Accessing addiction treatment is much less intimidating when insurance plans like Optum can help you cover the costs. Optum, which has carved out quite the space in the healthcare industry, offers a wide network of providers that work with numerous insurance plans. They provide coverage for drug and alcohol rehab, bringing great accessibility to individuals and their families to get the help they need.
At Tennessee Detox Center, we are proud to accept Optum’s network of providers, ensuring that those battling with addiction can pursue recovery and get the help they need instead of getting sidetracked with financial barriers. We put this guide together to help you understand how Optum’s coverage works and the steps needed to access life-changing rehab programs in Tennessee.
Understanding Optum’s Coverage
What is Optum?
Optum is one of the biggest networks of providers available for insurance providers with addiction coverage. Similar to MultiPlan, Optum won’t pay for your treatment directly; instead, they will act as a third-party administrator and connect you with their network of providers.
Some of the many benefits of using Optum include:
- Over 2,000 sites of care available
- 70,000 employed or aligned doctors
- 3,700+ behavioral health specialists (in network)
Because of its popularity, Optum is one of the most recommended insurance providers with addiction coverage. If your health provider is under their network, chances are you’ll be able to get a referral and find highly qualified addiction treatment centers also part of Optum.
Types of Plans Accepted by Optum Providers
Optum providers work with several different insurance plans. Optum insurance coverage for drug and alcohol rehab can come from plans like:
- HMOs: Health Maintenance Organizations (HMOs) are popular types of plans that typically have lower costs and require patients to see in-network providers. Optum has over 70,000 employed or aligned doctors, making it easy for HMO members to find a provider.
- PPOs: Preferred Provider Organizations (PPOs) offer more flexibility when choosing a healthcare provider. PPOs might be a bit pricier than HMOs, but they usually have a larger network of providers to choose from. You might also have the option of seeking out-of-network care, albeit, pay for the price difference out-of-pocket.
- Medicare: Medicare is a federally-run program that provides healthcare coverage for individuals over the age of 65 and those with certain disabilities. It includes Part A (hospital insurance) and Part B (medical insurance). Medicare can help pay for costs associated with addiction treatment, and many Optum providers accept Medicare coverage.
- Medicare Advantage: Also known as Medicare Part C, Medicare Advantage plans are offered by private companies approved by Medicare. These plans provide all the same coverage as Medicare, but often include additional benefits such as prescription drug coverage and dental care. Optum providers are involved in both medicare advantage and supplement plans. If you qualify for low or $0 plans, consider using one that has Optum’s network of providers.
How to Choose the Right Optum Plan For Addiction Treatment Coverage
When going over your Optum plan and choosing what works for you, it’s important to verify the details of addiction treatment coverage. Here are some key questions to consider:
- Does my plan cover inpatient and outpatient rehab?
- Is detoxification covered?
- Are there any out-of-network limitations?
- What is the copayment or out-of-pocket expense for addiction services?
- Can I switch facilities if I find one that better aligns with my needs?
- Is aftercare covered?
Call Optum’s member services or log in to your account to review this information. You can also reach out to Tennessee Detox Center, and we’ll be happy to walk you through understanding your benefits.
While we can’t help you enroll directly, we can help you understand any out-of-pocket costs and payment options if you’re interested in enrolling in our inpatient treatment rehab or other drug rehab programs in Tennessee.
Types of Drug and Alcohol Rehab Programs Covered by Optum
One of the major benefits of Optum is the variety of addiction treatment programs its plans may cover. With the multitude of providers and many different kinds of treatment plans to suit individual needs, Optum makes it feasible to get what you need. Depending on your specific plan, here’s what you can expect to get from Optum insurance coverage for drug and alcohol rehab.
Detox Services
By far one of the most medically necessary and intensive types of drug and alcohol rehab programs, detox services are often the first step in a comprehensive treatment plan. Optum’s network of providers partners with insurance companies that may cover some or all costs associated with medical detox. Medical detox is vital to help individuals safely and comfortably withdraw from drugs and alcohol under the supervision of medical professionals.
Unfortunately, it’s a myth that you can simply detox at home. Withdrawal symptoms, such as those from alcohol, can lead to health complications and even be fatal. Because of how serious detoxing from substances is, we encourage all of our clients to seek medical detox first before enrolling in additional treatment.
