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.
If you’re checking out various recovery programs, you can learn more about rehab options to see what fits your coverage.
Symetria is unbelievably amazing!!! The Hurst staff is phenomenal!!! I can't imagine that another location has a better staff. A special shout out to Deborah, Benjamin, and Samantha of course. You all are doing amazing, amazing, selfless work. You all are very special to so many!!!
Vernon Godsey III
1 month ago
Huge shout out to the team at symetria who make me feel like family I appreciate everything they do and huge shout out to Osagie for helping me! He is AWESOME!!! I love you symetria❤️❤️❤️
Chloe Roseman
2 months ago
BEST PLACE EVER. I have tried various other doctors/clinics and none of them even begin to compare to this one. The staff here is absolutely amazing. I can’t even make a single complaint. Dr Son is the best as well. He explains everything and you truly feel like he understands you. I can proudly say this, this place saved my life. If you or someone you know needs help getting off opiates do it right the first time and come here. You won’t be disappointed. If you are specifically struggling with fentanyl please don’t waste your time with other ways. I have tried 6 other methods from lazer therapy to having the earpiece to suboxone. Methadone is the key to our current fentanyl crisis. This clinic makes recovery possible again!
Good people... Both the other clients and staff were supportive and caring...the food was terrible...and communication between departments could be improved. I feel my needs were met adequately and I was giving the tools and resources to continue in my recovery
This place gave me my life back! If you are ready to change & have a new chance at life this is the place to come.
Gabriel Lavigne
2 weeks ago
This place really does go above and beyond for people. I have never felt so understood and heard before. They made it feel so personal and real. They allowed me to find myself and really heal. Shout out the angel Cruz for all his help as well ✌️ I owe you guys my life.
This place is so well managed and organized! The staff is seriously amazing!! Front desk is amazing!!!! Everyone is so kind and actually cares about you and your recovery!! I LOVE THIS PLACE. Legit the best if you need help!
Juliet Newton
2 weeks ago
These people have helped me recover from the worst point in my life to become a much better happier person today. I owe my life and my family to this place. Especially Leia, Cynthia, and Mary. But I want to thank everyone else for being a part of this process.
Daymond Johnson
2 months ago
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!!!
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My names Anthony, I just gotta say I moved up to Pennsylvania from south Florida 2 months ago and I’ve been through others programs before in the past and at Provive I’ve been welcomed with open arms. The community of therapists and practitioners go above and beyond to provide guidance and support for me and patients as a whole. I love this program and have never been better in my life
Thanks Provive !!
ANTHONY ERNEST
4 weeks ago
Simply an awesome caring facility. The staff gives 100 percent and then some! They display a true genuine concern for those in their care. Communication is exceptional! My son has been in many facilities over the years and Provive Welles is the best place that he has been in and made the most progress. Everyone that I’ve communicated with was phenomenal.
However, the majority of my communications were with Megan, Emily and David. I must give them special recognition for my sincerest appreciation.
Thank you Provive Wellness for caring for my son above and beyond my expectations.
Tina & Thomas
Tina and Tom Roberts
2 months ago
I’ve been with Provive for about a month or so now. I was having urges to drink myself into a blackout state. Been this way for about a week….I mentioned it in front of the house manager and nothing happened. Today was the worst of my urges. Megan had reached out to check on me and she was able to help me through without relapsing…. Thank you, Megan for all your help!!
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
6 months ago
My experience at Banyan was great ,nurses and staff are great and the food is excellent 👍🏽.
Coastal was tough and fair…they prepared me for the real world!
The food is fabulous and the staff is wonderful!
peter haines
1 week ago
I just want to thank all of you from the bottom of my heart for the care and compassion you showed me during my stay .You helped me through one of the hardest times in my life with kindness, patience and understanding . Because of your support ,I found hope and strength again .I'll always be grateful for the way you helped me start this new chapter of my life . With love and gratitude you gave me freedom back from addiction to freedom after 15 years of being on opioids . Thank you for the true blessings I've received . Loretta
Loretta Slone
4 weeks ago
These people go over and above the gold standard of treatment in South Florida!
Manicured detailed excellence from the owners, chefs, medical staff, BHT's, and housekeeping!
This is very amazing and groups are very fun. Very interactive and helps me relax and the staff is amazing. For example Queen (Carol) Tiff Kim and Paul have been very supportive since I started the program. Thank you AWA!
James Santana
1 week ago
Recomiendo este lugar con los ojos cerrados.La entrega de sus trabajadores con los niños y con los padres está en otro nivel.Sientes que los conoces desde siempre por la confianza que te brindan.La Terapista de mi hijo que se llama Ornela muy profesional y entregada con nuestros problemas.Siempre dispuesta a escuchar en todo momento con una paciencia infinita.Contenta con la conciencia creada en mi hijo sobre su situación etcétera…..Por siempre agradecida con esta institución y ahora seguir trabajando en casa 🫶🏼
Mileivys Perea
3 weeks ago
We brought my son to meet Annie. Instantly she identified his issues and recommended the next steps to take. My son has been in residential care and Annie has been in contact throughout because she has our best interests at heart. We had seen educated psychologist/ psychiatrist for years but i have discovered the best people to help are those who have had experience of addiction and continue the fight . Their life experiences are invaluable in helping others overcome the disease Thank you Annie !
Okay let's start from the beginning back in January of 2025 I completely lost my mind due to alcoholism. I reached out the first steps and they help me not just once but twice get my life back together I lost everything and now 6 months later after my second shot going into first step recovery I will have 6 months clean as of the 26th of this month November. I want to give a special shout out to Jessica from first step recovery who helped me numerous times the facility in El Dorado hills is very clean. And they care I think that's what separates them from the others. Thank you so much for step recovery.
Justin Hill
4 weeks ago
I haven't gone here, but I would like to say that the intake specialist I spoke to when I called named Doug is an absolutely amazing man. He not only answered every question I had, but he also gave me sound advice and kind, supportive words that have really helped me in this process. Even after finding out that I would be attending a different facility, he has been there for me with support and help in any way he can and has kept up with me every day to see how things are progressing for me. Absolutely outstanding individual who clearly cares about people and is interested in their wellbeing and not just in getting them into the place he works for. Doug, you are a kind, caring, empathetic soul and have made a big impact on me and my journey through this process. Thank you for all that you do and will continue to do for people who need exactly the type of person you are on their side when they are arguably at their worst point in their lives.
Joel Fournier
1 month ago
First steps is one of the greatest places you could ever end up for recovery. This place was my home away from home for my stay of 90 days the great staff made me feel so welcomed as soon as I walked through the doors. To the amazing chef Darryn at the oak house cooking 5 star meals to the tech staff some of my favorite were David , Andrea , Jessica , Francisco , Char , and Angie some of the best and attentive staff! The experience was made even better by my counselor Zack p. I was so lucky to have him in my recovery this place is one of the best and I recommend it to anyone struggling with addiction you will not regret it
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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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