Therapy that takes UnitedHealthcare in Wisconsin

The card and the benefit are different companies

Behavioral health for these plans is generally administered by Optum, which sits under the same corporate parent. So the card in your wallet carries one name, and the organisation that decides what your therapy costs carries another.

Practically, this means two things. Calling the main number may get you transferred, and searching the wrong directory may tell you a therapist is out of network when they are not. If you look me up, look in the behavioral health directory rather than the medical one.

What this plan usually is

Most Wisconsin members have this through an employer, and the details are set by that employer’s group rather than by the insurer alone. A colleague at a different company with the same card can have a noticeably different mental health benefit from yours.

Which of their plans you have changes the answer

This insurer sells several quite different things: commercial coverage through employers, Medicare Advantage for people over sixty five, and a Community Plan that administers Wisconsin Medicaid benefits. They share branding and very little else.

If yours is the Community Plan, you are effectively covered by Wisconsin Medicaid, and the Medicaid page on this site is the more useful one to read.

If you are not sure which you hold, the card usually says, and member services certainly will.

What I’d ask them

• Is my behavioral health benefit administered by Optum, and what number should I use?
• What is my cost for outpatient psychotherapy with a Licensed Professional Counselor?
• Does my deductible apply first?
• Is telehealth covered at the same rate as in-person?
• Is prior authorisation needed for ongoing weekly sessions?