UMR Coverage for Mental Health Therapy Treatment in Florida

Mental Health Programs Covered by UMR Insurance

The specific mental health programs United Medical Resources provides can vary depending on the employer’s plan design and the services included. However, UMR plan options typically include coverage for a range of mental health programs and services to support its members’ mental health and emotional well-being.

UMR Coverage for Partial Hospitalization Programs

A Partial Hospitalization Program (PHP) is a structured treatment program for people with mental health disorders requiring intensive, short-term care. It involves extensive therapy but without 24-hour inpatient care. Patients participate in counseling and therapy sessions during the day and return home in the evenings to maintain their daily routines.

UMR typically covers PHP. However, reviewing your particular policy for coverage specifics is essential as they may vary depending on your personal circumstances and other factors.

UMR Coverage for Intensive Outpatient Program

An Intensive Outpatient Program (IOP) is a highly structured treatment option for people suffering from mental health or substance use disorders. It involves therapy, counseling, and support sessions multiple times weekly, allowing patients to continue living at home while receiving treatment. UMR healthcare management generally offers comprehensive mental health coverage, which includes IOP services.

UMR Coverage for Outpatient Program

Outpatient programs offer patients wellness and mental health assistance without needing an overnight stay in a medical facility. Patients can maintain their regular daily routines and return home after each session. UMR third-party administration generally covers a range of outpatient programs.

Treatment for Bipolar Disorder and Cyclothymia

Bipolar disorder disrupts an individual’s mood, leading to intense shifts between manic highs and depressive lows. Conversely, Cyclothymia represents a less severe variant of bipolar disorder characterized by milder mood fluctuations. Both mood disorders substantially impact emotions, energy levels, and daily cognitive functioning, necessitating medical and therapeutic interventions to attain stability and effective management.

UMR typically provides coverage for these psychiatric conditions, guaranteeing access to treatment and mental health assistance. Nevertheless, it’s important to remember that the coverage details may vary from policy to policy.

Treatment for Borderline Personality Disorder (BPD)

Borderline Personality Disorder (BPD) is a mental health disorder marked by enduring patterns of instability in emotions, self-perception, and interpersonal connections. People with BPD frequently contend with intense mood fluctuations, impulsivity, unstable self-esteem, and difficulties in nurturing stable relationships, which negatively impact psychological health, relationships, and overall quality of life.

Nevertheless, through suitable therapy and treatment, it is possible to address and manage the symptoms effectively. UMR typically includes coverage for diagnosing and treating BPD, encompassing various psychotherapy techniques, medication management, and other interventions.

Treatment for Anxiety Disorder

Anxiety is a prevalent mental health disorder defined by an abundance of concern, fear, and unease regarding upcoming events or circumstances. Those grappling with anxiety frequently encounter physical manifestations such as restlessness, a swift heartbeat, perspiration, and muscle strain. Anxiety can substantially impact daily life, influencing work, relationships, and overall well-being.

United Medical Resources typically provides coverage for anxiety treatment, which may entail cognitive-behavioral therapy (CBT), medication management, and other methods grounded in scientific evidence to diminish symptoms and enhance overall well-being.

Treatment for Depression

Depression is a common mental health condition marked by enduring feelings of sadness, despair, and a lack of enthusiasm for once-enjoyed activities. Depression symptoms frequently involve changes in eating and sleeping routines, decreased energy levels, and challenges in maintaining focus, all of which can disrupt daily life, impact relationships, and, if untreated, even give rise to thoughts of self-harm.

UMR, as a third-party administrator, generally extends coverage for depression treatment. This may encompass preventive care benefits, therapy sessions, prescription drug coverage, and other evidence-based methods designed to alleviate depression symptoms and restore mental and emotional well-being.

Treatment for Post-Traumatic Stress Disorder (PTSD)

Post-Traumatic Stress Disorder (PTSD) may emerge after exposure to or observing a distressing event. Symptoms include intrusive flashbacks, disturbing nightmares, heightened anxiety, and emotional detachment. Those with PTSD might also exhibit hypervigilance and tend to evade situations that trigger memories of the traumatic incident. This condition can have a substantial impact on everyday existence and overall welfare.

UMR typically provides coverage for PTSD treatment, encompassing therapeutic interventions, medication, and other evidence-based approaches to develop effective coping strategies for stress management.

How To Check My UMR Health Insurance Coverage Levels

If you want to understand the extent of your health insurance coverage, call 877-958-9212. Our patient advocates are here to help. We’ll contact UMR member services to verify your coverage specifics. Following that, we will carefully review your policy with you, providing a clear explanation of the treatment and program choices that are accessible.

