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.
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 symyetriaTo all staff : thanks so much. N.B
Nolan Brown
3 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.
Symetria of Lewisville is a great place to all those in recovery. The entire staff is super friendly and helpful. They re there to help. Trust me. Special thanks to Cynthia and Ashley. Keep up the great work!
Ross
2 months ago
Costello is my SAG name. My name is James Dupee. I have been visiting the clinic for over a year and have been very pleased. Adam is the best Counselor/Therapist I have ever confided in. He is personable and understanding as well as straight forward with his advice. Cynthia is the most amazing face of a company I have ever met. She is kind and professional yet makes me laugh every time I stop in. The nurses are equally professional and personable. 5 Stars from me.
Jimmy Costello
2 months ago
Symetria Recovery saved my life!! I was driving down the highway suffering major withdraw from opioid addiction. I found Symetria Recovery and they had me in the very next day. When I got tested, I was positive for Fentanyl, which had to of come from something off the street. I nearly had a panic attack thinking about my life ending, leaving behind my wife and 3 beautiful children. I've been here for about 18 months clean and sober and have never been happier. It feels great to be "me" again. Addiction causes you to lose yourself. With the help of the staff at Symetria, you CAN be saved!! Come get saved at Symetria Recovery!!
This placed saved my life the staff are amazing I learned so much while I was in there Paul the director was always so nice to talk to and was always open to talk I can see that he just does not do this for the money he cares and is an amazing man thank you Kemah palms and thank you Paul
Matthew Styskel
2 months ago
Love this place saved my life help me get in tune with myself discover who I am and find new meaning in my life the director their Paul is just such a passionate guy very caring and really has a deep understanding and commitment to recovery also their affordable sober living right across the street has allowed me to participate in their alumni program outside of treatment highly recommend to people struggling with a substance use disorder
Grant Anderson
2 months ago
Kemah Palms Recovery has saved my life! All of the staff was amazing! I d like to give a special shout out to Paul. He put his sweat and tears into this recovery program. Going as far as providing sober living, alumni meetings twice a week, a specialty class at 3 every Monday-Friday, PHP, IOP, the list goes on! I can never thank yall enough for giving me the tools to turn my life around.
I have the pleasure of working with Anny, as she effectively takes care of our referrals from our facility. I always recommend their programs and facility to families and community , they have a caring staff and strong programs. I highly recommend their services and im proud to call them a community partner and a referral partner.
matthew langford
3 months ago
AWA is great! They have wonderful staff who genuinely care about their clients. I specifically loved Anny and how welcoming/compassionate she was at every step of the way!
Danielle Worthalter
3 months ago
This place is wonderful, it helped us change our lives and that of our son, Anny is a being of light, God bless you!!!
Maple Mountain Recovery utilizes a unique environment of therapeutic care.The staff are trained, responsible, and show their commitment to provide clients with the best modalities to fit their needs.Clinical and Therapeutic staff encourage clients to process learned techniques, and the application they ll find accessible into the lifelong recovery process.The environment is clean and kept in order. A nutritious diet made easy to integrate through the use of professional chefs. An overwhelmingly positive atmosphere and support of peers and staff create motivation to improve upon the struggles of life.I highly recommend Maple Mountain to those seeking care for their mental wellbeing.
Hunter Reynolds
2 months ago
Maple Mountain has been an absolutely life changing experience for me. I was fortunate to have been assigned Sarah as my therapist. Her support and counselingA.R.T. sessions, thoughtful reflections and her exceptional abilities as a therapist have healed deep and traumatic experiences.Kevin and Vikki have given me a place of compassion, understanding and direction that are invaluable.The food is excellent, fresh and varied. Chefs are talented and accommodating, always going above and beyond.Beds are very comfortable and the facility is impeccably clean and welcoming. Maria in hospitality is warm and friendly offering uplifting conversations and makes you feel at home.And Angel, therapy doggo extradonaire is THE best support dog ever!The wound is the place where the light enters you - RumiWe help you walk through the dark and back to the healing light - the experience of Maple Mountain!
Gigi Crowe
2 months ago
The facility is beautiful and maintained very well. I came here feeling like I had changed into a person I wasn t proud of after experiencing intense traumas throughout life, I am leaving feeling lighter and brighter and much more like the best parts of myself. The chefs are great and accommodating at all times, my therapist Kevin helped me through things I didn t think were things I could work through. The techs Chay, Natalie, Chelsea, and Kailea are full of kindness and will make you feel at home and secure. On the negative side I do think the program lacks consistent communication at times which can be triggering, to be told one thing and it ends up being different.
