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
2 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 symyetriaTo all staff : thanks so much. N.B
Nolan Brown
4 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.
Adult ProgramYoung Adult ProgramLGBTQ ProgramMilitary ProgramTeen ProgramSeniors Program
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I had a wonderful experience with my program! Everyone was amazing and i truly wouldn’t be in such a good place in my life without the help from this facility! Life feels beautiful again and i couldn’t be more thankful! Brad is a wonderful human and you can really feel how much everyone there cares. Highly recommend for treatment programs and will be continuing my journey with my psychiatrist there! Thank you! 🩷
Shelby Clemens
2 months ago
This place and its staff are truly amazing at what they do. At this location you can tell the care and support they give you comes from a truly genuine place. I can’t appreciate that enough.
Rachel K
8 months ago
I can't say enough good things about the people I encountered here. They are truly special, and the work they do is amazing. You get of the experience what you put in, and I am grateful for the support they gave me in one of the most difficult periods of my life. Would highly recommend.
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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
8 months 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
1 year 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!
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
3 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
3 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
3 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
3 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.
“Real People. Real Impact.”
I’ve been through my share of treatment centers, and I’ve even worked in the field. I’ve seen programs that talk the talk but don’t follow through. Bright Futures is different. It’s the most well-structured, consistent program I’ve been a part of. No place is flawless, and sure, there’s always room to grow but overall, this is a place that works if you let it.
What truly makes Bright Futures stand out isn’t just the system, it’s the people. As much as it pains me to say it… Uncle Al! 😝 As no human is perfect I can genuinely say this man really cares I think people fail to understand the role of this man he is the backbone of this company. I will vouch for this man and say if you have something pressing he WILL make it happen! (Within means obviously). I can honestly say it wouldn’t be BF without Al. Carolina Ruiz, Randy Robinson, Trish Corcoran man I have no words. Three people haven’t touched me like they did ever in the better part of 30 years of me trying to get this thing. They each made a lasting impact on me. This place wouldn’t be what it is without them. They challenged me, pushed me, and didn’t let me slip through the cracks. They don’t just see you they make you know you are not only heard but seen. When you feel like the world 🌎 doesn’t. Whether they realize it or not, they helped me see myself differently. I’ll eternally be grateful to these 3 people. (But shout out to everyone)
If you’re looking for a place where structure meets real support and where the right people will call you on your BS while still having your back—Bright Futures is it.
₿ ♾️Sky’s the limit♾️₿
Kristopher Roop
2 months ago
I’ve been to multi treatments and this is by far one of the best I’ve been too they truly are amazing thanks too all staff and of course AL his made this decision worth it for me
Sunshine Ward
3 months ago
I’m currently in bright futures I’ve been to a lot of treatment center and have never been made to feel more loved and safe then Al and the staff have made me feel anywhere else. I feel blessed to be getting sober here
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
4 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
4 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!!!
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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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