UMR Plan for Therapy

UMR, which used to stand for United Medical Resources, is a company owned by the UnitedHealthcare Group. UMR is actually not an insurance company — it’s what’s called a “third-party administrator” (TPA). This means that your employer pays UMR to provide administrative support for you when it comes to healthcare expenses, including billing and reimbursements. However, for your purposes, UMR acts like a health insurance, meaning that you’ll encounter in-network and out-of-network providers, copayments, and coinsurance rates.

Does UMR cover therapy?

Yes, UMR provides coverage for mental health services, including therapy. It’s important to note that, because UMR serves as the administrator between your employer and their selected insurance company, how much coverage you receive from a UMR plan will vary. Because UMR offers support for many companies around the country, your plan will likely be different from other plans in place at other companies. This means that it’s important to locate and review your company’s specific Summary of Benefits document, which lists out the coverage rates for all healthcare services.

How do I check if my UMR plan covers therapy?

To check if your UMR plan covers therapy services, refer to your Summary of Benefits document. You’ll likely receive this document when you’re onboarded to your company, or once per year when you have the chance to review and make changes to your benefits packaging. If you’re struggling to find your Summary and Benefits document, request one from your company’s HR contact, as they will be familiar with the company’s health insurance benefit plans.

Once you have your Summary of Benefits document, look up “mental health services.” You will likely see both in-patient and outpatient categories. Individual therapy is generally listed as an “outpatient service” — you might also find this information under “behavioral health” or “substance abuse services.”

If you have an insurance card with UMR’s details, you can give them a call at the number that is typically on the back of your card. They’ll be able to look up your specific plan and explain to you what your benefits are, including how much coverage you have in place for therapy services.

How much does therapy cost with UMR?

How much you’ll pay per therapy session will vary depending on your location, company, and plan. As UMR isn’t directly providing the coverage, you may need to learn more about your specific insurance provider — your employer will know this information. Your employer might also provide additional coverage past your insurance coverage as a general benefit to working for them.

However, in general, expect to pay between $20-$120 per session. UMR operates through a provider network, which means that picking an in-network therapist may be less expensive than choosing an out-of-network therapist. For in-network therapists, you might pay a $20 copay for one visit, if you don’t have a deductible to meet first. For other therapists, you may have to pay a $100 copay and also be responsible for 5% of the full session fee.

Preauthorization may be required to access these coverage benefits, which means that you might need permission from your insurance company before they begin to help you pay for your therapy treatment. Be sure to read your Summary of Benefits document or give UMR a call to better understand what steps you need to make before you start working with a therapist.

What types of mental health conditions does UMR cover?

UMR plans provide coverage for a wide range of mental health conditions. You will likely need to receive a diagnosis from your therapist to access this coverage — this is one way that health insurance companies track their members’ progress and what coverage they’re entitled to.

Here are some examples of the types of mental health topics that may come up in your therapy:

What types of therapy does UMR cover?

UMR covers all types of therapies that are evidence-based and provided by a credentialed mental health professional. To receive the benefits of UMR coverage, therapists must have professional training and licensure to practice therapy. This aims to maintain a high standard of clinical expertise, and to offer clients the best possible outcomes for their time, effort, and money.

Some of the most popular types of therapy provided by licensed mental health professionals include:

Your therapist may use an “integrated approach,” which means that they draw from several different types of therapy approaches or modalities during each one of your sessions.

What types of therapy does UMR NOT cover?

UMR does not cover types of therapy services that are not evidence-based to treat a mental health condition. This includes life coaching or career counseling, which may be beneficial but do not require the same level of clinical rigor. Additionally, UMR does not cover some holistic treatment modalities, including aromatherapy, massage therapy, or non-medically required acupuncture. Reiki healing, hypnosis, and psychedelic treatments are also not covered.
If you aren’t sure what types of therapies qualify for UMR coverage, refer to your member handbook for a detailed description. You might also give UMR a call to learn more about what they cover when it comes to mental health treatment.

Does UMR cover online therapy?

UMR typically covers online therapy. Online therapy is an excellent way to work with a therapist, as it offers flexibility and will save time in commuting. For these reasons and more, many people who work with therapists prefer to take their sessions from their phones or computers.

If your UMR plan covers therapy, you’ll likely pay the same copayment or coinsurance rate if you were going to their office as an outpatient visit. You can refer to the “outpatient services” portion of your Summary of Benefits document.

Does UMR cover couples therapy?

There are some UMR plans that offer coverage for couples therapy. Whether or not couples therapy is covered by your UMR plan depends on your location, employer, and plan, so it’s important to check the details on your specific plan’s details.

In general, health insurance plans do not cover couples therapy. However, your plan may be different, as it’s provided by your employer — your employer might offer couples therapy benefits even if your insurance does not.

Do I need to see my primary doctor before starting therapy?

Many insurance plans require you to see your primary doctor before starting therapy, and several UMR plans are the same. Some plans require preauthorization before starting a relationship with a therapist. This means that you need an assessment by a primary doctor and a referral for mental health services. If your plan requires preauthorization, it’s likely a good idea to make an appointment to see your primary doctor and learn what they think is the best next step.

Otherwise, check to see if your plan is a PPO or an HMO, as this will inform whether you need to get a referral from a healthcare provider before searching for the right therapist for you.