Some of the many benefits of using medical detox include:
- Access to healthcare professionals 24/7 to monitor and assist with any potential complications
- Use of medication to ease withdrawal symptoms and reduce discomfort
- A personalized detox plan tailored to your specific needs and substance use history
- Opportunity for a smooth transition into further treatment, such as therapy or support groups
If your provider determines medical detox is necessary, he or she can put a referral for our medical detox treatment. You can then choose a facility that works within Optum’s network, like TN Detox Center.
Inpatient Rehab
For those who require more intensive care, inpatient rehab programs provide structured, supportive, and life-changing treatment for individuals struggling with addiction and co-occurring mental health disorders. Inpatient rehab programs offer round-the-clock medical supervision, a safe and comfortable living environment that facilitates healing, and evidence-based therapies to help people achieve long-term recovery.
What is Inpatient Rehab?
Inpatient rehab, which is sometimes called residential treatment, involves staying at a facility for a set period of time to receive focused, total treatment for substance abuse or addiction. This kind of program usually lasts anywhere from 30 to 90 days, although some may last longer depending on your needs and level of addiction severity.
During inpatient rehab, our clients live at our luxury rehab retreat in Tennessee and participate in a structured daily schedule. Some of the many treatments we offer during inpatient rehab include:
- Individual Therapy: This involves one-on-one sessions with a licensed therapist to address underlying issues and develop coping strategies.
- Group Therapy: Clients participate in group therapy sessions with their peers, providing support and accountability as they work towards recovery.
- Family Therapy: Addiction can affect not just the individual, but also their loved ones. Family therapy helps repair relationships and provides education on how family members can best support their loved one’s recovery journey.
- Medication-Assisted Treatment (MAT): Certain medications can be prescribed to help manage withdrawal symptoms and cravings during detoxification. MAT is closely monitored by our medical team and is used in conjunction with other therapies.
- Holistic Therapies: We believe in treating the mind, body, and spirit. Our holistic therapies, such as yoga, meditation, and art therapy, focus on promoting overall wellness and reducing stress.
- Relapse Prevention: Recovery is a lifelong journey, and relapse can happen to anyone. That’s why we provide tools and strategies for preventing relapse and maintaining long-term sobriety.
Outpatient Programs
Outpatient rehab is designed for those who don’t need round-the-clock care. It allows people to attend therapy sessions while continuing their daily responsibilities. Optum may cover services like individual counseling, group therapy, and relapse prevention as part of outpatient programs.
If you’ve been told Optum’s network of providers will only cover outpatient treatment instead of inpatient treatment, we at TN Detox Center provide several levels of care for our outpatient clients. These include:
- PHP: Also known as Partial Hospitalization Program, PHP is the most intensive form of outpatient treatment. It typically involves attending therapy sessions for 5-6 hours a day, 5-6 days a week. This level of care is suitable for those who require more support than traditional outpatient rehab but don’t need 24/7 medical supervision.
- IOP: Intensive Outpatient Program (IOP) is a step down from PHP and requires patients to attend therapy sessions for about 3 hours a day, 3-4 days a week. IOP provides more structure and accountability than traditional outpatient rehab while still allowing patients to maintain their daily responsibilities.
- Standard Outpatient: This level of care is the least intensive option and typically involves one or two therapy sessions per week. It is suitable for those who have completed a higher level of care but still need ongoing support and accountability in their recovery journey.
Even after completing an addiction treatment program, it is important to continue attending support groups and therapy sessions as part of an aftercare plan. This can help individuals maintain their sobriety and prevent relapse by providing ongoing support, guidance, and tools for coping with triggers and cravings. Optum insurance coverage for drug and alcohol rehab should cover the costs of outpatient care to help you stay clean for as long as possible.
Dual Diagnosis Treatment
If you’re dealing with both addiction and a mental health condition, dual diagnosis programs can address both issues simultaneously. Many of Optum’s plans include coverage for integrated treatment of co-occurring disorders.
During dual diagnosis treatment at TN Detox Center, you can expect a combination of therapy, medication management, and other evidence-based practices that target both your addiction and mental health. This type of treatment can be highly effective in helping you achieve long-term recovery.
It’s important to note that not all insurance plans cover dual diagnosis treatment. Be sure to check with Optum before beginning any program to ensure coverage for this type of care.
