Optum Mental Health Coverage for Rehab at ChoicePoint
If you have an Optum or UBH logo on your insurance card, you are already covered for Optum mental health rehab. Under the Mental Health Parity and Addiction Equity Act (MHPAEA), Optum is legally required to cover mental health care at the same level as physical health. When covered, you may avail outpatient therapy, IOP, PHP, inpatient care, and residential treatment for your mental health concerns. ChoicePoint is in-network with Optum and verifies your benefits the same day, free of charge, with no obligation.
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✓Same-Day Benefits
Verification -
✓ In-Network with
Optum -
✓Serving Patients
Across All 50 States
How Optum Manages Your Mental Health Benefits
Optum is a behavioral health management company that processes mental health and substance use benefits. Using Optum for mental health services means your in-network providers, prior authorization requirements, and coverage details are all managed through Optum’s system. ChoicePoint works directly within that system, which means fewer delays, faster approvals, and no confusion on your end.
Optum Plans That Cover Mental Health Rehab
Optum manages behavioral health benefits across several plan types. Understanding your plan type helps you know what to expect in terms of referrals, costs, and access to care at ChoicePoint.
How Optum Manages Your Mental Health Benefits
Optum is a behavioral health management company that processes mental health and substance use benefits. Using Optum for mental health services means your in-network providers, prior authorization requirements, and coverage details are all managed through Optum’s system. ChoicePoint works directly within that system, which means fewer delays, faster approvals, and no confusion on your end.
| Employer-Sponsored Plans (Optum manages behavioral health separately from the main employer health plan and requires prior authorization for IOP, PHP, and inpatient care). |
| UnitedHealthcare Individual and Family Plans (Mental health is a built-in benefit, and most PPO plans allow you to come to ChoicePoint directly without a referral). |
| Medicare Advantage Plans (Available to members aged 65 and older, or those qualifying through disability, with therapy and psychiatric care covered when medically necessary) |
| Medicaid Managed Care Plans (Some state Medicaid programs contract with Optum for mental health, and these plans typically carry little to no out-of-pocket cost for members) |
Mental Health Conditions Covered by Optum
Optum covers a wide range of mental health diagnoses. A licensed provider at ChoicePoint will confirm your diagnosis and establish medical necessity before your coverage is approved.
- Mood Disorders: Major Depressive Disorder, Bipolar Disorder I and II, Postpartum Depression
- Anxiety and Trauma Disorders: Generalized Anxiety Disorder, PTSD, OCD, Panic Disorder
- Personality and Behavioral Disorders: Behavioral Disorder, ADHD
- Co-Occurring and Complex Conditions: Dual diagnosis treatment
Mental Health Rehab Services Covered by Optum at ChoicePoint
ChoicePoint offers every level of mental health therapy and is in-network with Optum for all of them. Your benefits are confirmed before your first session, so there are no surprises about what is covered or what it will cost you.
| Service | Details |
| Psychiatric Evaluation and Medication Management | ā¢ A licensed psychiatrist assesses your condition, prescribes medication if appropriate, and monitors progress through follow-up visits.
ā¢ Covered when medically necessary under most Optum plans. ā¢ Some HMO plans may require a referral from your primary care physician before your first appointment. |
| Inpatient and Residential Mental Health Treatment | ā¢ Around-the-clock care at a licensed residential facility.
ā¢ Designed for individuals in a serious mental health crisis or those who have not improved with lower levels of care. ā¢ Optum-covered inpatient rehab requires prior authorization before admission. |
| Partial Hospitalization Program (PHP) for Mental Health | ā¢ Five to six hours of structured clinical program per day, five days a week.
ā¢ Provides hospital-level treatment during the day while you return home each evening. ā¢ More intensive than IOP but less restrictive than inpatient care. ā¢ ChoicePount Optum-covered PHP rehab handles all renewals to help prevent coverage lapses. |
| Outpatient Mental Health Therapy | ā¢ Weekly individual or group sessions with a licensed therapist while you continue living at home.
ā¢ ChoicePoint therapists offer CBT and DBT, available both in-person and via telehealth. ā¢ No prior authorization is typically required. ā¢ Optum covered outpatient rehab coverage continues with no hard session cap as long as clinical need is documented. |
| Telehealth Mental Health Therapy | ā¢ Therapy and psychiatric sessions available by phone or secure video.
ā¢ Available to patients across all 50 states. ā¢ Most Optum plans cover telehealth at the same rate as in-person visits. ā¢ DEA-certified providers are available for remote psychiatric care, including medication management. |
How Long Will Optum Cover Your Treatment at ChoicePoint?
