Oscar Insurance Coverage for Drug Rehab & Addiction Treatment
Discover how Oscar Insurance covers addiction treatment, mental health care, and virtual services. Learn about plan types, benefits, and options.
Oscar Insurance Coverage for Drug Rehab & Addiction Treatment
Discover how Oscar Insurance covers addiction treatment, mental health care, and virtual services. Learn about plan types, benefits, and options.
Oscar Insurance was started in 2012 and is a healthcare technology company that uses proprietary software and an online platform to connect with its customers. They have 1.5 million members in 18 states.
Oscar focuses on providing virtual medical care, so customers are encouraged to use the website or app to find providers, get prescriptions refilled, and contact their Virtual Care Team. The company also has a limited network of in person care providers.
Oscar Insurance prioritizes diversity, inclusion, and belonging. It is a majority female company. In addition, they offer yearly grants of $150,000 to organizations across the United States that are committed to serving underserved communities.
Does Oscar Insurance Cover Addiction Treatment?
Oscar plans do offer some coverage for mental health treatment and substance use because they are sold on states’ Insurance Marketplaces. However the company focuses on virtual care, and the in person provider network is quite small.
Even though Oscar works with Optum to provide mental and behavioral health care, it can be challenging to find an addiction treatment provider that takes Oscar in many areas.
Mental healthcare is more likely to have available in person providers than substance use treatment. However, this varies dramatically depending on where you live. You can check the available providers in your area without signing up, which is helpful if you’re considering an Oscar Plan.
Coverage for treatment is usually based on your doctor’s recommendations. If you have Oscar coverage, work with your primary doctor to determine an appropriate treatment plan for your needs.
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This place is amazing. Amazing staff. Attractive facility. Very therapeutic. Attention to everyone's needs. Highly recommended. I wish I knew about this place 4 treatments ago.
Marco Hernandez
3 months ago
My experience at Banyan was great ,nurses and staff are great and the food is excellent 👍🏽.
I AM SO THANKFUL FOR SYMETRIA AND THE GREAT STAFF.
They are very helpful with any questions or concerns you may have about the program They make you feel at easeThey don't judge you it's a really great and safe place to began recovery. I highly recommend symyetria
To all staff : thanks so much. N.B
Nolan Brown
6 months ago
Symetria saved my life in more than one way. Each member of this team deeply cares about the patient without judgement. Vannah is such an incredible Clinician who truly listens, is an advocate for her patients, and is helping me work through my trauma to heal in a healthy way. I am forever grateful for this entire team: Samantha, Vannah, Dr. Son, the wonderful nurses. Thank you for saving my life and helping me heal.
Memorial Regional is definitely #1 .
From the ER staff to the employers on the 7th floor where i was a patient.
I want to specially thank the ER Dr Tommy and my Nurse Daisy, Resheena,
Natalie and my very Compassionate
and very competent PCA's
Sydoney not sure if it's the correct spelling,Casheem and just about everyone.
Great Hospital ,Excellent Care.
Thank you very much for all you do
God's Blessing on you all.
