Find Alcohol & Drug Rehabs that Accept Oscar Insurance

Oscar’s behavioral-health strategy focuses on giving members access to licensed clinicians, accredited rehab facilities, and mental-health professionals through its network partners.

Most Oscar plans integrate addiction treatment with overall mental-health care to support whole-person recovery. This means that if you’re managing both substance use and emotional or psychiatric concerns, your benefits are typically coordinated under one umbrella.

Oscar also offers virtual tools—such as care guides, telehealth options, and in-app support—to help members navigate next steps, find in-network providers, and access care more quickly.

In many cases, yes. Oscar members may receive coverage for addiction treatment when it meets the insurer’s medical-necessity requirements. Coverage depends on:

• Your plan type (Bronze, Silver, Gold, etc.)
• Your state of residence
• Whether the provider is in-network
• The clinical recommendation for your level of care

Because Oscar plans vary by region and metal tier, it’s important to check your specific benefits before selecting a rehab facility.

When treatment is considered medically necessary, Oscar may offer coverage for a range of substance-use-related services, which commonly include:

1. Detoxification Care

• Medically supervised detox to safely manage withdrawal
• Inpatient or outpatient detox, depending on severity
• Monitoring from licensed medical professionals

2. Residential and Inpatient Rehab

• 24-hour structure and clinical oversight
• Therapy, counseling, and medication support as needed
• Typically used for moderate to severe substance use disorders

3. Partial Hospitalization Programs (PHP)

• High-intensity daytime programming
• Helps transition from inpatient to outpatient care

4. Intensive Outpatient Programs (IOP)

• Multiple weekly sessions
• Long-term support while living at home

5. Standard Outpatient Therapy

• Individual and group counseling
• Relapse-prevention planning
• Family therapy, when appropriate

6. Medication-Assisted Treatment (MAT)

• FDA-approved medications for opioid or alcohol addiction
• Combined with behavioral therapies as part of whole-person care

7. Dual-Diagnosis/Co-Occurring Disorder Care

• Integrated treatment for individuals with both SUD and mental-health conditions
• Support from mental-health specialists and addiction professionals

The level of coverage depends entirely on your plan’s benefits and whether the treatment meets Oscar’s criteria.

Oscar uses clinical guidelines to decide whether a specific addiction treatment is appropriate. Factors may include:

• Severity of your substance use
• Withdrawal risks or medical complications
• Prior treatment attempts
• Co-existing mental-health conditions
• Provider recommendations

Before approving certain levels of care, Oscar may require a clinical review or additional documentation from the treatment facility.

Your coverage can change significantly based on your provider’s network status.

In-Network Providers

• Usually, lower copays and coinsurance
• No balance billing
• Streamlined authorization process

Out-of-Network Providers

• Limited coverage depending on your plan
• Higher deductibles and member responsibility
• More complex approval requirements

Out-of-pocket costs differ widely depending on your plan, but Oscar members can generally expect the following:

• Deductible: You may need to meet it before coverage begins.
• Copay or Coinsurance: You pay a portion of each service after the deductible.
• Plan Tier Impact: Bronze plans may have lower premiums but higher cost-sharing, while Gold plans generally reduce your share of costs.
• Network Differences: In-network services almost always cost less.

Better Addiction Care can walk you through your estimated expenses so there are no surprises later.

To approve certain services, Oscar may request:

• A formal screening or assessment from a licensed clinician
• Documentation supporting medical necessity
• A recommendation for the level of care (detox, IOP, PHP, etc.)
• Use of an in-network facility whenever possible
• Prior authorization for specific treatment programs

These steps help ensure the treatment plan aligns with Oscar’s coverage policies.

Yes. Many Oscar plans include virtual behavioral-health benefits, which may cover online addiction counseling, virtual therapy, and MAT follow-up appointments. Telehealth is especially helpful for individuals in rural areas, those transitioning out of inpatient care, or anyone who needs flexible access to support. Coverage depends on whether the provider participates in Oscar’s network and your plan’s telehealth benefits.

Oscar does not set a universal number of days for rehab coverage. Instead, the length of stay depends on:

• Clinical assessments
• Provider recommendations
• Medical necessity
• Progress updates from the treatment team

Some individuals may receive approval for 30 days of inpatient treatment, while others may require extended residential care or step-down services like PHP or IOP. Better Addiction Care can help determine what duration your plan is likely to approve.

In many cases, yes. Some Oscar plans include coverage for adolescent addiction treatment, depending on state regulations and provider availability. Teen-specific programs often include family therapy, age-appropriate counseling, and academic or developmental support. Because not all facilities accept adolescents, verifying both coverage and program availability beforehand is important.

Yes. Oscar typically includes mental-health services under the same behavioral-health umbrella, allowing members to receive integrated dual-diagnosis care. This may involve therapy for depression, anxiety, trauma-related disorders, or other conditions that contribute to or result from substance use. Treating both issues together often leads to better long-term outcomes.

You may need:

• Your Oscar insurance ID card
• A clinical assessment or referral
• Medical history and current medications
• Prior authorization paperwork
• Documentation supporting medical necessity

Better Addiction Care can coordinate these requirements with the treatment center to avoid delays.

If Oscar issues a denial, you still have several options:

• Request an internal review
• File an appeal
• Submit additional medical documentation
• Ask for a peer-to-peer review between your provider and Oscar
• Explore alternative covered levels of care

Many denials are due to missing paperwork—not lack of coverage. Better Addiction Care can help you understand the denial, gather proper documentation, and guide you through the appeal process.

Checking your benefits before enrolling in treatment helps you understand:

• Whether the facility is in-network with Oscar
• Which levels of care are covered under your plan
• Any pre-authorization requirements
• Expected deductibles, copays, and coinsurance
• Whether MAT, detox, PHP, or residential care is included
• What portion of the services will you need to pay

Better Addiction Care handles this process for you so you can focus entirely on recovery rather than paperwork or confusion.

You can verify your benefits through several methods:

1. Call the Member Services Number

Located on your Oscar ID card, member support can explain your behavioral health benefits and network options.

2. Check Your Online Portal

Oscar’s digital member platform allows you to review plan summaries, search for in-network facilities, and browse coverage details.

3. Let Better Addiction Care Verify for You

We can contact Oscar on your behalf to confirm:

• Coverage eligibility
• Network status
• Required authorizations
• Estimated costs
• Approved programs that match your needs

Oscar offers plans in select states but continues expanding. Coverage and available addiction-treatment facilities vary based on:

• Your state
• Your specific plan type
• Local network partnerships
• Regional treatment-center availability

Better Addiction Care works with centers across the country that accept Oscar plans and can help you find suitable options—locally or out of state—based on your clinical needs.

If your plan doesn’t fully cover the recommended treatment, you still have options:

• Select an in-network facility to minimize costs
• Explore sliding-scale arrangements when available
• Consider step-down levels of care if clinically appropriate
• Ask your treatment center about financing plans
• Discuss alternative programs that still meet your health needs

Better Addiction Care can help you evaluate these alternatives so you can still access safe and effective care.

Our team helps you maximize your Oscar benefits by assisting with:

• Insurance verification and cost breakdowns
• Benefit explanation in simple, understandable language
• Pre-authorization coordination
• Matching you with accredited, high-quality treatment facilities that take Oscar
• Navigating requirements, documents, and clinical reviews

We streamline the insurance process, saving you time and reducing stress during an already overwhelming moment.