I had the immense privilege of attending the Canyon twice. I completely turned my back on sobriety and found myself in a place of hopelessness and despair. The Executive Director Antonio refused to give up on me and moved heaven and earth to make sure I would get the help I needed. Since the day I met him he as been in my corner and I have watched as he has worked tirelessly every single day to ensure each and every one of his clients are taken care of. He is constantly reinventing the program making sure the best clinicians are on staff. Their level of knowledge and professionalism blended with kindness, patience, and unconditional love is special to be a witness to and a recipient of. They blend CBT, ACT, Mindfulness, Eastern Philosophy, Scientific Study, SMART Recovery, Refuge/Dharma, AA and all other 12 Step recovery programs into an actionable toolkit that equips their clients to find a path that works for them and to completely rebuild themselves into a brand new life.I cannot express my gratitude enough to this program. It truly works if you're willing to try.
Camilo Gonzalez
2 months ago
My experience at The Canyons was life changing. Antonio and his team of therapists, support groups and staff are all wonderful to work with and truly care about your recovery and well being. I have had other experiences in recovery and have never come out with a more solid foundation and hope for the future than I have since leaving the canyon. They have all the necessary resources and even offer post recovery Alumni services that I plan to unitize moving forward. If you have problems with addiction or questions about your sobriety and substance use, the Canyons is a place that I highly recommend for a better chance at a brighter future and one that doesn t depend upon substance abuse. A big thank you to the entire team at The Canyons you have changed my life and myself, my kids and family are appreciative of all that you have done for me!
Mason Terheggen
3 months ago
The Canyon was the turning point in my sobriety journey. As a gay man, it was crucial for me to find treatment that focused on addressing addiction itself rather than its symptoms, such as sex or objectification. The inclusive and affirming environment at The Canyon provided exactly that.I am deeply grateful for the unwavering dedication of Antonio, Franchesca, and the entire staff, who helped guide me from a place of hopelessness to healing. Completing the program has transformed my perspective I now see the world through a lens of abundance and am committed to helping others in their recovery journey.A special shoutout to Michaelis and Kelani for their incredible support throughout this process. Thank you, The Canyon, for giving me the tools to reclaim my life.
Costal detox has been very helpful. The staff is super supportive and friendly. The facility itself is clean and a safe environment. The therapist are very knowledgeable and listen attentively. All in all Coastal Detox has been very helpful and I would definitely recommend.
Bradley Bourbon
2 months ago
This detox was one of the best places I've ever been they really care and want to help on top a beautiful facility offering options that I've never seen like massages and chiropractor and all the staff is amazing
Regan Regan
2 months ago
If you or your loved ones need a comfortable place to go and detox to get your life back together I would HIGHLY recommend Coastal Detox. The whole place Ross, Judy, the techs/Staff, nursing, Amanda the doctor, the therapists and everyone else actually cares about you. As well as making you feel safe and as comfortable as you can. Amanda accommodates you to your needs and is the best. I absolutely am very thankful for Coastal Detox this place has saved my life. I was there for about a month this time and towards the end actually didn t want to leave. You gain friendships with everyone here. The place is absolutely gorgeous. The groups and meetings are amazing. They make sure you re well taken care of. The food is awesome too. Out of any rehab I would recommend going here and no where else. There s a lot of places that the staff and everyone there doesn t care but coastal as I said is the exact opposite. If it weren t for Coastal Detox I m not sure what I would have done. I refused to go anywhere else but there. Thank you so much again Ross and Judy as well as everyone else. I love everyone of you guys Coastal Detox I would give rating that s off the charts.
My 24 year old son completed the entire program at the IAR facility in Houston, twice. I considered both stays very successful; my son's improvement has been remarkable. The staff was great about communicating to me. I would particularly like to commend Cory McCork, who constantly reached out to my son to make sure he was OK during his relapses. Cory answered the phone at some pretty unusual times when I needed help or advice. He has a lot of experience and very good judgement.
P Carter
2 months ago
Hitting my sobriety year mark so I finally feel comfortable leaving a review. I am so grateful I went to IARC and listened to the program they implemented. Cory as everyone has said is great with following up. The only 2 things negative were the lack of female sponsors available. Although I understand statistically there are less women in recovery, it was still something I did not have. I m glad I went and got my own as soon as I got back home. I know that at the end of the day it is still a for profit center but maaaan do they push sober living. Most of us were adults that had to go back to their kids, so it wasn t an option and we were often made to feel like we would relapse without going into sober living. Ive beaten the odds on that so far. My favorite things were the counselors like Ms D and Richard s morning readings. Ms D if you are still there I want you to know I still quote your little nuggets of wisdom and I miss the sound of your angel voice. Oh I m so grateful I had the option to utilize the gym! The food will get you fat as f&@k so try to stay active. In the end You either want recovery or you don t. I know I couldn t have gotten sober on my own. I believe 1000% that IARC helped show me the way. So if you re looking at reviews debating I am telling you right now don t wait. Let this be the one that makes you pick up the phone and get help.
Amber Herrera
3 months ago
Into action recovery changed my life especially after I came back home to New Mexico. I still have a staff member Corey McCormick who reaches out to see how my recovery is going. Makes me still feel part of the community out there ! And reminds me of my experience strength and hope I gained from my time out there !! 10/10 would recommend for anyone struggling and looking for a solution!
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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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