Networks change. We verify your specific UnitedHealthcare plan before your first visit; call with your member ID and we will confirm benefits, copay and any referral or authorization requirements.
Also appears on cards as: UHC, United Healthcare, United, UnitedHealthcare Choice, UHC Choice Plus, All Savers, UHC StudentResources, Surest, AARP UnitedHealthcare.
UnitedHealthcare is the largest commercial insurer in the United States, and its behavioral health benefits are administered by Optum Behavioral Health, a sister company. If your card says UnitedHealthcare, your psychiatry visits are typically authorized, credentialed and paid through Optum, which maintains a separate provider network from the medical side. Choice, Choice Plus and Navigate plans cover in-network psychiatry for a specialist copay or coinsurance, and referrals are not required for behavioral health even on gatekeeper plans. Telehealth psychiatry is covered at parity with office visits for Florida and South Carolina members, with video visits a permanent benefit.
UnitedHealthcare's medical policy for transcranial magnetic stimulation covers TMS for major depressive disorder with prior authorization when you have had an inadequate response to at least two antidepressants and have documented symptom severity, generally approving an initial course of up to 36 sessions. Spravato is covered under the medical benefit, or through OptumRx for some plans, with prior authorization that requires treatment-resistant depression, a concurrent oral antidepressant and administration at a REMS-certified site. Approvals usually cover the induction phase first, with continuation reviewed based on documented improvement. Stedfast Psychiatry staff submit and track both authorizations.
What we check before your visit
- Whether your plan is in network at the office you chose and for telehealth
- Your copay or coinsurance for an evaluation and for follow-ups
- Whether a primary-care referral is required (common with HMO plans)
- Prior-authorization criteria for Deep TMS and Spravato, if those are being considered
Frequently asked questions
Does UnitedHealthcare cover visits at Stedfast Psychiatry?
Stedfast Psychiatry accepts most UnitedHealthcare commercial plans. Because UnitedHealthcare routes mental health through Optum Behavioral Health, confirm that our providers appear in the Optum directory or call the behavioral health number on your card. Our front desk can also run an eligibility check and tell you your copay before you come in.
What is the copay for a psychiatrist with UnitedHealthcare?
Most UnitedHealthcare plans charge a specialist office copay, typically $30 to $70, for outpatient mental health. High-deductible plans charge the contracted rate until the deductible is met. Some employer plans set mental health visits at the primary care copay. Your summary of benefits lists the outpatient behavioral health cost share.
Can I see a Stedfast provider by video with UnitedHealthcare?
Yes. UnitedHealthcare covers video psychiatry at the same benefit level as in-person visits for members physically located in Florida or South Carolina during the appointment. Telehealth works well for evaluations, medication management and follow-ups. Deep TMS and Spravato require in-person visits at the offices that offer them.
Will UnitedHealthcare approve Deep TMS?
UnitedHealthcare covers TMS for major depressive disorder with prior authorization when medical necessity criteria are met, including documented failure of at least two antidepressants and a current severity score. Our TMS coordinator at Palm Beach Gardens gathers your records, submits the request through Optum, and arranges a peer-to-peer review if the first decision is a denial.
Is Spravato covered by UnitedHealthcare?
Spravato is covered with prior authorization for treatment-resistant depression. Requirements include failure of at least two antidepressants, a concurrent oral antidepressant and treatment at a REMS-certified clinic. Depending on your plan, the drug is billed under the medical benefit or supplied by a specialty pharmacy through OptumRx. We coordinate the approval and the drug supply.