I had little to no hope before coming to Kemah Palms Recovery. I had just spent 8 days at a med-center hospital after a suicide attempt and they wouldn't discharge me unless it was to a rehab. Kemah Palms was actually my 6th rehab in the past year and a half. It was the first one I actually finished. I had left against medical advice at all the others. I was on a tremendous downward spiral with so much momentum that there was no stopping this fall. I was coping with the pressures of a recent divorce and spending the last two plus years fighting for my son's life who had had 4 open heart surgeries and 3 brain surgeries amongst many others. That was in addition to life's other traumas and pressures. I am dual diagnosed and my PTSD is so extreme it doesn't usually allow me to deal with situations of chaos and high stress. The team at Kemah Palms developed a treatment plan just for me and weren't so legalistic with the rules that I couldn't make it through there, but also had enough order that it was a safe environment. Earlier in this review I mentioned this being the first rehab I finished. That begs the question "what was different about Kemah Palms Recovery?" The biggest difference for me were that the people who are with you day in and day out are former recovering addicts themselves and actually care about recovery. They understand this is life and death and come at you from a place of understanding and love. From their director Paul (no one knows more about recovery than this man) to their clinical director Tabitha (compassionate and intuitive) to my counselor Mrs. Day (best in the business and a true overcomer) to all the RA's and I do mean absolutely all of them, they prioritize you as a person and put your recovery first. From Raquel (super sweet and caring) to Michael (now my sponsor and I wouldn't have it any other way) to Cody (a fantastic recovery ally who I can still call and process with today) to Kristen (super caring) to Christian (rooted in faith) to Matt (a caring recovery advocate) to Abbie (authentically cares for you as a person) to Julie (who knows how to keep you grounded) to Ember (heart of gold) to Ashton (strong advocate) Mandy (super love her and no more caring/empathetic person alive) to the nursing staff, Hailey,(actually saved me when I was choking and also grounded in faith) to Carmen (fantastic nurse.) From Ashlynn who was kind and caring during my intial call, to even Jennifer and Stephanie who make sure you're set up for success when you leave by making sure you have living arrangements and appointments set. Basically just everyone from the doctors to even the maintenance staff Andy, Curt, and Cameron, this place is all about recovery and doing what it takes to get you healthy and the best version of you. I must also mention Mrs. Clara the cook. That was some of the best eating I have ever had. I even spoke with the owners several times while I was there and they are absolutely awesome. You'd think a place like this would be profits over people and most rehabs are, but it is super refreshing that this is the exception to that rule where people and their recovery come first. I love this place. I have to mention the equine therapy they have with two awesome horses, (Star and Cassie) and Sparky the recovery dog was there to love on you when you needed a friend. The community and love here and the continued connection has laid the foundations for what my recovery will be for the future. I am now participating in their PHP program and Jason and John are fantastic. They are the counselors running that program and they really challenge your old thought processes. I am approaching 2 months sober at this time, which is huge if you know me, and nothing short of a present day miracle. If you're looking for a place to partner with you and give you the necessary tools for you to be sober and successful I highly recommend this place. Kemah Palms Recovery is more than a rehab, they are love. ❤️
J.C. Harrington
2 months ago
Well considering I’ve been to quite a few rehabs, Kemah Palms has hands down been the best one. All the staff was very welcoming from the moment I walked through the front door. Detox was surprisingly good, Residential had its ups and downs but that’s all about perspective. The counselors were amazing! Told me what I needed to hear not what I wanted to hear. I’ve never felt so confident in recovery. They gave me wonderful tools to use. Taught me away to handle life in a more affective way. I would recommend KPR to anyone looking to change their life.
Elizabeth Faust
3 months ago
I was unsure of how this program would benefit my recovery in the beginning; I did not buy in fully for almost two weeks, but I am so glad I did. I want to thank the amazing staff- RA’s, Counselors, Admin, Groundskeepers, and especially the other clients I befriended along the way for their role in my recovery. I am a better man for it today, and I’m eternally grateful.
First Steps saved my life. The whole staff was amazing. They met my every need and it allowed me to live a better sober life. I was given the tools I needed for success, and the support needed to live. Thank you all, that was there for me, and still are as an alum.
They Ubered me to the clinic when my car broke down and even they stayed open late because of the bad weather. These people always go the extra meter to take care of me no matter what. Five stars!!!
Gwen R
1 month ago
Everytime I come here the staff are beyond amazing very personable no judgement passed on and extremely helpful always quick and easy Cynthia is still my favorite though ;)
Adolescence Wellness Academy is truly a wonderful organization with a real purpose. They have completely changed my nephews life for the better and given my family back. The entire staff has been amazing—caring, supportive, and professional—with not a single complaint thus far. A very special and big “Thank You” to Tiffany, who has been incredibly empathetic, kind, and strong in her role as a counselor. Her compassion and guidance have made such a difference. I am forever grateful for everything this program has done for my nephew, sister, and our family.
Cristina Rivera
1 week ago
If I could give 10 ⭐️ I would.
