Is Portland Treatment in-network with UMR?

Yes. We participate in the UnitedHealthcare and Optum Behavioral Health networks that UMR-administered plans use, so your treatment is billed in-network and your cost share is based on the contracted rate.

Is UMR the same as UnitedHealthcare?

Not exactly. UMR is UnitedHealthcare's third-party administrator for self-funded employer plans. You typically access UnitedHealthcare or Optum networks, but your employer funds the claims and sets the benefit design.

Does UMR cover addiction treatment?

Yes. Nearly all UMR-administered plans cover PHP, IOP, outpatient therapy and medication-assisted treatment as behavioral health benefits. The cost share and authorization requirements come from your employer's plan document.

Do I need prior authorization with UMR?

Usually for PHP and often for IOP. We complete the clinical assessment and submit the authorization request for you, then handle concurrent reviews as treatment continues.

Will my employer see that I went to treatment?

No. Self-funded employers receive aggregate cost data, not individual diagnoses or treatment records. Substance use treatment records carry additional protection under 42 CFR Part 2.

What if my UMR plan carves out behavioral health?

Then a separate vendor, often Optum, manages your mental health and substance use benefits, with its own phone number and authorization process. We identify that during verification and work with whichever entity applies.

Can I use UMR for evening IOP while I keep working?

Yes, and that's the most common arrangement. UMR plans cover IOP regardless of the time of day it's delivered, and evening programming lets you keep your job and your paycheck.

Insurance · UMR / UnitedHealthcare

Using UMR insurance for addiction treatment

In-network provider

Portland Treatment is in-network through the UnitedHealthcare / Optum networks that UMR plans use.

UMR isn't technically an insurance company, it's UnitedHealthcare's third-party administrator for self-funded employer plans, and a lot of Maine employers use it. That distinction changes how your addiction treatment benefits work, and it's worth understanding before you call anyone.

855-449-7674

Plan type: Self-funded employer plans
Network status: In-network (UHC / Optum)
Levels covered: PHP · IOP · OP · MAT

Accredited & Licensed

LegitScript Certified
Joint Commission Accredited
Maine DHHS Licensed
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What's covered

What UMR typically covers at Portland Treatment

Because UMR administers rather than underwrites, your covered services come from your employer's plan document. In practice, nearly every UMR plan we see in Southern Maine covers this continuum:

Partial Hospitalization (PHP)

Our most structured outpatient level, full days of clinical programming. UMR plans typically cover PHP with prior authorization, which our admissions team requests for you.

More about partial hospitalization (php)

Intensive Outpatient (IOP)

Three to five sessions a week, mornings or evenings, so you can keep working. IOP is the most commonly authorized level of care under UMR behavioral health benefits.

More about intensive outpatient (iop)

Outpatient Program (OP)

Weekly individual and group therapy for step-down and long-term maintenance. Usually the lowest-cost level under a UMR plan.

More about outpatient program (op)

Medication-Assisted Treatment (MAT)

Buprenorphine, naltrexone and related medications, billed through your medical and pharmacy benefits. Coverage and preferred formulary vary by UMR plan.

More about medication-assisted treatment (mat)

Dual diagnosis care

Depression, anxiety, PTSD and bipolar disorder treated alongside substance use, one treatment plan, one set of clinicians, billed under your behavioral health benefit.

More about dual diagnosis care

Detox placement

We don't run a detox unit. We coordinate placement with licensed Maine detox providers and confirm they take your UMR plan before you go.

More about detox placement

Plan details

Know which UMR plan you actually have

Three things about UMR plans surprise people, and all three are worth knowing before your first call.

Your employer funds the claims

UMR processes them. That means benefit design, deductible, coinsurance, session limits, is set by your employer, not by a standard statewide plan.

The network is usually UnitedHealthcare

Look at the back of your card. Most UMR members access the UHC Choice Plus or Optum Behavioral Health network, and we are in-network in both, so your care is billed at the contracted rate.

Behavioral health may be carved out

Some employers route behavioral health to Optum or another vendor with a separate phone number. We identify which one applies to you during verification.

Authorization is common for PHP

Intensive levels of care usually need prior authorization plus periodic concurrent review. We submit and manage both.

