Does UMR Cover Partial Hospitalization Programs for Addiction and Mental Health?

Written by Zainab Iqbal | Reviewer: Jessica Plonchak | Date: 19-03-2026

Does UMR Cover PHP?

Yes, UMR may cover partial hospitalization programs for addiction and mental health when deemed medically necessary. The exact benefits vary based on specific insurance plan and network status, but may typically include a range of medical services to support proper recovery.

ChoicePoint accepts UMR coverage for alcohol and drug rehab, offering:

✓Nationwide admissions
to the PHP program
✓Same-day insurance
verification
✓Compassionate care
without judgement

What are the UMR PHP Program Benefits?

PHP is a structured yet flexible program designed to provide intensive care without 24/7 supervision. It combines the features of both inpatient and outpatient treatment programs to treat moderate to severe addiction, without necessarily committing to full-time residential rehab.

Opting for PHP rehab for alcohol and drug addiction enables you to access the following benefits:

Significantly reduced treatment costs for eligible members.
Access to intensive care paired with compassionate support.
Professional relapse prevention counselling to support long-term abstinence.
Flexibility to return home after treatment.
Aftercare services for life-long sobriety.
Medication-Assisted Treatment for risky withdrawals.
Behavioral therapies to reframe cognitive thought patterns.
Dual Diagnosis care for co-occurring mental health disorders.

Besides the UMR PHP program benefits listed above, individuals also benefit from a structured treatment routine. PHP lasts several weeks, including four to five sessions a week at the facility for up to six hours a day.

What Substance Addictions does UMR cover for PHP?

UMR may typically cover a vast range of substance addictions for PHP treatment, including:

Take ChoicePoint’s free addiction treatment evaluation to take the first step towards lifelong sobriety with our PHP addiction treatment.

Does UMR Cover Partial Hospitalization Treatment for Co-Occurring Mental Health Disorders?

Research shows a positive relationship between addiction and mental health disorders, with addiction worsening mental health and vice versa. Both may continue to affect each other and complicate recovery without timely intervention.

UMR is required by law to ensure that benefits include care for mental health at par with physical care. Hence, UMR may also cover PHP for co-occurring mental health disorders, including:

Factors Affecting UMR Partial Hospitalization Program Coverage

UMR Partial Hospitalization Program coverage varies based on your specific plan. However, besides that, other factors may affect how much UMR covers for PHP treatment, such as:

Factor	How it Affects Coverage
Medical Necessity	A licensed medical professional must recommend PHP as the appropriate level of care for you to qualify for coverage.
Prior Authorization	PHP programs typically require prior authorization before treatment begins.
Specific Insurance Plan	Your exact benefits, including services, out-of-pocket expenses, treatment facilities, and referrals, depend on your specific insurance plan.
Network Status	In-network and out-of-network partners generally have varying levels of copays, deductibles, and out-of-pocket expenses.
Length of Treatment	UMR may cover a specific length of treatment initially, which may be later extended after clinical review.

Our team understands that each substance affects the brain and body differently. That is why we create an IOP plan tailored to individual needs so patients can achieve optimal outcomes.

We Accept

Insurance Plan

ChoicePoint collaborates with UMR Insurance to review your coverage. We go over your plan details and explain the expected costs, so you understand exactly which services are included

Does UMR Cover PHP Costs Entirely?

While UMR helps relieve your financial burden by covering a major portion of the PHP treatment cost, you may still be liable for certain out-of-pocket expenses:

Costs	Descriptions
Deductible	The amount you pay out-of-pocket before insurance starts covering costs.
Copayment	A fixed fee you pay for each visit or service, regardless of total cost.
Coinsurance	Your percentage share of costs after meeting your deductible.
Out-of-pocket Maximum	The most you'll ever pay in a year; insurance covers 100% after this.
Network Status	Whether your provider is in-network (lower cost) or out-of-network (higher cost) with your insurer.

What Does UMR Partial Hospitalization Program Coverage Include at ChoicePoint?

At ChoicePoint, we are committed to providing the best quality care to help you recover and lead a healthier life. Our DEA-certified addiction experts conduct elaborate drug and alcohol evaluations to understand your recovery needs.

UMR Partial Hospitalization Program coverage at ChoicePoint may include the following:

Services	Drug/Substance Addiction	Alcohol Addiction
Psychiatric Evaluation	✅	✅
Medication-Assisted Treatment Drug/Substance: Buprenorphine, Suboxone, Subutex Alcohol: naltrexone, acamprosate, disulfiram	✅	✅
Dual Diagnosis Care	✅	✅
Individual Therapy	✅	✅
Group Therapy	✅	✅
CBT Therapy	✅	✅
DBT Therapy	✅	✅
EMDR Therapy	✅	✅
Relapse Prevention Support	✅	✅
Aftercare Support	✅	✅
Inclusive Programs LGBT addiction treatment program Expecting mothers’ addiction treatment program Student addiction treatment program Veterans addiction treatment program	✅	✅

How to Verify Your Health Net IOP Benefits at ChoicePoint

Before starting any treatment, it is important to confirm exactly what your Health Net plan covers. Here are three simple steps to verify your insurance at ChoicePoint.

Step 1: Verify Insurance Online

Visit the website and navigate to Admissions > “verify your insurance” through ChoicePoint or call us at 844-44-2565.

Step 2: Add Your Details

Fill out your insurance details and click submit.

Step 3: Receive Benefits Details

Our admissions team will get back to you the same day with your insurance details.

Check Your Insurance Coverage With ChoicePoint

Whether you’re in Fair Lawn, NJ, or anywhere else in the United States, call 844.445.2565 Our admissions team verifies your exact in minutes and handles prior authorization so you can start treatment stress-free.

FAQs

Listed below are commonly asked questions regarding UMR PHP coverage:

How do I verify my UMR benefits before starting a PHP program?

There are a few ways to verify your UMR benefits before beginning a PHP program:

You can log in to your member portal to review your coverage details.
Call the member services number on the back of your insurance card.
Verify benefits through the treatment facility of your choice.

Does UMR require prior authorization for Partial Hospitalization Programs?

UMR typically requires prior authorization for higher levels of care, including PHP. This may include submission of clinical documents to help ensure that PHP is medically necessary for your situation.

Does UMR cover PHP for both mental health and substance use disorders?

Yes, UMR coverage for PHP may also include dual diagnosis care to treat co-occurring mental health disorders. Since addiction and mental health continue to worsen each other, the integrated approach of dual diagnosis treatment helps patients recover by simultaneously treating addiction and mental health.

Can I use my UMR insurance at an out-of-network PHP facility?

Some UMR plans include out-of-network benefits; however, your out-of-pocket expenses will also be substantial compared to in-network facilities. If you’re considering an out-of-network PHP facility, it is recommended to contact UMR directly to understand what costs you may be responsible for.

Other Major Insurance Plans We Accept

ChoicePoint accepts major commercial insurance providers in the U.S to help make treatments more accessible. We accept nationwide admissions while managing all your insurance-related verifications so you may begin treatment without any hassle.