I’m an aunt to a child in the program, and it has truly been such an amazing experience.
I’ve notice so much growth and change.
Huge s/o to Tiffany; she is their FAVORITE.
S C
1 week ago
Amazing program and team. I am so happy to have found this organization!
Evolutions Treatment in Miami is truly a life-changing facility. The staff is wonderful—attentive, compassionate, and genuinely invested in your recovery. A special thanks to Tonya in alumni for reaching out and offering continued support. This place really cares and makes a difference!
Kevin Y
1 month ago
I've heard mixed experiences from other but I can speak for myself that treatment has been intense and careful from staff. I personally recommend it.
William Bryant
5 months ago
The staff here is very caring. Especially the therapists, they are super talented.
This place works! Every piece of this place is perfectly designed to work in tandem. Maple Mountain saved my life.
Bethany Burns
1 month ago
Maple Mountain Recovery in Utah completely exceeded my expectations. From day one, their team created a highly personalized treatment plan tailored just for me—every session felt tailored to my needs.
What really sets them apart is the way they seamlessly blend healing with genuine care and enjoyable experiences. Between therapy sessions, I had options like yoga, cold plunges in nature, art therapy, acupuncture, and many therapeutic adventures. It felt like real recovery, not just treatment.
The staff is amazingly attentive—every single team member knew my name, remembered my goals, and checked in regularly to see how I was doing. They made sure I felt supported 100% of the time and built an environment that was both professional and warm.
If you’re looking for a recovery center that cares deeply, customizes your journey, and injects a dose of fun and relaxation into the process—Maple Mountain Recovery is it. Highly recommend!
Lexi Verschoore
1 month ago
Wonderful place with great staff and fantastic programming. I rediscovered myself while there.
Ripple Ranch gave my daughter her life back. We will forever be grateful that God put everything into motion so perfectly & gave her such an incredible, healing testimony to share with others. Ripple Ranch is family to us.
April Goodenberger
1 week ago
These people are doing life saving work. Grateful to have these people in our community.
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Frequently Asked Questions
What Are Oscar Insurance Plans?
Oscar offers insurance plans on the state Insurance Marketplace in 18 states. These plans have metal tiers that help you understand what percentage of your care they will generally cover.
For example, a Bronze plan covers only about 60% of the cost of care, but you pay a much lower premium. A Gold plan covers 80% of the cost of care but has a higher monthly premium. A Silver plan balances the two by covering about 70% of your medical costs with a monthly premium in between Bronze and Gold.
There are also different types of plans available from Oscar, depending on the state you live in. There are Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), Exclusive Provider Organizations (EPOs), and Point of Sale plans (POS).
The differences between these plans are focused on two areas: Can you get care outside the network and do you need a referral to see a specialist (such as an addiction counselor)?
An HMO and EPO require you to stay within the plan’s provider network. A PPO or POS allows you to get coverage out of network, but your deductibles and copayments will be much higher because the plan covers much less of the cost of care.
An HMO and a POS plan both require you to have referrals to specialist care, even if the specialists are in network. A PPO and EPO give you the freedom to go to any specialist in the provider network without a referral.
Because an HMO has the most restrictions, it tends to have the lowest monthly premium. A PPO has the fewest restrictions, so they tend to be more expensive each month.
Does Oscar Cover Mental Healthcare?
Oscar offers a variety of mental healthcare options. They have in person mental healthcare in their network in many areas. If that’s not available or you prefer virtual care, you can access Doctor on Demandand use your Oscar ID to sign up for an account.
You can also search for a mental or behavioral health provider on Optum’s website using the code OHP or by calling Optum at (877)-855-1317.
Optum also offers an emotional support hotline that’s free of charge and available 24/7. Anyone can use it, whether or not they have coverage through Optum. The number is (866) 342-6892.
Finally, the Perks area of your member account on Oscar’s website gives you access to the Calm app for 40% off the normal annual subscription.
What Special Benefits Are Available From Oscar Insurance?
