Oscar Insurance Coverage for Addiction Treatment

Using Oscar Insurance Coverage to pay for addiction treatment: One of the first things that someone thinks of when considering going to treatment for substance or alcohol abuse is the cost of the program. Substance abuse treatment can be costly. Fortunately, your Oscar insurance plan will cover alcohol and substance abuse treatment. Treatment could be free or at a fraction of the costs that you would expect. Our addiction treatment specialists can help you find treatment options for substance abuse and mental health disorders that your insurance plan will cover. We work with programs that are both in-network and out-of-network with Oscar Insurance.

Having health insurance does not guarantee coverage for all types of treatment for alcohol or drug addictions. Health insurance coverage can vary by plan. Most health insurance plans will cover most or part of treatment for a substance abuse disorder depending on the plan you have chosen. You can call us to find out if there are any drug rehab centers nearby that take Oscar Insurance. If you would like to find out more about drug rehab programs near you, give us a call and we can get your insurance verified today.

1-800-513-5423

What you will learn:

• About Oscar Insurance
• Does Oscar cover drug and alcohol rehab center programs?
• What does Oscar Health Insurance cover for substance abuse treatment?
• How to verify your insurance
• Will Oscar insurance pay for out-of-state rehab centers?
• Types of Addiction Treatment Covered by Oscar Insurance
• Does Oscar Insurance Cover Mental Health and Co-occurring Disorders?
• Will my Oscar insurance cover sober living?
• How to get started

About Oscar Insurance

Oscar Health has been providing insurance since 2012 and has over 500,000 members across 19 or more states. Oscar Health offers insurance plans for individuals, families, and businesses, as well as Medicare Advantage supplemental plans. Oscar also has a working relationship with Cigna to provide insurance for small groups in some markets.

Does Oscar cover drug and alcohol rehab center programs?

Oscar insurance covers drug and alcohol treatment programs. What Oscar will pay will depend on the program you choose. Different variables for coverage can include in-network or out-of-network, type of program, or the policy that you have chosen.

What does Oscar Health Insurance cover for substance abuse treatment?

Oscar covers many forms of treatment including outpatient rehabs, inpatient substance abuse programs, day treatment programs, and general counseling for mental health. Depending on your plan you may need to come up with a copay to cover the costs of treatment. Staying in-network can save you possibly thousands of dollars in copays, and co-insurance, or cover the gap between what they will pay and what the center charges.

How to verify your insurance

When you have decided to get help for a substance abuse or alcohol dependency issue the last thing you need is to try and navigate the world of insurance. This can be overwhelming and lead to frustration. Fortunately, there are admissions specialists at drug rehab centers who are here to help you navigate such problems. If you have Oscar insurance, you may be covered for part or all of your treatment for alcohol or substance abuse. It does not matter if you are struggling with alcohol dependency or drug addiction, Oscar insurance can help cover expenses related to the treatment for addiction.

If you would like to verify your insurance coverage for substance abuse, alcohol misuse, or mental health care, you can log onto their portal and verify the benefits yourself. There is also a phone number on the back of your insurance card and one of their insurance specialists can guide you. Your insurance provider will not be contacted unless you have decided to enter one of the facilities we work with and would like to use your Oscar insurance to cover the costs.

Will Oscar insurance pay for out-of-state rehab centers?

Oscar may cover out-of-state rehab center programs, but it will depend on your current plan, which plan you have chosen, and whether your chosen rehab is in-network with or out-of-network with Oscar. Be sure to check your plan details and get the benefits verified before committing to a treatment program that is not in-network with your current plan.

Types of Addiction Treatment Covered by Oscar Insurance

DETOX: Oscar will pay for detoxification programs only if it is deemed medically necessary to ensure a safe detoxification from drugs or alcohol. Oscar may want a referral from your primary doctor to make sure that a detox program is medically necessary to ensure your health is not at risk when withdrawing from drugs or alcohol.

INPATIENT: Oscar will cover inpatient rehab center programs. As aforementioned there may be deductibles and copays that you will need to come up with to receive treatment and use your insurance plan.

MAT PROGRAMS: Medication-assisted treatment programs (MAT) treatment programs for opioid addiction, alcohol dependency, and benzodiazepine overuse can be covered by Oscar insurance. Oscar uses ASAM criteria to determine which services are medically necessary including MAT services. MAT is approved by the (FDA) Food and Drug Administration and is used in conjunction with counseling and therapy to help address the underlying issues that have led to addiction in the first place.

Does Oscar Insurance Cover Mental Health and Co-occurring Disorders?

Dual diagnosis programs such as treatment for depression, anxiety, or other mental health disorders that are concurrent with a substance abuse problem may be covered by your Oscar insurance plan. Coverage for dual diagnosis treatment may be dependent on your plan, mental health treatment may be covered in full or partially.

Will my Oscar insurance cover sober living?

Sober living can be used in conjunction with outpatient treatment, and for aftercare programs to give a safe place to transition from inpatient rehab to life back in the real world. This important step in the recovery process may be covered by Oscar insurance plans. Sober living can be thought of as a less restrictive program than an inpatient treatment program. Your Oscar insurance coverage may cover this form of treatment depending on your policy and the plan you have chosen.

Sober living environments have their own set of rules, curfews, and schedules, and administer drug and alcohol tests to ensure the safety of the group. These sober living homes provide a safe space while providing an opportunity to recover while living a life free of substance addiction. Learning to navigate life and relearn to have fun without the need to self-medicate is an important part of everyone’s recovery. Sober living gives the person a good start on living a life and enjoying activities without drugs or alcohol.

How to get started

You already have taken the first step which is admitting there is a problem that needs to be addressed. The next step is to verify and confirm your benefits which will help you determine the best place for you to receive treatment based on your coverage and needs. You can contact one of our insurance navigators and see if one of the programs we work with is right for you. 

1-800-513-5423

Sources

About Oscar Health

Oscar Health FAQ

Mental Health Substance Abuse Coverage

Erik Epp – Content Author