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Oscar Health Insurance Coverage for Substance Abuse Treatment Near Me

On this page, you will learn about Oscar Health Plan coverage for substance abuse treatment and how to confirm what benefits are available under your specific plan.
If you or a loved one are experiencing a medical emergency, call 9-1-1 immediately.
Oscar Health Plan INSURANCE FOR ALCOHOL and DRUG ADDICTION TREATMENT

Provider Overview

Does Oscar Health Insurance Cover Alcohol and Drug Rehab?

You can access your Oscar Health insurance if you’re struggling with an alcohol or drug addiction. Oscar Insurance provides flexible plans for people that include:1(click shop plans)

  • Individual and family plans.
  • Medicare Advantage plans.
  • Cigna + Oscar plans.
  • Oscar for Business plans.

When determining whether your policy will cover the rehab services you require, you can contact Oscar Health by calling the phone number on the back of your card. If you prefer to find out right away, you can contact the rehab facility directly, and they will verify your insurance information.

Check Oscar Health Insurance Coverage for Addiction Treatment

With an Oscar Health Plan, you can seek alcohol or drug addiction treatment at participating rehab centers.2(right above benefits at a glance) If you want to expedite the process, you can contact American Addiction Centers (AAC) now at , and they will verify your insurance coverage for you. There is a form on this page to fill out that will allow you to get an immediate answer about whether Oscar Health is in-network with AAC or not.

What is Oscar Health?

Since 2012, Oscar Health has worked to provide individuals, families, and businesses with superior healthcare choices.3(top) With over 550,000 members, Oscar Health continues to grow and offer solutions to people’s most pressing healthcare needs.3(yellow box)

Oscar Health insurance serves clients in close to 500 counties3(green box) and in the following states:4(p2)

  • Arkansas
  • Arizona
  • California
  • Colorado
  • Connecticut
  • Florida
  • Georgia
  • Iowa
  • Illinois
  • Kansas
  • Michigan
  • Missouri
  • North Carolina
  • Nebraska
  • New Jersey
  • New York
  • Ohio
  • Oklahoma
  • Pennsylvania
  • Tennessee
  • Texas
  • Virginia

Oscar Health Plans

Oscar Health behavioral health partners with Optum to provide plans for alcohol and drug abuse. Your policy benefits will vary depending on the plan you have. The plans that offer mental health and substance abuse coverage include: 2(our mental health network)

  • Individuals and family plans (Bronze, Silver, Gold, and Platinum levels).
  • Medicare Advantage plans.
  • Cigna + Oscar plans.

These plans provide services to assist people who want to recover from an addiction. You can call your insurance provider for additional answers about your specific policy.

What Will Oscar Health Insurance Cover?

With an Oscar Health insurance plan that includes mental health and substance abuse services, you are eligible for a variety of broad treatment categories according to your health plan. The general services that are covered under the Oscar Health plan include:2(benefits at a glance)

  • Inpatient and outpatient treatment.
  • Psychotherapy.
  • Prescriptions.
  • Group therapy.

Within these broad categories of rehab treatment, your admissions navigator will recommend a more specific treatment, such as:

  • Medical detoxification. Some people require medication as they withdraw from the substance they are on. A medical detox program will provide that in a supervised environment. You may attend this treatment in a hospital-like environment or on an outpatient basis.5(pre-treatment)
  • When you participate in inpatient rehab, you will be surrounded by doctors and therapists while there. You will stay overnight in a residential setting for the length of time your doctor recommends.6(third down)
  • Partial hospitalization program (PHP). A PHP provides thorough treatment at a supervised rehab center. Your stay there will be several hours a week, but you will go home at night.7
  • Intensive outpatient program (IOP). During IOP, you will attend therapy for much of the week but not as much as a PHP.8(How are behavioral therapies used to treat drug addiction? section, paragraph after 2nd list)
  • Outpatient treatment program and therapy. An outpatient treatment program consists of therapy sessions once or twice a week.8(How are behavioral therapies used to treat drug addiction? section, paragraph after 2nd list)

Does Oscar Health Insurance Cover Mental Health Treatment Facilities?

