UMR Insurance for Addiction Treatment in Orange County

Medical detox provides 24/7 clinical supervision to safely manage withdrawal symptoms. Medically managed withdrawal is often the first step in effective treatment, according to the National Institute on Drug Abuse.

UMR typically covers 24/7 nursing care, medication management, and clinical stabilization to prepare for residential treatment.

Residential treatment means living at the facility and receiving intensive, round-the-clock care. UMR approves residential treatment based on medical necessity—the clinical team must show you need 24-hour care. Coverage often includes individual therapy, group counseling, and psychiatric support.

Medical necessity is the standard insurance administrators use to decide if treatment is appropriate. UMR reviews clinical documentation provided by the treatment center.

UMR considers:

• Severity of Withdrawal: Risk of seizures or severe physical symptoms.
• Co-occurring Conditions: Presence of mental health disorders like depression or PTSD.
• Relapse Risk: History of relapse and ability to maintain sobriety in less restrictive settings.
• Living Environment: Stability and safety of the patient’s home life.

Most UMR plans require pre-authorization for higher levels of care, such as inpatient detox and residential rehab. The facility submits a detailed clinical assessment to UMR for review. Without pre-authorization, UMR can deny coverage—leaving you responsible for the full cost.

You can call UMR directly, or have a treatment center verify benefits for you.

1. Locate the Number: Find customer service on the back of your UMR ID card.
2. Prepare Information: Have the member’s name, date of birth, and ID number ready.
3. Ask Specific Questions: Inquire about “inpatient substance abuse treatment” and “medical detox.”
4. Record Details: Write down the representative’s name and reference number.

Call Ocean Recovery, and our admissions team will verify your benefits. We need:

• Member ID Number: Found on the front of the insurance card.
• Group Number: Identifies your specific employer plan.
• Policyholder Information: Name and date of birth of the primary insured.
• Patient Information: Name and date of birth of the person seeking treatment.

The admissions and billing teams at Ocean Recovery are experienced in working with UMR’s coverage requirements.

We handle:

• Benefit Verification: Thorough review of your specific plan details.
• Utilization Review: Communicating with UMR reviewers to advocate for continued coverage.
• Claims Management: Handling all billing and paperwork.

We offer the full spectrum of care—addressing physical, emotional, and psychological aspects of addiction.

• Gender-Specific Programs: Specialized treatment environments for men and women.
• Dual Diagnosis Care: Integrated treatment for addiction and co-occurring disorders.
• Evidence-Based Therapies: Modalities such as CBT, DBT, and EMDR therapy.

We start with a confidential assessment, reviewing your medical history and insurance to determine the right level of care.

For many people, recovery starts with detox. We provide 24/7 medical monitoring to safely manage withdrawal.