Most insurance plans will cover either all or a portion of the treatment.
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SUD treatment executive, national news contributor & keynote speaker.
Navigation:
- Overview
- 24-7 Substance Use Disorder Helpline
- What Kinds of Substance Use Treatment Does Oscar Health Insurance Cover?
- How Do I Find Out What My Oscar Treatment Plan Covers?
- Find Treatment Centers That Take Oscar Health Insurance Plans
Overview
Oscar Health Insurance provides a wide range of customized health insurance products for individuals and organizations, including resources for substance use disorder. A relatively new enterprise, Oscar Health prides itself on making insurance easier and more accessible to its members. They operate in 17 states and are powered by a convenient and easy-to-use mobile platform to streamline communications between patients and providers.
Oscar Health offers a robust network of treatment providers who are trained in addiction science. Their behavioral health services are managed by Optum to bolster their coverage offerings and maximize treatment and support for their members.
24-7 Substance Use Disorder Helpline
Oscar Health offers a free helpline that provides round-the-clock support for substance Use disorder. Members can speak anonymously with a recovery advocate for immediate guidance and help in understanding treatment options. Because the helpline doesn’t require eligibility verification, family members can also call if they’re concerned about a loved one. During the call, Optum will outline the next steps, including an assessment and individualized treatment strategy provided by a licensed clinician. When you’re ready, an advocate can guide you to an in-network virtual or in-person SUD provider.
What Kinds of Substance Use Treatment Does Oscar Health Insurance Cover?
Oscar helps facilitate coverage for a wide range of behavioral and mental health treatment options. While each patient’s scope of coverage will vary based on their state of residence, plan type, and other factors, some of the most common types of treatment they offer include:
- Inpatient and Residential Treatment – Programs that allow patients to stay at their treatment center while they’re getting the help they need. Inpatient programs last for an average of 28-30 days, depending on progress and ongoing care needs, and often provide a full continuum of care and wraparound services during and after treatment.
- Outpatient and Intensive Outpatient (IOP) Treatment – Programs that allow patients to attend daily treatment sessions and return after their treatment. It provides an opportunity for them to get the care they need while giving them a chance to maintain their financial stability and work on their family relationships, two of the most critical pillars of relapse prevention. The length of outpatient treatment programs varies, but they generally consist of around three to five treatment sessions per week, lasting six to eight hours per session. IOP treatment generally lasts longer than regular outpatient care.
- Medically Supervised Detoxification and Withdrawal Management – Safe, compassionate, and supportive management of withdrawal symptoms administered by trained and experienced doctors and nurses. Medical detox helps ensure patients are medically stabilized before doing the important emotional work of behavioral rehab. Detox generally lasts between three and seven days, but withdrawal symptoms can linger based on ongoing care needs and substance abuse history.
- Partial Hospitalization Programs (PHPs) – A Partial Hospitalization Program (PHP) offers intensive, structured mental health treatment daily, acting as a bridge between outpatient care and inpatient hospitalization, allowing patients to live at home while receiving services like group/individual therapy, skills training, and medication management to stabilize acute symptoms, prevent relapse, and transition back to daily life. These programs provide comprehensive support for various conditions (depression, anxiety, addiction, etc.) in a structured setting without overnight stays, often lasting several weeks.
- Addiction Psychiatry/Psychology Services – Targeted and in-depth analysis and counseling for a full range of addiction-related mental health issues, including various types of depression and anxiety disorders, bipolar disorder, borderline personality disorder, schizoaffective disorder, and others.
- Remote Therapy and Counseling – Online counseling from trained doctors and therapists from the comfort, safety, and convenience of your own living or working space. Online treatment may also include medication management, case management, and other support services.
Your Oscar Health plan may cover all or part of your treatment, depending on what kind of plan you have. Treatment is available for all types of addiction issues, including alcohol, opioids, cocaine, heroin, and more.
How Do I Find Out What My Oscar Treatment Plan Covers?
The fastest way to find out what your Oscar Health Insurance plan covers is to talk to a member services representative. If you need help finding a provider, call Optum’s customer support line at (877)-855-1317 or the state-specific phone number on the back of your Oscar ID card. You can also contact an admissions representative at the facility you’re considering. They will provide a complete insurance verification to determine what portion of your treatment is covered and how much will need to be paid for out of pocket.
Oscar Health Insurance has endeavored to provide a personalized, accessible, and supportive pathway to treatment. If you live in a state that doesn’t currently partner with Oscar, you may be eligible for other means of payment, including sliding scale arrangements, scholarships, and other insurance companies, and more.
Find Treatment Centers That Take Oscar Health Insurance Plans
Use our nationwide directory to find addiction treatment centers that accept Oscar Health Insurance plans. Our directory connects individuals and families with rehab programs across the U.S. that work with Oscar coverage, helping reduce out-of-pocket costs while accessing quality care.