Because Oscar focuses on offering virtual medical care and support, they have a variety of unique benefits.
For example, Oscar’s plans include Oscar Care. This program allows almost all members to get free virtual urgent care visits. Some Oscar members will also have access to free virtual primary care visits for those 18 and older as well.
Oscar allows members to order prescription refills virtually and have them delivered by mail. Many common medications cost only $3 per refill.
The company also refers people to visit WeConnect’s free Online Support Meetings. These meetings allow you to talk about grief, mental health, substance use, and more. There are general meetings and specialty meetings with a specific focus.
If you have a Diabetes Care Plan with Oscar, you can enroll for free in Livongo, which provides resources for those living with Diabetes.
What Outpatient Rehab Does Oscar Cover?
Most of Oscar’s resources are focused on mental healthcare. However, in some areas they also have in network providers that offer outpatient addiction treatment.
Outpatient programs allow you to live at home or in a sober living environment while you attend treatment during the day. Options include partial hospitalization programs (PHP), intensive outpatient programs (IOP), and regular outpatient (OP) programs.
Partial hospitalization programs allow you to attend treatment during the day and return home at night. They typically run 4 to 8 hours a day, three to four days a week, and last between 30 and 90 days.
Intensive outpatient programs often offer 9 to 20 hours of treatment per week, spread over 3 to 5 days, with a total of 90 days of treatment recommended.
In general outpatient programs, you may be seen at a clinic or rehab facility one or more times a week. Group counseling and education on addiction and relapse prevention are typically provided, and when needed, individual sessions may be offered.
Once you finish treatment, you may have access to aftercare resources such as peer support and social services.
What Inpatient Addiction Treatment Does Oscar Cover?
Inpatient addiction treatment is very intensive. You may have to spend several weeks at a facility. For these reasons, it’s important to make sure that it’s the right treatment for you. Typically, your doctor will use an American Society of Addiction Medicine (ASAM) assessment to determine whether you need residential care or can start with an outpatient program. Then they will call Oscar to get their prior approval for coverage.
If you find yourself in residential rehab expect to be in scheduled programming for the duration of each day you spend there. You may get a little free time to attend to self care and chores. The rules and the structure are as much a part of treatment as the programming itself. The programming focuses on building skills to help you avoid relapse.
You may have to go through medical detox before you can participate in residential rehab. In residential detox, trained medical professionals supervise your withdrawal from substances like alcohol and benzodiazepines and opioids. Their goal is to prevent the harm that withdrawing from these substances can cause to your health.
Does Oscar Cover Methadone & Suboxone (MAT)?
MAT stands for medication assisted treatment. If it’s right for you, Oscar may be able to cover it. With MAT, medical professionals use FDA approved drugs to treat you for alcohol or opioid dependence. Medications can be used to get you through withdrawal and then help you stay in recovery. In the case of opioid use disorder they can also be used as maintenance treatment.
What to Do if Oscar Won’t Cover the Cost of Rehab
If you can’t find a drug rehab that’s in network through Oscar start by calling Optum. Since Optum is the company that manages behavioral health benefits for Oscar they may be able to find a provider or make an exception for you.
If you can’t get an exception you have a few options. You might consider traveling the distance to a facility they do cover. If you decide to do this you’ll want to make sure the facility will take you. You should also get prior approval from Oscar.
Next consider ways to cover treatment yourself. Many non profit rehabs have income based sliding scales. Some will take you without regard for your ability to pay. Some faith based organizations offer residential rehab for free. There may also be state and county level resources that will work with you.
You may also be able to get referrals to alternatives that are cheaper. If your counselor is the one referring you to treatment they can assess if a more affordable alternative is appropriate. People with opioid use disorder can sometimes avoid residential rehab if they get on MAT. Others may be able to manage with a partial hospitalization program while living in a sober house.
Calls to any general helpline will be answered or returned by a paid advertiser.
By calling the helpline you agree to the terms of use. We do not receive any commission or fee that is dependent upon which treatment provider a caller chooses. There is no obligation to enter treatment.
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