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Oscar Health Insurance Coverage for Opioid Rehab Near Me

Can Oscar Health Plan Insurance Be Used for Opioid Addiction Treatment?

In light of the opioid crisis in America, more and more people are looking for information on whether or not their health insurance plan will cover opioid rehab. More than 70% of all treatment facilities accept private insurance coverage for opioid rehab, while 64% accept Medicaid and 35% accept Medicare insurance policies.1

Oscar Health is one of the most popular health insurance providers in the country, so many of their clients are no doubt wondering “does Oscar Health Plan cover drug rehab?” To answer this question, you need to look into your specific policy and other factors such as length of treatment, the scope of services provided, the type of program referred to, and more. In general, Oscar Health Plan policies should cover at least some if not the entire cost of treatment in accordance with the Affordable Care Act.2

More Information About Oscar Health Insurance

Oscar Health Insurance is one of the most popular health insurance providers in the United States, serving 19 states. Founded in 2012, the company offers a variety of health insurance plans, including plans for individuals, families, and businesses and serves over 560,000 members. Oscar Health Insurance also offers Medicare Advantage plans and small-group plans through Cigna.3,4

One of the things that set Oscar Health Insurance apart from other health insurance providers is the company’s focus on technology. Therefore, Oscar Health Insurance is a great option for people who are looking for an innovative and customer-focused health insurance company.3,4

What Opioid Treatment Services Are Included in Oscar Health Plan Coverage Nationwide?

Opioid addiction can be a difficult disease to overcome, but with the help of a qualified treatment program, many people are able to regain control of their lives. Oscar Health Plan addiction treatment nationwide may cover a variety of opioid treatment services, including screenings and interventions, detox, inpatient treatment, outpatient treatment, and behavioral therapies. Treatment for co-occurring disorders may also be included in your coverage.5


Opioid detoxification is the process of removing opioids from the body, usually through a gradual process of tapering the dose. Detoxification is often necessary prior to admission into opioid addiction treatment programs, especially medication-assisted treatment.6

Inpatient Treatment

Inpatient opioid addiction treatment involves living at a treatment center while receiving care. Inpatient treatment provides 24-hour supervision and care from addiction specialists. This type of treatment is often necessary for people with severe addictions or those who have relapsed multiple times.6

Outpatient Treatment

Outpatient opioid addiction treatment allows patients to live at home while attending regular therapy sessions and appointments with addiction specialists. Outpatient treatment is less intensive than inpatient treatment, but can still be very effective.6

Behavioral Therapies

Behavioral therapies are a key part of addiction treatment, as they help patients identify and change the behaviors that contribute to their addiction. Common behavioral therapies used to treat opioid addiction include cognitive-behavioral therapy, contingency management, and 12-step facilitation.5

Treatment for Co-Occurring Disorders

Many people with opioid addiction also suffer from other mental health disorders, such as depression or anxiety. Any dual diagnoses will be assessed prior to starting treatment. It is important that these disorders be treated at the same time as the addiction, in order to give the patient the best chance at recovery.5

Are There Any Services Oscar Does Not Cover?

Yes, there are some services that Oscar does not cover. These include non-medical amenities, holistic care services, recreation programs, food delivery, private treatment services, and alternative therapies.2 

While these services may be important to some people, they are not considered essential medical care and therefore are not covered by private insurance companies, including Oscar. If you need any of these services, you may be able to find a provider that accepts Oscar Health Plan insurance coverage, but you will likely have to pay for these services out of pocket.2 

How To Determine the Cost of Opioid Treatment?

The cost of opioid treatment can vary depending on the intensity and scope of services offered, the duration of treatment, and the amenities available. Some facilities may charge a flat rate for all services, while others may charge by the hour or by the day. Some facilities may also offer amenities such as integrated couples’ treatment options or emergency same-day treatment admission, which can add to the cost of treatment. To get an accurate estimate of the cost of opioid treatment, it is best to work with the facility representatives and insurance company agents.2

Cost of Inpatient Treatment

The cost of inpatient opioid treatment is determined by a number of factors, including the severity of the addiction, the length of time in treatment, and the type of treatment. Inpatient treatment can be very expensive, but private insurance coverage such as Oscar Health Plan rehab coverage may offset the cost. In the United States, inpatient treatment costs are typically covered by private insurance, Medicaid, or state-funded programs. In some cases, patients may be able to pay for the treatment with their own funds.2,6

Cost of Outpatient Treatment

There are many factors that determine the cost of outpatient opioid rehab. The main factor that affects the cost is the location of the rehab center. If the rehab center is located in a major city, it will likely be more expensive than one located in a rural area. The type of program and services offered at the rehab center can also affect the cost. Some outpatient opioid rehab centers offer more intensive programs that may be more expensive than others.5

The cost of outpatient opioid rehab can also vary depending on the length of treatment. Some outpatient rehab centers offer short-term programs, while others may offer long-term ones. The type of addiction insurance coverage you have can also affect the cost of outpatient opioid rehab. Some insurance plans may cover some or all of the cost of treatment, while others may not.2

If you are considering outpatient opioid rehab, it is important to speak with your physician or a treatment center about costs. Treatment centers can usually provide you with an estimate of the cost of their services and work to verify your insurance coverage.

