UnitedHealthcare Community Plan of Kentucky addiction treatment coverage
UnitedHealthcare Community Plan covers the clinical continuum of substance use treatment for substance use disorder. Discuss your coverage with Golden Grove Recovery in Louisville, Kentucky.
What UnitedHealthcare Community Plan is
UnitedHealthcare Community Plan of Kentucky is UnitedHealthcare's Kentucky Medicaid managed care plan. It covers the full ASAM substance use disorder (SUD) treatment continuum and integrates behavioral health services for members with co-occurring mental health conditions. The plan also administers specialized programs for pregnant members and members transitioning from justice-involved settings.
What UnitedHealthcare Community Plan covers for SUD treatment
- Residential SUD treatment (ASAM 3.1, 3.3, 3.5) based on medical-necessity determination
- PHP (ASAM 2.5) and IOP (ASAM 2.1) with concurrent-review authorization
- Standard outpatient SUD counseling, group therapy, and
- Medication-Assisted Treatment — Suboxone, Subutex, methadone, Vivitrol, oral naltrexone
- Integrated treatment for co-occurring mental health conditions
- Maternity Support Services for pregnant members with SUD (coordinated MAT during pregnancy)
- Non-emergency medical transportation (NEMT) for treatment appointments
Levels of care UnitedHealthcare Community Plan covers
| ASAM | Description |
|---|---|
| 1 | Outpatient (ASAM 1) |
| 2.1 | Intensive Outpatient (ASAM 2.1) |
| 2.5 | Partial Hospitalization (ASAM 2.5) |
| 3.1 | Clinically Managed Low-Intensity Residential (ASAM 3.1) |
| 3.3 | Clinically Managed Population-Specific High-Intensity Residential (ASAM 3.3) |
| 3.5 | Clinically Managed High-Intensity Residential (ASAM 3.5) |
MAT covered by UnitedHealthcare Community Plan
UnitedHealthcare Community Plan covers the following FDA-approved medications for opioid and alcohol use disorder:
SuboxoneSubutexMethadoneVivitrolOral Naltrexone
Read more about how Medicaid covers MAT, including authorization and pharmacy benefits.
How prior auth works with UnitedHealthcare Community Plan
UnitedHealthcare Community Plan typically applies ASAM criteria for SUD medical-necessity determinations. Residential admissions require prior authorization; PHP/IOP are generally handled through notification plus concurrent review.
Member benefits that apply to SUD
Members access UnitedHealthcare's 24/7 nurse advice line, Optum Behavioral Health network for dual-diagnosis services, and care management for complex SUD and pregnancy-related cases.
More on UnitedHealthcare Community Plan at https://www.uhccommunityplan.com/ky.
Talk to admissions about UnitedHealthcare Community Plan coverage
Call us or send a message — we'll discuss what your UnitedHealthcare Community Plan plan covers and the next step.
Frequently asked questions
Does UnitedHealthcare Community Plan cover residential addiction treatment?
Yes. UnitedHealthcare Community Plan covers residential SUD treatment (ASAM 3.1, 3.3, 3.5) based on medical-necessity determination using ASAM criteria. Prior authorization with concurrent review is typical.
Does UnitedHealthcare Community Plan cover Suboxone or methadone?
UnitedHealthcare Community Plan covers Suboxone, Subutex, Methadone, Vivitrol, Oral Naltrexone as part of its MAT benefit. Methadone is delivered through licensed opioid treatment programs (OTPs).
Will UnitedHealthcare Community Plan cover medical detox?
Kentucky Medicaid plans cover medical withdrawal management when medically necessary, with coverage details that vary by level of care and setting. If detox is part of your situation, talk to our admissions team about the right path for you.
What does prior authorization look like with UnitedHealthcare Community Plan?
UnitedHealthcare Community Plan typically applies ASAM criteria for SUD medical-necessity determinations. Residential admissions require prior authorization; PHP/IOP are generally handled through notification plus concurrent review.
Is Golden Grove Recovery in-network with UnitedHealthcare Community Plan?
Golden Grove Recovery is in pre-opening setup. The information on this page is provided to help you understand Kentucky Medicaid coverage for substance use treatment. Contact our admissions team to discuss your individual situation and treatment options.