Understanding what’s covered ensures you can select the best kind of support for your recovery needs. If you need help determining which aftercare services are covered by your plan, contact Optum or TN Detox Center for assistance.
Aftercare Services
Aftercare services play an important role in sustaining recovery and preventing relapse. It’s important to have a plan in place for continued support after completing treatment. In addition to traditional therapy and counseling, there are many other types of aftercare services that can aid in the recovery process.
Whether you’re interested in sober living, outpatient treatment, peer programs, or other services, having access to aftercare can make a huge impact on your recovery. Optum’s network might include providers and facilities that offer aftercare programs.
Finding Optum Drug and Alcohol Rehab Centers
The next step is locating a rehab center that accepts Optum insurance. Thankfully, Optum has a comprehensive network of providers. Here are some tips to simplify your search:
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Log into Optum’s member portal and use their database to find in-network rehab facilities near you. You can also search providers, which include therapists, psychologists, and psychiatrists, individually. This is by far the best way to find a treatment center like TN Detox Center that is fully partnered with Optum.
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Call the number on the back of your insurance card to speak with a representative who can assist you in finding approved rehab centers near you. You can also contact their healthcare services line at 1-877-267-8861 from Monday-Friday, 8 a.m. – 5 p.m.
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If you know someone who has used their Optum network of providers for rehab services, ask them for recommendations. They may be able to provide insight on their experience at a particular facility and recommend addiction specialists or providers. At TN Detox Center, we pride ourselves on our compassionate and highly regarded staff of medical professionals, addiction therapists, and more. We’ll be happy to share testimonials and let you speak to our team yourself for added insight.
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Your doctor may have knowledge of local rehab centers that accept Optum’s network of providers and can provide referrals. For some people and their plan, asking your primary care provider for a referral might be the only way to enroll in treatment.
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Call treatment centers, like Tennessee Detox Center, to confirm that they accept Optum insurance. Our team is more than happy to assist you with insurance verification.
With Tennessee Detox Center in Optum’s network, you’ve already found a trusted option for high-quality care.
Navigating the Approval Process
While many services are covered, gaining approval for addiction treatment might require a few steps. Certain rehab programs might require pre-authorization from Optum. This means your provider will need to confirm that the treatment is medically necessary. It’s a good idea to be open and honest with your provider about addiction issues. The more information they have, the better chances are they can make a referral.
Your healthcare provider may need to submit documentation proving your need for rehab, such as medical records or assessments. It’s a good idea to communicate with your provider or their office in case more documentation is needed.
Lastly, Stay in touch with Optum’s member services to check the status of your authorization. At TN Detox Center, we can help you manage this process to make it as seamless as possible. Don’t hesitate to reach out if you encounter any issues with approvals. Our team is here to support you.
Additional Resources and Support
If your Optum plan doesn’t cover addiction treatment or you don’t currently have insurance, you still have options. Here’s what you can do:
Get Help Today at Tennessee Detox Center
Yes, Your Insurance Covers Detox and Rehab Treatment
Your insurance may pay for all of your addiction treatment. Call for a confidential conversation with a treatment provider about your financial options.
Frequently Asked Questions: Optum Insurance Coverage for Drug & Alcohol Rehab
Optum plans often include behavioral health and substance use disorder benefits that may help cover treatment at Tennessee Detox Center. Coverage is based on your specific Optum-managed plan, medical necessity, and any required authorizations.
Optum typically administers behavioral health benefits for many insurance plans, including employer-sponsored and PPO plans. While Optum manages approvals and care coordination, coverage details ultimately depend on your underlying insurance policy.
Depending on your plan, Optum may help cover:
Medically supervised detox
Residential or structured rehab services
Partial Hospitalization Programs (PHP)
Intensive Outpatient Programs (IOP)
Outpatient therapy and recovery support
Coverage is determined by clinical assessment and level-of-care criteria.
Many Optum-managed plans cover medical detox when withdrawal symptoms require 24/7 monitoring or medical intervention. Detox coverage is typically based on medical necessity and may require prior authorization.
Optum generally reviews factors such as:
Substance use history and severity
Withdrawal risks and medical stability
Mental health or co-occurring conditions
Prior treatment history
These factors help determine the appropriate level of care and length of treatment.
Many Optum plans include coverage for co-occurring mental health conditions treated alongside substance use disorders, such as anxiety, depression, PTSD, or mood disorders, when clinically indicated.
