Optum Therapy for Addiction and Mental Health
ChoicePoint offers Optum therapy for addiction and mental health to eligible members across the United States. As a federally mandated essential health benefit, Optum is required to cover mental health and substance use treatment under most plans. Coverage includes inpatient care, outpatient therapy, counseling, and more. ChoicePoint is an in-network provider with Optum, which means lower costs and direct billing on your behalf.
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✓Verify your insurance
for free. -
✓ All major therapy services
are covered. -
✓Serving patients across
all 50 states.
Is Therapy Covered as a Standalone Service, Apart from a Full Rehab Program?
Yes. You do not need to enroll in a residential or inpatient rehab program to use your Optum therapy benefits at Choice Point. Optum covers outpatient therapy, individual counseling, and group sessions as independent services.Ā
This means you can access structured, professional therapy while continuing to live at home and maintain your daily routine. Our outpatient programs are specifically designed for people who want the clinical support of a treatment program without the need for full-time residential care.
Optum Therapy Servicesā Covered Under Your Plan at Choice Point
Most Optum plans cover the following therapy services at Choice Point, either fully or with a cost-sharing contribution, depending on your plan type and level.
1) Cognitive Behavioral Therapy (CBT)
- CBT helps you identify and change the negative thought patterns that drive addiction and harmful behavior.
- It is among the most well-researched therapies for substance use disorders, depression, anxiety, PTSD, OCD, and behavioral disorders.
- Optum covers CBT across Optum-covered inpatient, outpatient, and intensive outpatient levels of care.
- Sessions are focused on building practical coping skills you can apply in everyday situations.
- CBT is available in individual and group formats at Choice Point.
2) Dialectical Behavior Therapy (DBT)
- DBT is a structured therapy that helps people manage intense emotions and build healthier relationships.
- It teaches four core skills like mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness.
- DBT is especially effective for borderline personality disorder, self-destructive behaviors, and dual diagnosis conditions.
- Optum recognizes DBT as a covered treatment across most commercial and individual plans.
- At Choice Point, DBT is offered within both Optum-covered residential and Optum-covered outpatient treatment programs.
3) Eye Movement Desensitization and Reprocessing (EMDR)
- EMDR is a trauma-focused therapy that helps the brain reduce the emotional weight of painful memories.
- It uses guided eye movements alongside memory recall to reprocess experiences driving addiction or mental health struggles.
- EMDR is one of the most effective treatments available for Post-Traumatic Stress Disorder (PTSD) and trauma-related conditions.
- Optum covers EMDR under most behavioral health plans, though the extent of coverage may vary by plan type.
- Choice Point provides EMDR through trained, trauma-informed therapists who specialize in outpatient substance addiction and co-occurring conditions.
4) Individual Therapy
- Individual therapy involves private, one-on-one sessions between you and a licensed therapist.
- It gives you a confidential space to work through the experiences and patterns connected to your addiction or mental health condition.
- Your therapist builds a treatment plan around your specific goals, history, and progress.
- Optum covers individual therapy under most plans, with session limits varying by your specific plan level.
- It is available across Optum-covered outpatient, Optum-covered inpatient, and telehealth formats at Choice Point.
5) Group Therapy
- Group therapy brings a small number of people together in a structured session led by a licensed therapist.
- It reduces isolation, which is one of the most common triggers for relapse during addiction recovery.
- Participants share experiences, support one another, and build accountability within the group setting.
- Research shows that group therapy improves long-term recovery outcomes when paired with individual treatment.
- Optum covers group therapy as part of both inpatient and outpatient programs at Choice Point.
6) Family Therapy
- Family therapy brings you and your loved ones into structured sessions with a licensed therapist.
- It helps rebuild trust, improve communication, and repair relationships affected by addiction and mental health struggles.
- Family members learn how to support your recovery without unintentionally enabling harmful patterns.
- Optum covers family therapy as part of an inpatient or outpatient treatment plan when it is clinically necessary.
- At Choice Point, we encourage family involvement because research shows it improves long-term recovery outcomes.
7) Mental Health Therapy
- Mental health therapy at Choice Point covers conditions including Major depressive disorder, generalized anxiety disorder, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), behavioral disorders, ADHD, and postpartum depression.
- It is delivered by licensed professionals trained in therapy methods suited to your specific diagnosis.
- Optum covers mental health therapy under its behavioral health benefits, protected by the Mental Health Parity and Addiction Equity Act.
- Treatment plans may combine individual sessions, group therapy, and medication management based on your clinical needs.
- Mental health therapy is available across inpatient mental health treatment, partial hospitalization for mental health treatment, online mental health treatment, and outpatient mental health treatment.
What Factors Can Affect Your Optum Coverage?