Cost of Partial Hospitalization Programs

The cost of a partial hospitalization program will vary depending on several factors, including the length of the program, the number of hours of treatment per week, the number of weeks in the program, and the type of services provided. In addition, the cost may also be affected by whether the program is covered by insurance.7

The cost will mostly vary depending on the number of hours of treatment per week. Programs that meet for fewer hours per week tend to be less expensive than more intensive daycare programs that involve more hours per week. Typically, the cost of PHPs falls between inpatient and outpatient opioid programs, mirroring the concept and services this type of treatment offers.7

Cost of Medication-Assisted Treatment

There are several factors that determine the cost of medication-assisted treatment for opioid use. The cost of the medication itself is one factor, as is the cost of administering the medication. The length and severity of the addiction can also affect the cost of treatment. In some cases, insurance may cover the cost of treatment.8

Medications for opioid use treatment approved by the FDA include:1,8

  • Methadone is offered at 97% of opioid treatment programs at an average price of $125 per week.
  • Buprenorphine is offered at 22% of opioid treatment programs at an average price of $115 per week.
  • Naltrexone is offered in an injectable form at 12% of opioid treatment programs at an average price of $1,180 per month.

Comparing the Cost of Opioid Addiction to the Cost of Treatment

The cost of opioid addiction is significantly higher than the cost of treatment, especially if it can be covered by your Oscar Health Plan. Treatment for opioid addiction typically costs less than $1,500 per patient, while the average annual cost of opioid abuse is more than $11,000.9

This difference in cost is due to a number of factors, including:8

  • Treating overdose
  • Treating babies born to opioid-using mothers
  • Lost wages and lost productivity costs
  • Intoxication-related injuries (driving accidents)
  • Other health concerns (such as the increased transmission of STDs)

Even with the high price of opioid addiction treatment, it’s important to remember that it’s a life-changing investment. Addiction to opioids has significant effects on your relationships, health, and longevity.10

How Long Does Oscar Health Plan Insurance Cover Opioid Rehab?

The length and coverage of Oscar Health Plan opioid rehab treatment varies based on a client’s specific policy and the severity of their addiction. Generally, most insurance companies will cover a certain number of days or weeks for treatment, but it can vary based on the plan. Clients with more severe addictions may need to seek longer-term or inpatient treatment options that insurance may not cover. It’s important to speak with a treatment specialist to understand all of the available options and coverage before beginning any type of rehab program.5

To find out more about your specific plan and what is covered, be sure to call the number on the back of your insurance card. The insurance agents will outline the specifics of your plan, including the number of days or weeks of coverage for opioid rehab.2

Those looking for treatment can also reach out to American Addiction Centers to verify their coverage prior to starting treatment. The team at American Addiction Centers can help them understand their specific insurance plan and what is covered. They can also provide information on the different types of treatment available to make the best decision for their needs.

Comparing Oscar Health Plan-Covered Inpatient and Outpatient Opioid Treatment

When it comes to opioid addiction, every individual is different and what works for one person might not work for another. There are two most common types of opioid treatment: inpatient and outpatient. Inpatient treatment requires that the patient lives at the facility for a certain period of time, usually 30 days or more. Outpatient treatment allows the patient to live at home and come to the facility for treatments and sessions.5

Both inpatient and outpatient treatment have their own advantages and disadvantages. Inpatient treatment is more intensive and can provide a higher level of care, but it is also more expensive. Outpatient treatment is less expensive and can be more flexible, but it might not be as intensive. The most important thing is to choose the type of treatment that is right for you.5

Inpatient opioid treatment offers 24/7 care and support, which will allow patients to focus on their recovery without any distractions. In addition, inpatient treatment offers a higher level of emotional and psychological support and helps build a sense of accountability. Patients will be able to get the support they need to overcome their addiction and talk to people who understand what they are struggling with.5

How to Get Started With Oscar Health Plan Addiction Treatment?

When it comes to getting help for an addiction, there are several different ways to start. One of the most common methods is by using your Oscar Health Plan Insurance to cover the cost of opioid rehab. Depending on your plan, you may have a wide variety of rehab centers to choose from.2

The first step is to discuss your problem with a doctor. They will be able to help you understand your condition and refer you to treatment. Some insurance companies may require clients to provide a doctor’s assessment prior to starting treatment. From there, you can start looking at different rehab centers and working with them to determine if they accept your insurance.2

It is important to find a local rehab center that you feel comfortable with and that has a good reputation. Once you have found a few options, you can start reaching out to them and working with their admissions navigators to see if they are a good fit for you.2

If you have any questions about getting started with Oscar Health Plan addiction treatment, be sure to ask their representatives or reach out to a rehab center for more information on available financing options, help to verify your coverage, and additional information, such as guidance through the intake process. They will be able to help you understand the process and get you on the road to recovery.3

Where to Find Oscar Health Plan Rehab Centers?

If you’re looking for an Oscar Health Plan rehab center, there are a few ways to find one. The first is to speak to their representatives or look for addiction treatment facilities on their website. This will help you narrow down your search by location, type of provider, and more.3

Additionally, you can call American Addiction Centers directly. Their admissions navigators will help verify your insurance coverage on the spot and get you started on the path to recovery by referring you to one of their facilities that accept Oscar Health Plan coverage nationwide.3

Some options include:

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