stress, are not considered a diagnosable mental health condition.
- Life coaching – Life coaching is not covered by insurance because it focuses on achieving personal goals, rather than treating a diagnosable mental health condition.
- Career coaching – Career coaching is not covered by insurance because it focuses on achieving professional goals, rather than treating a diagnosable mental health condition.
United is also unlikely to cover therapy sessions occurring outside the therapy office, because of the greater potential for risk involved.
While clients may sometimes benefit from services rendered outside of the therapy office, such as a client with an eating disorder needing support in the grocery store, or a client with a phobia of driving needing support in the car, these services are not likely to be covered by insurance and must be paid for out-of-pocket.
Does United Behavioral Health cover couples therapy?
No. While it depends on your specific plan, it is unlikely that United will cover couples counseling.
That said, even if your insurance doesn’t directly cover it, you still have options for getting affordable couples counseling. Here are five ways to pay for couples counseling if it’s not included in your health insurance plan.
Do I need to see my doctor before visiting an United therapist?
If you need to see your primary care doctor before visiting a United therapist depends on your insurance plan type:
- HMO or POS plan: Yes, you are typically required to see your primary care physician for a referral to therapy before United will pay for services
- PPO or EPO plan: No, you typically don’t need to see your primary care physician for a referral to therapy before United will pay for services.
This referral requirement is also called pre-authorization (or prior authorization). Pre-authorization is a process where a health provider, in this case your therapist, must get approval from your insurance company before providing you with care in order for the services to be covered.
Your Summary of Benefits should indicate whether you need pre-authorization for outpatient mental health services.
Does United Behavioral Health cover online therapy?
Yes, United does usually cover video therapy sessions, which you can use in place of an in-person visit to your therapist’s office.
Video sessions are also an option for managing medications without an office visit.