Navigating your mental health: a complete guide to Optum therapy coverage

Caring for your mental health is just as important as it is for your physical health . But with the American insurance landscape being so complicated and confusing, it can be tough to understand whether your health insurance covers what you need. If you have Optum insurance, this post can help you learn more about what mental health services are covered and what you might need to pay for them.

What is Optum?

Optum is a healthcare company that offers a wide range of health solutions and care services. For example, Optum Rx provides pharmacy care services to help people find affordable medication. Optum Insights provides data, consulting, and management services to improve performance and operations for a variety of healthcare clients. Optum Health helps employers, health systems, and health plans manage direct care for their members, including behavioral health care.

Health plans that provide direct behavioral health care through Optum can offer members simplified digital experiences and tools to easily identify the types of mental health treatments they might need, such as therapy or counseling. Members can then choose from a wide network of providers with options to also take advantage of virtual care. Optum’s overarching goal is to ensure that individuals have coordinated care for both the mind and body.

Does Optum cover therapy?

Depending on your insurance plan, Optum may provide services such as in-person and online therapy, as well as a wide range of mental health services that are designed to help with substance use, depression, anxiety, trauma, and more. To confirm that therapy is covered by your specific plan, we recommend you reach out to your insurance provider directly.

What therapies does Optum cover?

Insurance can cover many types of therapy that serve as quality care options for different conditions. You need to confirm what types of therapy your specific insurance plan covers. If your insurance plan works with Optum to deliver mental health care, the general the types of therapy plans may cover include:

• Cognitive behavioral therapy
• Dialectical behavior therapy (DBT)
• Family therapy
• Group therapy
• Marriage and couples therapy 

Learn more about other types of therapy you might find when seeking mental health care. Please be sure to double check your specific insurance plan, or reach out to Optum directly, to understand what therapy may be covered.

Does Optum cover online therapy?

Your insurance plan will determine what types of therapy are covered. Optum provides access to both online therapy (also referred to as telehealth or virtual therapy) as well as in-person therapy. Online therapy through Optum is available nationwide, based on the platform you may be seeking care through.

You can receive virtual therapy on Grow Therapy in every state we are available in.

Does Optum cover out-of-network therapy?

Optum insurance may cover out-of-network therapy in certain circumstances. If you want to see an out-of-network mental healthcare provider, it may cost much more than seeing an in-network provider.  You may have to pay out of pocket, and you should check beforehand to see if you will be able to file for any kind of reimbursement from Optum. If you have questions about out-of-network therapy coverage, please refer to your Optum summary of benefits (SOB) as described below, or reach out to Optum directly.

How to check if your Optum plan covers therapy

There are three main ways to find out whether you are covered for therapy and, if so, how much it will cost.

1. Check your insurance “summary of benefits” (SOB)

On the SOB, look for a row titled “If you need mental health, behavioral health, or substance abuse services” and refer to the second column that says “Outpatient services.”

Sample image—your summary of benefits may look different depending on your provider

If the “Network Provider” and/or “Out-of-Network Provider” say “not covered,” then your insurance plan does not cover mental health services such as therapy.

If the “Network Provider” and/or “Out-of-Network Provider” give cost information, such as a copay or coinsurance, then your plan does cover mental health services.

To learn more about how an SOB is structured, you can refer to this sample SOB from the Centers for Medicare & Medicaid Services.

2. Contact Optum directly

Contacting Optum directly is the best way to get the exact information you need about what types of mental health care are covered. To find contact information for Optum, use the Optum website to log into your account, and either chat or email a representative directly

3. Use a therapy provider like Grow Therapy

With Grow Therapy, you can search for Optum therapists in your state who provide virtual or in-person care. Once you’ve found and booked an appointment with a therapist who you feel will be a good fit for your needs, Grow Therapy will verify your coverage and benefits and share any out-of-pocket expenses you need to be aware of. With Grow Therapy, there are no unexpected surprised with your therapy coverage.

How much does therapy with Optum cost?

Most people with insurance plans that administer mental health benefits through Optum will either fully cover therapy, or clients will have to pay a small copay amount. For most clients, the average cost of therapy is $4 – $71 per session, after the deductible has been met. For those who haven’t met their deductible yet, or for whose plan does not cover therapy, the typical range of cost is $80 – $200 per therapy session.

However, these are average ranges. The cost of therapy will depend on your plan’s specific coverage. You should always confirm your out-of-pocket costs before your appointment.

Average cost of therapy with Optum insurance by state.

Looking at the therapy cost table above, we find that 65% of the states listed above have an average cost of $75 or less, with almost 50% of the states being less than $50 per session.

The most expensive state for therapy with Optum insurance was Michigan ($0 – $137), and the least expensive states for therapy covered by Optum insurance were Utah and Alabama ($0 – $15).

Optum Therapy Copay

When paying for therapy, your copay—or copayment—is an important cost you should know about.

The copay is a fixed amount you have to pay for each therapy session. Copays can vary depending on your plan, so it’s important to double check your copay under the mental health coverage section on your SOB.

If you have any doubts or questions about if you have to pay a copay, or what your copay is, you should reach out to UnitedHealthcare support directly.

Sample image 

Does Optum require a referral to see a therapist?

Most Optum plans do not require a referral at this time. To be sure, reach out to your insurance provider to determine whether referrals for therapists are necessary.

Find an Optum insurance therapist

Finding an Optum therapist is not as difficult as you might think. There are several resources available to help you find a therapist online.

1. Check Your insurance plan

The first thing to do is check your insurance plan. This will show you what mental health services are covered, and what you might have to pay for. You can do this by looking at your online account, calling the customer service number on your insurance card, or reading your plan documents.

2. Grow Therapy

You can find an Optum therapist in almost every state within the U.S. using Grow Therapy. Simply select your state from the list below and explore our Optum therapists in your area.

Search Optum therapists by state.

Alabama Arizona Arkansas California Connecticut Delaware Washington DC Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas

Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New York

North Carolina North Dakota Ohio Pennsylvania South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Wisconsin

3. Liveandworkwell.com

To access the Optum online directory, you can visit their website or download their mobile app.

From there, you can search for providers by location, specialty, service, and other factors to help you find a provider that meets your specific needs. You can also read reviews from other patients and see ratings for each provider to help you make an informed decision.

Using the Optum online directory can save you time and effort in finding a mental health provider. Instead of calling multiple providers to see if they accept your insurance, you can quickly and easily find in-network providers in your area with just a few clicks.

Other insurance providers that cover mental health

• All Savers
• Aetna
• AmeriHealth Administrators
• AmeriHealth New Jersey
• AmeriHealth Pennsylvania
• AvMed
• Cigna
• Evernorth
• Harvard Pilgrim
• Husky Health
• Magellan
• Medicare
• Oscar
• Oxford
• Superior Health Plan
• Surest
• Tufts Health
• United Healthcare
• United Medical Resources
• UnitedHealthcare Shared Services
• Wellcare Medicare