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.
If you’re checking out various recovery programs, you can learn more about rehab options to see what fits your coverage.
By Michelle Tavares
Michelle Tavares is a registered nurse with over 15 years of experience in mental health nursing. She has worked in inpatient and outpatient settings as well as in bedside and administrative roles. She is a fighter of stigma and an advocate for getting people the mental health services they need.
Medically Reviewed by Anna Spooner
Anna has 10 years of experience in insurance and has been a content and copywriter since 2011. She strives to make all of her writing approachable and easy to understand while drinking copious amounts of tea. Anna writes about accessing addiction treatment, insurance, and finance.
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Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
Symetria is like a second family for me now and Mrs. Debrah , who runs the center is always awesome and also Mrs. Callie is my counselor and a great one at that! Come to Symetria if you need help you’re not alone they will treat you like your one of them. And the front desk lady Michelle is so sweet that she won’t let you miss a does so she calls every patient everyday in case you forgot so u don’t suffer!
Krystina Hubbell
3 weeks ago
I have been in the DARKEST place for so long. Symetria was my saving grace. My counselor Callie (my saving grace) showed me that I actually really do matter and gave me a sense of belonging for the FIRST time in my life! She truly cares and has helped me in so many ways that I can't thank her enough. If it weren't for her, I'm not sure where I'd be in life right now without her. Ms Callie, if you see this, thank you again. To all of the concerned mothers/fathers out there, I promise you, this is the best methadone clinic in the United States. Thank you for taking the time to read my comment, I promise I wouldn't steer you the wrong direction. <3 Please take into consideration coming to Symetria. I finally have hope.
Madi Murphy
1 month ago
This place is great. The entire staff had always been excellent
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
Very nice hospital and staff was very courteous . It made my experience great
Carla Cervantes
2 weeks ago
I had a personal surgery done yesterday and I could not thank these amesome nurses,doctors and anesthesiologists enough. They were absolutely amazing in making sure I was comfortable and felt safe. The only nurse I can remember was Robyn. Thank you again Bryan west for having some of the best staff!!
S Thompson
2 weeks ago
Thank you to every staff members for your help with the care of our family members.
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
Loving this app easy to do things are nice to work out and they also give you leads and show you places that help them work with treatment and they’re also nonjudgmental with the marijuana
Scott Gadd
1 week ago
It works, they are professionals, & they care!!!!
Jennifer M
1 month ago
10 out of 10 highly recommend for the busy person that wants to make addiction a priority but restriction is time or Transportation not anymore not with this program everything is done from the comfort of wherever you choose still private can get one-on-one or group feedback the qualifications and steps are easy and if you have insurance it's a walk in the park before I head insurance I would have given it for three stars just because it was very expensive $75 a week plus the cost of prescription otherwise their time out of 10 amazing and they will try and find a way to work with you when it comes to payments if you're in that position I did not ask enough questions when I was in that place so don't let that deter you#wedorecover
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Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
Best treatment facility in Lincoln, I've been there 2x and I have very close friends & family that have been in recovery since they completed treatment there. I wish they took medicare or medicaid though...
a p
4 years ago
My husband went through the independence center over 30 years ago. He did relapse after the first 3 months but he did not attend any aftercare or AA. Within a year he started going to AA and has been sober for almost 35 years. My son has also been through the independence center twice with varied success. He has had relapses but maintained sobriety for the majority of the time. He has used the tools he learned there to get sober again after relapsing without having to reenter treatment. The program will work for you if your honest with yourself and do the work. Good luck and god bless!
Judy Diller
4 years ago
When you are ready, you are ready. I did three rehabs in the span of three summers and I’ve been sober a year and a half since going to the Independence Center.
The ENTIRE staff wass genuinely interested in my recovery. Of course it’s up to me how honest I want to be with my counselor, Chaplin and myself (and God), but their unwavering encouragement doesn’t hurt and it didn’t. The facility is much better than others I’ve been to in Nebraska and they keep the distracting extracurricular horseplay to minimum. They have a great culture and alumni in the A.A. and Lincoln communities.