Many people with a substance use disorder also experience mental health problems.9(How common) Experts say that mental health problems can lead to substance use just as substance use can lead to a mental health disorder.9(why) When you have these two conditions occurring together, it is referred to as a co-occurring disorder, or comorbidity.9(top) If you suspect that you might have co-occurring disorders, it is best to seek a comprehensive treatment program that addresses both conditions.9(why)

You can rest easy knowing that Oscar Health takes these concerns seriously and provides benefits to treat both conditions together.2(4th para) Furthermore, you are eligible for the essential care benefits built into your insurance by the Affordable Care Act (ACA) mandates.10 These essential care benefits cover services for mental health and substance abuse.

How Long Does Oscar Health Insurance Cover Rehab?

How long you need to stay in a drug or alcohol rehab center will vary depending on your circumstances. When you talk to an admissions navigator, be sure to tell them your history and any symptoms you may be experiencing. Some of the factors that could influence how long you may need to stay in rehab include:

  • The substance you were taking.
  • The length of time you were taking the substance.
  • The number of substances you’re taking.
  • How you are ingesting the substance.
  • Your mental and physical health.

After you discuss your history with an admissions navigator, you can prepare for a stay in rehab. Professionals recommended a stay of at least three months in rehab for best results.11(point 5)

You can find out more information about your Oscar Health insurance coverage by verifying your benefits with AAC now.

What if My Oscar Health Policy Does Not Cover Rehab?

If you discover that your Oscar Health plan doesn’t allow for the services you need or doesn’t cover all the services you need, you can still seek other options. Some rehab facilities offer assistance for those who can’t pay for treatment. Check with AAC to find out if you meet the criteria. It’s best to move ahead and ask questions versus putting off improving your wellbeing.

Oscar Health In-Network vs. Out-of-Network Rehab Centers

Using an in-network rehab center means that you’re working with a medical provider that contracts with your insurance. This is beneficial because you won’t’ have to pay the out-of-pocket costs that come with seeking treatment out of network.

It’s easy to find in-network Oscar Health providers. If you have an online account, login and use the search textbox at the top of the homepage to search for the facility type or provider’s specialty.12(top) You can also add filters to narrow down your search results.12(top) If you don’t have an account, you can still search for a doctor here.

How to Read Your Insurance Provider Card
  • 1Insurance Provider Name
  • 2Policy Member's Full Name
  • 3Policy Membership/Subscriber ID
Local Alcohol Rehab Near Me
Local Opioid Rehab Near Me
Sources
  1. (2021). Home page.
  2. (2021). Let’s talk about mental health: A guide to your Oscar resources & more.
  3. (2021). About us.
  4. (2021). About us fact sheet.
  5. gov. (2019). Treatment options.
  6. National Institute on Drug Abuse. (2020). Types of treatment programs.
  7. Definition of partial hospitalization. The national association of private psychiatric hospitals and the American association for partial hospitalization. (1990). The Psychiatric hospital, 21(2), 89–90.
  8. National Institute on Drug Abuse. (2019). Treatment approaches for drug addiction DrugFacts.
  9. National Institute on Drug Abuse. (2018). Comorbidity: Substance use disorders and other mental illnesses drugFacts.
  10. gov. (n.d.). What marketplace health insurance plans cover.
  11. National Institute on Drug Abuse. (2020). Principles of effective treatment.
  12. (2021). How do I find providers and verify network status?

Check Your Policy Coverage

With the form below you can quickly and privately check your insurance benefits to see if you're covered for addiction treatment services. We’ll be able to tell you if your policy is in-network at an American Addiction Centers location.
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Smith
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John
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Smith
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(555) 555-5555
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jsmith@mail.com
MM/DD/YYYY
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