Home / Coverage / United Healthcare and UMR
United Healthcare and UMRUsing your UHC, UMR, or Optum plan for virtual outpatient treatment.
United Healthcare, UMR (UHC's self-funded administrator), and Optum (UHC's behavioral subsidiary) cover a big share of working adults in the United States. Your plan is unique. We verify yours specifically before you commit to anything.
The honest version.
We are out of network with commercial carriers. In-network credentialing is in progress. We verify your out-of-network benefits and tell you the real out-of-pocket number before you start.
What we will and will not tell you about cost.
We do not waive cost-shares. We do not tell you treatment is free. We verify your OON benefits, give you the real number, and if cost is a genuine barrier we will talk about it case by case.
A short overview, no fine print.
Plans vary widely, so the numbers below are intentionally not on this page. Yours are unique, and we pull them with you on the phone or in a two-minute form.
The pieces of the plan
- An allowed amount for each kind of visit or day of care.
- A deductible you meet before the plan starts splitting the cost.
- A coinsurance split after the deductible.
- An out-of-pocket maximum for the year, after which the plan covers more or all.
- An authorization step for intensive outpatient and PHP-intensity hour expansion, which we handle.
What we do for you on the benefits side
- Call your carrier on the back of your card and pull the actual out-of-network behavioral numbers for the level of care you need.
- Translate them into the dollar cost of a week of treatment, so there are no surprises.
- Submit the authorization and stay on the case through review and renewal.
- Bill what the plan considers reasonable, so there is no balance-bill surprise later.
What the UHC family of plans usually looks like.
United Healthcare and UMR (a UHC subsidiary that administers many large self-funded employer plans) route most behavioral health through Optum, UHC's behavioral subsidiary. The plan that pays your claim and the network you call for authorization may not have the same logo on the card. We sort that out for you on the benefit check.
The typical OON shape
Most UHC PPO and POS plans include an out-of-network behavioral health benefit with a separate OON deductible and a coinsurance split after that. The authorization for intensive outpatient and PHP-intensity hour expansion runs through Optum. We open the authorization with Optum on your behalf.
Start the benefit check UMR self-funded employerPlan rules come from the employer
UMR cards usually mean a large employer self-funds the plan and uses UMR to process claims. The employer's plan document sets the rules. Some UMR plans route behavioral through Optum, some through a carve-out vendor. Send us the front of the card and we will tell you which one and what your OON benefit looks like.
Start the benefit checkPlain-English answers.
Is Shift in-network with United Healthcare or UMR?
No. We are out of network with commercial carriers including UHC, UMR, and Optum. In-network credentialing is in progress. We bill out-of-network and many UHC family plans include an OON behavioral health benefit.
My card says UMR. Is that different from United Healthcare?
UMR is a United Healthcare subsidiary that administers self-funded employer plans. The plan rules come from the employer's plan document, not UMR. Behavioral health authorization usually runs through Optum, UHC's behavioral subsidiary. We sort that out on the benefit check.
Who handles my behavioral health authorization?
For most UHC and UMR plans, Optum manages the behavioral health authorization process. We open the authorization with Optum on your behalf and stay on the case through review and renewal.
Will I have an out-of-pocket cost?
Almost always, yes. Out-of-network plans use a separate deductible and coinsurance, and we collect the patient share as required. We pull your specific numbers before you start so there are no surprises.
Does telehealth count?
Yes. Virtual intensive outpatient and PHP-intensity hour expansion are reimbursable under almost all UHC, UMR, and Optum-administered plans when authorized. Authorization is part of what we handle.
How fast can you verify my benefits?
Same day in most cases if you send us the member ID and group number on the front of your card during business hours. The benefit check itself is no-cost and no commitment.
Verify your benefits in two minutes.
Send us the member ID and group number on the front of your card. We come back with your specific out-of-network deductible, coinsurance, out-of-pocket maximum, and what a typical week of intensive outpatient or partial hospitalization-intensity care would cost you. No commitment until you decide.
If you or someone you are with is in immediate danger, call or text 988 (the Suicide & Crisis Lifeline) or call 911. Shift Support Network is an outpatient program and is not an emergency service.