Optum Behavioral & Mental Health Insurance Benefits in Tennessee

Does Optum Insurance Cover Mental Health Services?

Yes, depending on your insurance provider, Optum’s network of healthcare providers may be able to cover mental health services. These services include individual therapy coverage within their provider network. However, Optum plans do not cover out-of-network therapy. Therefore, if you visit a therapist who is not part of the Optum network, you will be responsible for the entire cost.¹

In addition, as a subsidiary of UnitedHealth Group, Optum plans offer access to UnitedHealth Care’s Live and Work Well resources. Live and Work Well resources include educational material on mental health conditions, fitness and wellness, and important therapy coverage information for your Optum plan.²

How to Verify Optum Mental Health Benefits

Athena Care is in-network with most major insurance plans. To determine if your healthcare plan is part of Optum’s network, call your insurance company or contact us below. One of our care coordinators can help you navigate your insurance coverage and get the care you need.

Allow our highly trained care coordinators to manage the challenges of contacting your insurance carrier for information on your Optum mental health coverage.

Jump to Section

• Does Optum Insurance Cover Mental Health Services?
• How to Verify Optum Mental Health Benefits
• Which Mental Health Services Are Covered by Optum Insurance?
• Which Mental Health Conditions Are Covered by Optum Insurance?
• How To Find Mental Health Services Near Me in Tennessee?
• About Optum Health Insurance
• Is Online Therapy Covered by Optum Insurance?
• How Much Do Mental Health Services & Testing Cost?

Which Mental Health Services Are Covered by Optum Insurance?

Optum is not a health insurance plan. Instead, it’s a group of doctors who work with most major health insurance companies.

Optum behavioral health and mental health services include various evidence-based therapy approaches and programs. The following is a partial list³ of services that your Optum behavioral health benefits may cover:⁴

• Acceptance and Commitment Therapy (ACT)
• Applied Behavior Analysis (ABA)⁵
• Behavioral Health Assessments
• Cognitive Behavioral Therapy (CBT)
• Dialectical Behavior Therapy (DBT)
• Eye Movement Desensitization and Reprocessing (EMDR)
• Group Therapy
• Inpatient Care
• Medication Management
• Psychotherapy

Which Mental Health Conditions Are Covered by Optum Insurance?

Optum is a group of doctors who work with most major health insurance companies – not an insurance provider. The following mental health disorders may be covered, depending on your level of coverage and location:⁶

• Anger Issues
• Anxiety
• Depression
• Eating disorders
• Grief Counseling
• Medication Management
• Stress
• Substance Use Disorders

How To Find Mental Health Services Near Me in Tennessee?

Thanks to Athena Care, finding mental health specialists and gaining access to a mental health clinic in Tennessee has never been easier. A care coordinator will assist you at one of our various Tennessee clinics, open Monday through Friday, 7:00 a.m. to 6:00 p.m.

When choosing Optum behavioral health providers, it’s important to ask questions and keep the following in mind:

• Education, training, license, and years of experience
• Specialties and services offered
• Treatment methods and philosophies
• Insurance companies they work with
• Office hours
• Pricing
• Session length

You’ll find a list of practitioners organized by city, along with information about their backgrounds and specialties Here.

About Optum Health Insurance

Optum is a network of doctors who work with most major health insurance companies, providing products and services that help people take control of their health by addressing behavioral health issues.⁷ Optum is a subsidiary of UnitedHealth Group and Optum itself is not an insurance provider.

Individual and family HMOs, PPOs, Original Medicare, Medicare Advantage, and supplement plans are available within Optum’s network.⁸ Depending on your location, these may vary in deductible costs, out of pocket costs, and more.

Below is a brief breakdown of these types of health plans:

• HMO: Health Maintenance Organization is a health insurance plan that often only covers care provided by doctors who work for or contract with the HMO. Except in an emergency, it usually does not cover out-of-network care.
• PPO: Preferred Provider Organization is a health plan in which medical providers, such as hospitals and doctors, enter into contracts to form a network of participating providers. If you use providers who are part of the plan’s network, you will pay less.
• Original Medicare: Part A (Hospital Insurance) and Part B (Medical Insurance) are two elements of this fee-for-service health plan. Medicare pays half of the Medicare-approved amount after you pay your deductible. You pay your share in the form of coinsurance and deductibles.
• Medicare Advantage Plans: A health insurance program for adults over 65 and those receiving Social Security disability benefits. These plans include Health Maintenance Organization (HMO) and Preferred provider organization (PPO) options.
• Medicare with Medicaid: Adults over 65 and those receiving social security benefits who are eligible for both Medicare and Medicaid can choose this HMO plan.
• Medicare Supplement Insurance: Often known as a Medigap plan, this is a separate policy that adds to your Original Medicare Part A and Part B coverage. Medicare Supplement Insurance protects you from high out of pocket costs by assisting with paying qualifying healthcare expenses not covered by Medicare.

In addition, Optum and UnitedHealthcare Community Plan deliver integrated care and behavioral health services to roughly 600,000 TennCare members as part of Tennessee’s 2006 Medicaid transformation.⁹ Furthermore, Optum is the number one Health Savings Account (HSA) provider in the United States.¹⁰

Is Online Therapy Covered by Optum Insurance?

Yes, Optum behavioral health services include access to virtual care, depending on your insurance provider and plan.¹¹

How Much Do Mental Health Services & Testing Cost?

Costs can vary depending on your insurance coverage and personalized treatment needs. The following are average costs for therapy, though they may vary by location and other variables and may not reflect the actual cost of treatment or what you may pay.

For example, In the United States, the typical cost of psychotherapy ranges from $100 to $200¹² a session, dependent upon the state and the length of the session. You’ll most likely have a co-pay that can range from a few dollars to $50 or more a session with health insurance.

Cognitive Behavioral Therapy (CBT) sessions are typically 45+ minutes long and cost between $100 and $200 per session, while Dialectical Behavioral Therapy (DBT) usually consists of a weekly individual therapy session, a weekly group therapy session, and weekly phone conversations. DBT costs vary depending on the type of services rendered.

Whether the therapist is in-network or out of network can influence this out-of-pocket cost.

Even with insurance, you will normally have to pay some or all of your medical expenditures until your total medical expenses reach the deductible. Then, depending on your plan, you may be required to pay a co-pay or coinsurance for each treatment.

Some therapists will work with patients on a sliding scale for those who do not present insurance. If you find a therapist who offers a sliding scale payment plan, they will most likely base the cost of your sessions on your income. This sliding scale can also vary from therapist to therapist.

Other In-Network Insurance Providers

Aetna
Ambetter TN
Blue Cross Blue Shield
Cigna
Evernorth
Medicare
Multiplan
PHCS
TRICARE
United Healthcare
Vanderbilt