Your Optum plan covers therapy, but the exact amount depends on a few key variables you should be aware of before starting care.
| Factor | Explanation |
| Plan Type (HMO vs. PPO) | HMO plans generally require you to stay within the Optum network for full coverage. PPO plans offer more flexibility and may partially cover out-of-network providers. As an in-network provider, Choice Point works well with both plan types. |
| Plan Level (Bronze, Silver, Gold) | Your plan tier directly determines how costs are split between you and Optum. Bronze plans carry lower monthly premiums but higher costs when you use care. Gold plans cost more per month but cover a greater share of your treatment expenses. |
| Deductible Status | Your deductible is the annual amount you pay before Optum begins contributing to your care. If you have already paid toward your deductible this year, your costs at Choice Point may be lower than you expect. |
| Co-pay or Co-insurance | After your deductible is met, you may pay a fixed co-pay per session or a co-insurance percentage of each covered service. If your co-insurance is 20%, Optum pays the remaining 80% of the covered cost. |
| Prior Authorization Requirements | Inpatient rehab, partial hospitalization programs (PHP), and intensive outpatient programs (IOP) often require Optum’s approval before treatment begins. Routine outpatient therapy typically does not. Choice Point handles the prior authorization process on your behalf. |
| In-Network vs. Out-of-Network Status | Staying in-network at a facility like Choice Point is the most cost-effective way to use your Optum benefits. Out-of-network treatment may be partially covered under PPO plans, but will always result in higher out-of-pocket costs. |
Does Optum Pay For Therapy? What Will You Need to Pay Even If Optum Is Covering Your Therapy?
What does Optum pay for therapy? Optum covers a meaningful portion of your treatment costs, but there are some expenses you may still be responsible for. Here is a clear breakdown so there are no surprises when your treatment begins.
- Deductible: The annual amount you pay before Optum begins covering your costs; if you have already contributed to this earlier in the year, your remaining balance will be lower
- Co-pay: A fixed dollar amount per therapy session, which typically ranges from $10 to $50, depending on your specific plan
- Co-insurance: A percentage of the total cost of each covered service that you pay after your deductible has been fully met
- Out-of-pocket maximum: Once you reach this annual cap, Optum covers 100% of all additional covered costs for the rest of the benefit year
- Non-covered or supplemental services: Certain services that fall outside your plan’s defined benefits may not be billed to Optum; our team is transparent about these before your treatment begins
The good news is that most people with Optum are genuinely surprised by how little they end up paying when they receive care at an in-network facility. Our admissions team provides you with a full, itemized breakdown of your expected costs before you make any treatment decisions.
What Addiction and Mental Health Conditions Does Optum Cover Therapy For?
Most Optum plans cover therapy for a wide range of mental health and substance use conditions. At Choice Point, we provide covered treatment for the following:
If you are unsure whether your specific condition qualifies for covered therapy, our admissions team can verify your benefits and give you a direct, clear answer 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 Insurance at Choice Point
Getting started is simple. We handle the process so you can focus on what matters most.
Step 1: Reach Out
Visit the website and navigate to Admissions > āverify your insuranceā through ChoicePoint or call us at 844-44-2565.
Step 2: Submit Your Insurance Information
Provide your name, date of birth, Optum member ID from your insurance card, and the type of treatment you are looking for.
Step 3: We Verify and Call You Back
Our team contacts Optum on your behalf, confirms your active coverage and plan benefits, and calls you back with a clear breakdown of your expected out-of-pocket costs before treatment begins.
FAQs About Optum Therapy for Addiction and Mental Health
Answers to the questions we hear most from people who are ready to get help.
Is Choice Point in-network with Optum?
Yes. Choice Point is an in-network provider with Optum, which means your therapy is billed at pre-negotiated rates that significantly reduce what you pay out of pocket compared to out-of-network care.
Do I need a referral from my doctor to start therapy at Choice Point?
It depends on your plan type. HMO plans may require a referral from your primary care physician, while PPO plans typically do not. Our team checks this detail for you when we verify your benefits.
Does Optum require prior authorization for therapy?
Routine outpatient therapy sessions generally do not require prior authorization under most Optum plans. Higher levels of care, such as inpatient rehab, PHP, and IOP, typically do require it. Choice Point manages this process on your behalf at no extra cost.
How many therapy sessions does Optum cover per year?
This varies by plan. Some Optum plans cover an unlimited number of medically necessary sessions, while others set an annual session limit. We confirm this during your benefits verification, so you know what to plan for.
Does Optum cover dual diagnosis treatment?
Yes. Optum’s behavioral health benefits cover integrated treatment for co-occurring mental health and substance use disorders. Dual diagnosis care is a core specialty at Choice Point.
What is the out-of-pocket maximum under my Optum plan?
Your out-of-pocket maximum is the most you will pay for covered services in a single benefit year. Once you reach that amount, Optum covers 100% of additional covered costs. The exact figure depends on your specific plan, and our team confirms it during verification.
Does Optum cover telehealth therapy?
Yes. Optum covers virtual therapy under most plans. Our team can confirm whether your plan includes telehealth coverage and how to access it through Choice Point.
How do I know exactly what my Optum plan covers at Choice Point?
Contact our admissions team, and we will verify your Optum benefits directly at no cost and with no obligation. We will call you back with a full, specific breakdown of your coverage and expected costs before you decide anything.
Other Major Insurance Plans We Accept