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Supporting Families Through Recovery
We understand addiction affects the whole family. Our comprehensive family program helps rebuild trust and restore relationships.
Weekly Family Therapy Sessions
Educational Workshops
Support Groups
Communication Skills Training
Get Family Support Now
Insurance and financial information provided on Tennessee Detox Center pages is intended for informational purposes only and should not be interpreted as a guarantee of coverage, reimbursement, or payment approval.
Insurance plans vary widely based on provider, policy type, medical necessity criteria, and authorization requirements. Coverage may change without notice. Tennessee Detox Center strongly encourages individuals to contact our admissions team directly to verify benefits prior to treatment.
Financial discussions on this website do not replace direct communication with insurance carriers. Out-of-pocket costs may apply.
If you are experiencing a medical emergency, call 911 immediately.
Detox and rehab services require professional evaluation and oversight. Outcomes are not guaranteed.
External references are informational only and not endorsements. No provider-patient relationship is established through website use.
Addiction Group. (n.d.). Tennessee drug and alcohol statistics. Retrieved July 28, 2025, from https://www.addictiongroup.org/tennessee/drug-statistics/
Substance Abuse and Mental Health Services Administration (SAMHSA). (2023). 2023 ICCPUD state report: Underage drinking prevention – Tennessee. U.S. Department of Health and Human Services. Retrieved from https://library.samhsa.gov/sites/default/files/tennessee-iccpud-state-report-2023.pdf
Tennessee Alcoholic Beverage Commission. (2024). Report to prevent underage drinking, drunk driving, and other harmful uses of alcohol (PC 961). State of Tennessee. Retrieved from https://www.tn.gov/content/dam/tn/abc-documents/abc-documents/PC-961-2024-Report-to-Prevent-Underage-Drinking-Drunk-driving-and-Other-Harmful-Uses-of-Alcohol.pdf
National Institute on Alcohol Abuse and Alcoholism (NIAAA). (2012). Alcohol withdrawal syndrome. In S. C. Merrill & B. S. Frances (Eds.), The management of alcohol use disorders: A practical guide for clinicians (NIH Publication No. 12–5191). National Center for Biotechnology Information. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK64119/
Medically Reviewed By:
Dr. Vahid Osman, M.D.
Board-Certified Psychiatrist and Addictionologist
Dr. Vahid Osman is a Board-Certified Psychiatrist and Addictionologist who has extensive experience in skillfully treating patients with mental illness, chemical dependency and developmental disorders. Dr. Osman has trained in Psychiatry in France and in Austin, Texas. Read more.
Clinically Reviewed By:
Josh Sprung, L.C.S.W.
Board Certified Clinical Social Worker
Joshua Sprung serves as a Clinical Reviewer at Tennessee Detox Center, bringing a wealth of expertise to ensure exceptional patient care. Read More
The Joint Commission – The Gold Seal of Approval® signifies that Tennessee Detox Center meets or exceeds rigorous performance standards in patient care, safety, and quality. It reflects a commitment to continuous improvement and clinical excellence.
LegitScript Certified – Confirms that Tennessee Detox Center operates in full compliance with laws and regulations, and meets high standards for transparency and accountability in addiction treatment marketing.
BBB Accredited – Demonstrates ethical business practices, commitment to customer satisfaction, and a trusted reputation within the community.
Psychology Today Verified – Indicates that Tennessee Detox Center is listed on Psychology Today, a trusted directory for verified mental health providers and treatment centers.
HIPAA Compliant – Ensures all patient health information (PHI) is protected and managed in accordance with strict federal privacy and data security standards.
ASAM Member – Tennessee Detox Center is a proud member of the American Society of Addiction Medicine (ASAM), reflecting a commitment to science-driven and evidence-based treatment standards.
Rutherford County Chamber of Commerce – Membership signifies active participation in the local community and support for regional growth and civic collaboration.