Under federal parity law, Optum cannot end your coverage based solely on a set number of sessions or a time cap. At ChoicePoint, your coverage continues for as long as your treatment is clinically necessary.
| Level of Care | Coverage Details |
| Inpatient and Residential | Covered for the full duration your clinical team determines is medically required, whether that is 30, 60, or 90 days. |
| IOP and PHP | Covered for as long as your care team confirms that the current level of care remains clinically appropriate for your condition. |
| Outpatient Therapy | The coverage continues as long as your ChoicePoint provider documents ongoing clinical need. |
ChoicePoint manages all authorization renewals throughout your treatment so your coverage stays active and never lapses at a critical point in your recovery.
What Your Treatment at ChoicePoint Will Cost With Optum?
Your out-of-pocket costs depend on several factors specific to your Optum plan. Knowing these upfront helps you plan without any financial surprises before treatment begins.
Plan Type
HMO, PPO, EPO, and HDHP plans each structure cost-sharing differently between you and Optum.
In-Network Status
ChoicePoint is in-network with Optum, which keeps your costs as low as your plan allows.
Deductible
You pay the contracted cost of care until your annual deductible is met. Some plans carry a separate behavioral health deductible.
Copay or Coinsurance
After your deductible is met, you pay either a fixed amount per visit or a percentage of the total service cost.
Out-of-Pocket Maximum
Once your annual spending reaches your plan limit, Optum covers 100 percent of all covered services for the remainder of that plan year.
Prior Authorization
If a required authorization was not secured before treatment began, Optum may deny the claim and hold you responsible for the full cost. ChoicePoint handles every authorization before your treatment starts.
Who Is Eligible for Optum Mental Health Coverage at ChoicePoint?
Most active Optum members can access mental health benefits at ChoicePoint. You are likely eligible if you meet the following:
- You hold an active plan administered by Optum or United Behavioral Health
- A licensed provider has diagnosed you with a covered mental health condition
- Your ChoicePoint provider has documented that your requested level of care is clinically appropriate
- Required prior authorizations are in place before treatment begins
- Your plan premiums are current, and your coverage is active
- Treatment is received at a licensed facility such as ChoicePoint
Spouses and dependents listed on your policy are also eligible for covered services. If you are unsure whether you qualify, our team will review your plan and confirm your eligibility at no cost.
Check Your Insurance Coverage With ChoicePoint
Whether youāre 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.
How to Verify Your Optum Benefits at ChoicePoint?
Confirming your mental health covered by Optum benefits before treatment starts is the most important step you can take. ChoicePoint makes the process free and completes it the same day you reach out.
Step 1: Contact Us
Visit the website and navigate to Admissions > āverify your insuranceā through ChoicePoint or call us at 844-44-2565.
Step 2: Submit Your Details
Provide your name, date of birth, and your Optum or UnitedHealthcare member ID.
Step 3: We Review Your Coverage
We contact Optum directly and confirm your deductible status, copay amounts, authorization requirements, and which levels of care are covered at ChoicePoint. You receive everything in plain terms before your treatment begins.
Frequently Asked Questions About Optum Mental Health Coverage for Rehab
Does Optum cover mental health treatment at ChoicePoint?
Yes. ChoicePoint is in-network with Optum and accepts Optum-administered insurance for all levels of mental health rehab. Your full benefits and out-of-pocket costs are confirmed before your first session.
Do I need a referral to start treatment at ChoicePoint?
It depends on your plan. HMO plans require a referral from your primary care physician before you can begin. PPO plans allow direct access to ChoicePoint without one. We confirm your requirement during your free benefits check.
Does Optum cover inpatient psychiatric care at ChoicePoint?
Yes, when treatment is medically necessary, and prior authorization is secured in advance. ChoicePoint manages the full authorization process so your coverage is confirmed before you are admitted.
Can I appeal if Optum denies my mental health claim?
Yes. You have the right to file a formal internal appeal within 180 days of receiving a denial. If that appeal does not succeed, you can request an independent external review. ChoicePoint supports you through the entire appeals process, including documentation and peer-to-peer clinical review requests.
Does Optum cover telehealth therapy at ChoicePoint?
Yes. Most Optum plans cover phone and video therapy sessions at the same rate as in-person visits. ChoicePoint provides telehealth mental health services to patients across all 50 states.
Other Major Insurance Plans We Accept
