In short, yes, UMR health insurance may cover some or all of the cost of drug and alcohol addiction treatment in Dallas, TX. The Mental Health Parity and Addiction Equity Act (MHPAEA) requires insurance companies like UMR to provide the same level of benefits for addiction and mental health treatment as they do for other types of medical care.
Although Drug and Alcohol Treatment must be covered under MHPAEA, the amount of coverage will depend on your exact plan and if the Treatment Facility is in-network with your insurance.
Lighthouse Recovery is out-of-network with UMR health insurance. This means that Lighthouse does not have a contract with UMR, but can still offer services in Dallas to its members depending on the type of policy.
The cost for Drug and Alcohol treatment will vary based on the specific care you need and the exact plan you have with UMR. Some common costs you may encounter include:
- Annual Deductible: The dollar amount you pay before your insurer begins covering costs. After the deductible is met, the plan begins covering some or all of the costs.
- Coinsurance: The portion of medical costs you are responsible for paying after your deductible has been met. For example, if your coinsurance is 20%, you pay 20% of the cost and your insurance pays the other 80% up to the “out-of-pocket limit” (see below).
- Out-of-pocket limit: This is the maximum amount you will pay for medical expenses in a year. This amount includes deductibles, coinsurance, and copays. Once you have reached your out-of-pocket limit, your insurance will pay for any medical costs for the remainder of the year.
- Copayments: A flat fee you pay per session of treatment (per group session for example).
As mentioned previously, your coverage for Drug and Alcohol Treatment in Dallas will vary depending on your exact UMR plan. A helpful first step is to verify your benefits, which you can do quickly and confidentially on this page. The information you provide will be sent to our Admissions Department and you will receive a phone call from one of our professionals to further guide you through the process.