Addiction Group. (n.d.). Tennessee drug and alcohol statistics. Retrieved July 28, 2025, from https://www.addictiongroup.org/tennessee/drug-statistics/
Substance Abuse and Mental Health Services Administration (SAMHSA). (2023). 2023 ICCPUD state report: Underage drinking prevention – Tennessee. U.S. Department of Health and Human Services. Retrieved from https://library.samhsa.gov/sites/default/files/tennessee-iccpud-state-report-2023.pdf
Tennessee Alcoholic Beverage Commission. (2024). Report to prevent underage drinking, drunk driving, and other harmful uses of alcohol (PC 961). State of Tennessee. Retrieved from https://www.tn.gov/content/dam/tn/abc-documents/abc-documents/PC-961-2024-Report-to-Prevent-Underage-Drinking-Drunk-driving-and-Other-Harmful-Uses-of-Alcohol.pdf
National Institute on Alcohol Abuse and Alcoholism (NIAAA). (2012). Alcohol withdrawal syndrome. In S. C. Merrill & B. S. Frances (Eds.), The management of alcohol use disorders: A practical guide for clinicians (NIH Publication No. 12–5191). National Center for Biotechnology Information. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK64119/
Medically Reviewed By:
Dr. Vahid Osman, M.D.
Board-Certified Psychiatrist and Addictionologist
Dr. Vahid Osman is a Board-Certified Psychiatrist and Addictionologist who has extensive experience in skillfully treating patients with mental illness, chemical dependency and developmental disorders. Dr. Osman has trained in Psychiatry in France and in Austin, Texas. Read more.
Clinically Reviewed By:
Josh Sprung, L.C.S.W.
Board Certified Clinical Social Worker
Joshua Sprung serves as a Clinical Reviewer at Tennessee Detox Center, bringing a wealth of expertise to ensure exceptional patient care. Read More
The Joint Commission – The Gold Seal of Approval® signifies that Tennessee Detox Center meets or exceeds rigorous performance standards in patient care, safety, and quality. It reflects a commitment to continuous improvement and clinical excellence.
LegitScript Certified – Confirms that Tennessee Detox Center operates in full compliance with laws and regulations, and meets high standards for transparency and accountability in addiction treatment marketing.
BBB Accredited – Demonstrates ethical business practices, commitment to customer satisfaction, and a trusted reputation within the community.
Psychology Today Verified – Indicates that Tennessee Detox Center is listed on Psychology Today, a trusted directory for verified mental health providers and treatment centers.
HIPAA Compliant – Ensures all patient health information (PHI) is protected and managed in accordance with strict federal privacy and data security standards.
ASAM Member – Tennessee Detox Center is a proud member of the American Society of Addiction Medicine (ASAM), reflecting a commitment to science-driven and evidence-based treatment standards.
Rutherford County Chamber of Commerce – Membership signifies active participation in the local community and support for regional growth and civic collaboration.
Did you know that your insurance plan may cover medical detox?
Get Family Support Now
Supporting Families Through Recovery
We understand addiction affects the whole family. Our comprehensive family program helps rebuild trust and restore relationships.
Weekly Family Therapy Sessions
Educational Workshops
Support Groups
Communication Skills Training
Get Family Support Now
What Our Patients Say: Stories of Hope and Recovery
Thank you all so much!
The facility itself is clean, well-maintained, and equipped with all the necessary amenities to provide a serene and supportive environment.
What truly stands out is the personalized approach to care. The team developed a treatment plan tailored to my specific needs, incorporating both medical and holistic therapies. This comprehensive approach not only addressed my physical withdrawal symptoms but also supported my mental and emotional well-being.
The counselors and therapists offer a range of therapies that helped me understand the root causes of my addiction and develop effective coping strategies. Group therapy sessions provided a safe space to share experiences and gain insights from others on similar journeys.
Overall, my experience with this medical detox program was life-changing. The compassionate and skilled staff, combined with the personalized treatment approach, provided me with the foundation I needed for a successful recovery. I highly recommend this facility to anyone seeking a safe and supportive environment for detox and recovery.
But it's the people who make this place truly special. The staff, they've been there, they understand the struggle. No judgment, just support, encouragement, and a genuine desire to help you heal. They treated me like an old friend, even though I was just visiting for my buddy.
They've got a whole range of therapies to help you on your journey – individual counseling, group sessions, and even a fitness center to get you moving again. It's not just about detox. It's about rebuilding your life from the ground up.
My friend, the owner, he's living proof that this place works. He poured his heart into creating a haven for those seeking recovery, and his passion shines through in every detail.
So, if you're ready to take that first step, this is the place. Trust me, they'll walk beside you every step of the way.