How Many Times Will United Medical Resources Pay for Rehab?

The number of times that United Medical Resources will pay for rehabilitation will depend on several factors, including the specific UMR-administered health plan, the type of rehab needed, and the medical necessity. UMR typically provides coverage for rehab services when they are deemed medically necessary and within the scope of the plan’s coverage.

Here are some key points to consider:

• Medical Necessity: UMR, like other healthcare providers, bases coverage decisions on medical necessity. This means that the treatment must be recommended by a healthcare provider and considered essential for recovery or well-being.
• Type of Rehab: The coverage for each type of rehab may have different criteria and limitations.
• Plan Design: The specific UMR-administered health plan offered by your employer can have varying levels of coverage and limits. Some plans may have a set number of covered rehab sessions, while others may provide coverage as long as it is medically necessary.
• Preauthorization: Some rehab services may require preauthorization or prior approval before they are covered.
• Out-of-Pocket Costs: Even with coverage, you may still be responsible for out-of-pocket costs, such as copayments, deductibles, or coinsurance.

UMR Mental Health Treatment Coverage Guide

Other Mental Health Treatment Insurance Providers in Florida

Rehab and Mental Health Statistics in Florida

In Florida, recent trends in substance use and mental health paint a complex picture of challenges and progress. Mental health issues are widespread, with limited access to care. A survey of Florida high school students reveals that a significant 21.4% have experienced four or more adverse childhood experiences (ACEs), indicating a high level of trauma.

Substance use and mental health trends show progress but also persisting challenges. Marijuana use among students has decreased, but high-risk drinking behavior remains prevalent. Early intervention and education efforts are needed to protect the well-being of Florida’s young population and address the barriers to treatment for adults.

• The long-term pattern of marijuana use among Florida students shows some fluctuations, but the general trend points toward a decrease in usage. Specifically, the prevalence rate of past marijuana use has declined from 13.0% in 2010 to 8.3% in 2022.¹
• Although there has been a decrease in alcohol consumption, there remains a prevalent pattern of high-risk drinking behavior. This is evident as 7.5% of high school students have reported engaging in binge drinking, and 11.0% have experienced blackout episodes due to alcohol consumption on one or more occasions.
• A survey of Florida high school students found that 21.4% reported experiencing four or more adverse childhood experiences (ACEs), which is considered a high level of trauma.
• 4% of these students reported that their parents had separated or divorced, followed by 32.9% who reported mental illness in the household and 31.2% who reported emotional neglect. On the lower end of the scale, 6.6% reported sexual abuse, 6.7% reported physical neglect, and 8.5% reported physical abuse in the household.
• 1% of Florida students reported attempting suicide in the past year, with females being twice as likely as males (12.9% vs. 5.1%).
• Nearly 2.9 million Floridian adults have a mental health condition, but only about 36% receive treatment, per the National Alliance on Mental Illness (NAMI).²
• The Substance Abuse and Mental Health Program under the Department of Children and Families offers services to individuals with low income or those without insurance coverage. However, a legislative report from the State Commission on Mental Health and Substance Abuse has indicated that there is a monthly waitlist of over 1,300 individuals seeking these services.
• Suicide is more common than homicides in 62 of Florida’s 67 counties.³
• Florida ranks 49th in the United States regarding accessibility of mental healthcare.^{4 5}
• 8% of adults with any mental illness in Florida are uninsured.

Sources

1. “2022 Florida Youth Substance Abuse Survey.” Florida Department of Children and Families, 2022, www.myflfamilies.com/sites/default/files/2022-12/2022%20Statewide%20FYSAS%20Report%20Per%20Section%20C2-2.3.pdf.
2. Bolden, Louis. “Less Than Half of People in Florida With Mental Illness Don’t Get Treatment.” WKMG, 24 Feb. 2023, www.clickorlando.com/news/local/2023/02/24/less-than-half-of-people-in-florida-with-mental-illness-dont-get-treatment.
3. “Facts About Mental Health in Florida.” Florida Behavioral Health Association, 2018, cdn.ymaws.com/www.fadaa.org/resource/resmgr/files/Mental_Health/FADAA_Slipsheet1_Final.pdf.
4. Zizo, Christie. “Florida Is 49th in US for Access to Mental Health Care. The New Budget Could Change That.” WKMG, 19 Dec. 2022, www.clickorlando.com/news/politics/2022/05/26/florida-is-49th-in-us-for-access-to-mental-health-care-the-new-budget-could-change-that.
5. “Access to Care Data 2022.” Mental Health America, mhanational.org/issues/2022/mental-health-america-access-care-data.