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
El mejor lugar para tratar la adiccion de un ser querido. Un excelente grupo de profesionales que hacen mas q su trabajo, es su vocacion. Recomendado al 100% El mejor centro en Puerto Rico. Mi agradecimjento a Josefina q fue la persona contacto en Puerto Rico, quien con mucha paciencia y amor nos facilito llegar a este lugar maravilloso
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
ICFR was just what I needed to learn about my addiction and learn about ways to recover successfully. The clinical staff and support staff are outstanding in every way. The accommodations are comfortable and they do everything they can to address your needs.
Michael Pritchard
1 week ago
Great place would recommend to anyone in need.
Joseph Hickman
4 weeks ago
Really changed my life. Feel like a completely different person leaving than when I first got here. The group facilities are fantastic and really are able to help you on a deep level. The community overall is phenomenal and recommend it to anybody who is struggling
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
The Ranch and staff was instrumental to my start of recovery. Couldn’t have done it without them and the support
Alex Prugh
3 weeks ago
This place is great! đź‘Ť Amazing staff and awesome ranch. Happy to be part of the Alumni!
Kyle Taylor
3 weeks ago
The best recovery center in the country. This place WILL Get you sober IF YOU’RE WILLING TO WORK THE PROGRAM!! It saved my life and family, it will save yours if you work it. I Thank my higher power to show me that self will is not enough. Thank you Luke, Andrew and the entire staff. I will be forever grateful.
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
I use to go to denton clinic last year and even years ago and I was honestly struggling very hard to keep up with payments and Im not here to bash... I blame myself for not communicating better. At the time I was forced to leave my denton home and stay with family in the colony and had to drive every day Mon thru Fri to denton. I finally tried looking for some place closer and thank the Lord He led me here. I called and they asked about insurance which I gave all my info about. I seriously had doubts that it would be of any help. Years ago methadone wasnt covered easily by insurance...
But they made my day when they told me yep they take my insurance which is through marketplace. AND I would not have to pay anything out of pocket!! I was singing and dancing. Been here ever since. Even when I messed up and missed open enrollment, they still worked with me without insurance... i was so worried but everyone reassured me that they would find a way to help me here and they did. Everyone is SO NICE also. Love it here.
Anita
7 months ago
I absolutely love this place from the front staff all the way to the back staff. Everybody is so amazing and so kind. The office manager helped me find a location where I could get my dose since I missed it on Saturday and I was so grateful for him to reach out because I finally got my dose I needed Because THEY CARE! I recommend this place to anybody struggling with opioid Use disorder or pain. Don’t be afraid to pick up the phone and call. Everybody is so nice and you’ll be taken care of🖤
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
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I really appreciate the workers at this hospital. They are kind, accomodating and respectful. I didn't feel condescended to, nor treated like less of a human being. I felt that the workers set a tone of respect and dignity and support on the unit. The groups were awesome and very well facilitated. I felt like they weren't just there for a paycheck, that they actually cared about doing a good job. I would definitely go back there if I ever need mental health inpatient care.
Leah Freeman
1 year ago
It was a safe place during my most suicidal years. I really appreciated the ability to isolate in my room, unlike other facilities that lock the rooms during the day. That was a necessity for me as an autistic person, in order to prevent overwhelm and truly feel safe. Therapy groups could be stressful, but I wasn't forced to attend which I really appreciate. When life feels so out of control, small things like that can go a long way
Rivka Sawyer
2 years ago
I came to this center after a traumatic experience. These people made me whole again. I cannot say how much this place meant to me the 4 months I was there. Caring nurses, wonderful doctors and a cook who knew how to make hospital food palatable. I cannot recommend this place more!
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Frequently Asked Questions
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.
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.
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.
Calls to numbers on a specific treatment center listing will be routed to that treatment center. Calls to any general helpline could be forwarded to SAMHSA or a verified treatment provider.
If you wish to connect with non-sponsor centers, you can browse top-rated listings, visit our homepage and browse by state, or visit SAMHSA.
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