What you'll pay

What determines your out-of-pocket cost

Self-funded plans vary more than commercial ones, so a real estimate requires reading your specific benefit. These are the levers:

Whether you've met your deductible for the plan year, in January this is the single biggest driver of what you pay.
Your coinsurance or copay per session or per program day once the deductible is satisfied.
Network status, and this one is usually in your favor: Portland Treatment is in-network with every major Maine payer except Cigna, so most clients are billed at the lower contracted in-network rate.
Whether the level of care requires prior authorization and how many days or sessions are authorized at a time.
Your out-of-pocket maximum, once you hit it, covered treatment for the rest of the plan year is paid at 100%.

How verification works

1. You call or submit. We take your UMR member ID and date of birth, nothing more invasive than that.
2. We call the plan. Our team gets the behavioral health benefit read directly from UMR (UnitedHealthcare), in writing.
3. You get a real number. Deductible remaining, coinsurance, authorization requirements and an estimated cost per week, before you commit.
4. We handle the rest. Prior authorizations, concurrent reviews and appeals are our job, not yours.

Call 855-449-7674

Southern Maine

Using UMR coverage close to home

We see UMR most often with larger Southern Maine employers and regional companies with locations in Biddeford, Saco, Sanford, Westbrook and greater Portland. If you commute to work, our evening IOP schedule is generally designed around the same drive you already make.

Because UMR plans differ so much, we don't quote numbers from memory. We call the behavioral health line printed on your card, get the benefit read in writing, and give you a written estimate before you commit to anything.

Biddeford Portland Saco All areas we serve →

UMR coverage questions

Is Portland Treatment in-network with UMR?: Yes. We participate in the UnitedHealthcare and Optum Behavioral Health networks that UMR-administered plans use, so your treatment is billed in-network and your cost share is based on the contracted rate.
Is UMR the same as UnitedHealthcare?: Not exactly. UMR is UnitedHealthcare's third-party administrator for self-funded employer plans. You typically access UnitedHealthcare or Optum networks, but your employer funds the claims and sets the benefit design.
Does UMR cover addiction treatment?: Yes. Nearly all UMR-administered plans cover PHP, IOP, outpatient therapy and medication-assisted treatment as behavioral health benefits. The cost share and authorization requirements come from your employer's plan document.
Do I need prior authorization with UMR?: Usually for PHP and often for IOP. We complete the clinical assessment and submit the authorization request for you, then handle concurrent reviews as treatment continues.
Will my employer see that I went to treatment?: No. Self-funded employers receive aggregate cost data, not individual diagnoses or treatment records. Substance use treatment records carry additional protection under 42 CFR Part 2.
What if my UMR plan carves out behavioral health?: Then a separate vendor, often Optum, manages your mental health and substance use benefits, with its own phone number and authorization process. We identify that during verification and work with whichever entity applies.
Can I use UMR for evening IOP while I keep working?: Yes, and that's the most common arrangement. UMR plans cover IOP regardless of the time of day it's delivered, and evening programming lets you keep your job and your paycheck.

Coverage details described here are general and change by plan year and plan design. Nothing on this page is a guarantee of benefits or payment. The only way to know your coverage is a benefit verification on your specific policy.

Other plans we work with

Anthem Cigna MaineCare (Medicaid)Harvard Pilgrim Martin's Point Aetna All insurance & payment options →

Keep exploring

Using UMR at Portland Treatment

Programs your plan may cover

Partial hospitalization program (PHP) in Biddeford
Our most structured day treatment, five days a week, home each night.
Intensive outpatient program (IOP) in Southern Maine
Nine-plus clinical hours a week with day and evening tracks.
Virtual IOP for anywhere in Maine
The same IOP curriculum by secure telehealth, statewide.
Outpatient program (OP) for ongoing recovery
One to two sessions a week that fit around work and family.

Other plans we accept

Anthem coverage for rehab in Maine
What Anthem BCBS typically covers for PHP, IOP and OP.
MaineCare (Medicaid) addiction treatment coverage
MaineCare members are welcome here.
Cigna coverage for addiction treatment
Verify your Cigna benefits in a few minutes.
Harvard Pilgrim coverage for rehab
A common New England plan for Maine members.

Helpful reading

Does insurance cover rehab?
Coverage, costs and what to ask your plan.
Working during rehab
Evening IOP, FMLA and keeping your job in treatment.
Maine recovery resources directory
Local meetings, crisis lines and state programs.
All Southern Maine areas we serve
Every city and town within driving distance of Biddeford.

Find out what UMR covers
today