United Healthcare is one of the largest health insurance companies in the United States, serving millions of members across the country. Known for its extensive network of healthcare providers, United Healthcare is committed to offering a wide range of health plans, including individual, employer-sponsored, Medicare and Medicaid plans. As part of this commitment, United Healthcare offers coverage for various mental health and addiction services, including treatment for gambling addiction.

In the wake of the Supreme Court’s May 14, 2018, decision to overturn the federal Professional and Amateur Sports Protection Act (PASPA), which granted states the right to legalize sports betting, the landscape of gambling in the United States has dramatically shifted. Recognizing the increasing prevalence of gambling addiction in this new environment, United Healthcare took a proactive step by offering coverage for gambling addiction treatment starting January 1, 2023. But what does this coverage include, and how can you access it? In this article, we’ll break down the specifics of United Healthcare’s gambling addiction treatment coverage and guide you on how to start the process of getting the help you need.

Am I covered for gambling addiction treatment with United?

If you're struggling with gambling addiction and have a United Healthcare plan, you may be wondering whether your insurance will cover the cost of treatment. The good news is that United Healthcare does provide coverage for gambling addiction treatment, but the extent of coverage can vary depending on your specific plan.

To determine whether you are covered, you can take several routes:

  • Check Your Member Handbook: Your United Healthcare Member Handbook is an essential resource for understanding your benefits. United Healthcare's Wellness4Me plan includes coverage for Gambling Disorder Treatment provided by Office of Addiction Services and Supports (OASAS) certified programs. This means you can receive treatment both face-to-face and through telehealth without needing a referral from your primary care provider.

  • Visit the United Healthcare Website: Log in to your member account on the United Healthcare website. From there, you can review your plan details, including coverage for mental health and addiction services. The website may also have tools to help you find a specialist who treats gambling addiction.

  • Search for a Specialist: Use United Healthcare's provider directory to search for mental health professionals or treatment centers that specialize in gambling addiction. Make sure to select providers who are in-network to maximize your coverage and minimize out-of-pocket costs.

  • Call the Number on Your Insurance Card: If you're unsure about your coverage, call the customer service number on the back of your United Healthcare insurance card. A representative can provide detailed information about your benefits and guide you through the process of finding treatment.

Will I need to pay a copay for gambling addiction treatment?

A copay is a fixed amount of money a health insurance patient pays for a covered health care service and is usually paid when the service is received. Outpatient treatment, inpatient treatment, individual counseling, group counseling or a visit to a physician may be covered by an insurance plan, but regardless of coverage, a copay is likely required.

The cost of a copay or a deductible for gambling addiction treatment depends on your specific United Healthcare plan. Some plans may require a copay for each session or service, while others may offer coverage with no copay. It's important to review your plan details or contact United Healthcare directly to understand what costs you may be responsible for. In some cases, the copay may be waived, especially if you choose an in-network provider.

Is Birches Health in network with United Health?

Yes, Birches Health is in-network with United Healthcare. This means that if you have a United Healthcare insurance plan, you can access gambling addiction treatment at Birches Health with the assurance your care will be covered under your insurance benefits. 

What if I cannot afford gambling addiction treatment

If and when considering whether gambling addiction treatment is a viable option, questions revolving around cost are natural. Fortunately, Birches Health being in-network with United Healthcare and other major commercial insurance companies can help keep your out-of-pocket costs low – or even at $0 for some plans.

Additionally, Birches Health has partnerships with state governments in Arizona, New Jersey and North Carolina that provide funding to help cover the costs of gambling addiction treatment. These programs are designed to ensure individuals who need help can access it, regardless of their financial situation.

If you're worried about affording treatment, Birches Health can work with you to explore all available options, including state-funded programs and sliding scale fees.

Starting the process of gambling addiction care

United Healthcare does offer coverage for gambling addiction treatment, making it accessible for those who need it. Whether you’re concerned about costs, wondering about copays or ready to start treatment, Birches Health is here to help you navigate the process and get the support you need. Don’t let financial concerns stand in the way of recovery – reach out to Birches Health today and take the first step toward a healthier, addiction-free life.

Here’s how you can start the process:

For immediate assistance, contact Birches Health at 833-483-3838 or email hello@bircheshealth.com.

Sources:

United Healthcare