Oscar Health Insurance Coverage for Alcohol Detox & Rehab Centers

Alcohol addiction affects millions of American families across the nation. Alcohol use is common in the U.S., with almost 70% of adults aged 18 and older reporting drinking alcohol in the past year in 2019. ^{1 Alcohol Use in the United States}

In 2019, nearly 15 million people aged 12 and older reported alcohol use disorder, yet only about 7% received treatment.^{1 Alcohol Use Disorder (AUD) in the United States + Treatment of AUD in the United States} Alcohol is responsible for more than 18% of emergency room visits and contributes to 22% of prescription drug overdose deaths.^{1 Alcohol-Related Emergencies and Deaths in the United States}

Oscar Health Plan is dedicated to providing quality healthcare services to its members throughout the nation. If you or a loved one is struggling with alcohol use disorder, many options for resources and support are available. Oscar Health Plan offers coverage for alcohol rehab and other addiction treatment services like outpatient programs and behavioral therapies.^{2 intro} Access to hundreds of nationwide in-network rehab centers is available through Oscar Health Plan.^{2 intro}

What Does Oscar Health Plan Insurance Cover for Alcohol Treatment?

Many treatment options for alcohol addiction are available to meet your specific needs. Since everyone is different, and no one treatment will work for all, a combination of therapeutic interventions like medical detox, behavioral therapies, and medication-assisted therapy (MAT) are often needed when treating alcohol use disorder.^{3 p. 6 #7}

Factors like the types of services you need and the duration of your treatment can affect your level of coverage. A portion, if not all, of the costs for the following could be covered under your Oscar Health Plan insurance:

• Screenings and interventions: Screenings and interventions performed by medical professionals help determine the severity of your addiction and recommend the best treatments to help you achieve sobriety. ^{3 p. 18 How do we get more substance-abusing people into treatment?}
• Medical detox: Detox is often the first step in effectively treating addiction. When a person stops using alcohol, their body must rid itself of harmful substances. Healthcare professionals help patients through detox by providing certain medications to aid in the withdrawal process and stop cravings. ^{3 p. 32 Types of Treatment Programs}
• Inpatient and residential rehab: People with severe addictions can benefit from inpatient and residential rehab. These safe spaces provide a place to live while in recovery and build healthy coping skills, promoting long-term sobriety. Many standard programs last between 30 and 90 days, but some offer longer stays.^{3 p. 33-34}
• Outpatient rehab: Outpatient rehabs are useful for treating mild to moderate addictions. With care options like medical detox and behavioral therapies, you can still live at home while developing coping skills to fight addiction triggers and prevent relapse.^{3 p. 35}
• Behavioral therapies: A combination of behavioral interventions and medication is often used to treat alcohol addiction. Cognitive-behavioral therapy (CBT) effectively treats substance use disorder by helping patients become aware of what triggers drug use and how to change their behaviors. ^{3 p. 10-11 What is drug addiction treatment?}
• Treatment for co-occurring disorders: A co-occurring disorder or “dual diagnosis” happens when someone suffers from addiction and a mental health illness. ^{4 intro} Nearly half of the 21 million people struggling with addiction have a co-occurring disorder.^{4 intro} Mental health professionals recommend treating both issues simultaneously for the most efficient results.^{4 what should I do}

Oscar Health Plan offers various plans and policies across 20 states.^{5 quick facts} Affordable behavioral and mental health services, including alcohol addiction treatment, are included in all Oscar Health Plan healthcare plans.^{2 Your Oscar plan comes with affordable mental healthcare} Many alcohol rehab centers accept Oscar Health Plan.

What Oscar Health Plan does not cover Alcohol Treatment?

Oscar Health Plan covers many evidence-based addiction services like medical detox, inpatient rehab, and outpatient care. But, non-medical amenities and supplemental services, such as holistic healthcare, recreation programs, food delivery, private treatment services, and alternative therapies likely won’t be covered.

Luxury and private rehabs often offer services like these to provide the utmost comfort during recovery. Although these services can be particularly helpful for supporting recovery, they’re often not seen as medically necessary to achieve sobriety.

What Is Oscar Health Plan Insurance?

Founded in 2012, Oscar Health Plan Insurance is the first health insurance company built around a full-stack technology platform.^{5 intro} Oscar serves over 1 million members across 20 states and delivers healthcare products for individuals and families, Medicare, and small businesses.^{5 quick facts} Oscar Health Plan is determined to conveniently provide affordable, high-quality healthcare while improving the health outcomes of its members.^{5 Solving for the biggest challenges and frustrations with U.S. health care.}

Oscar Health Plan has different plans and coverage levels, including:⁶

• Platinum: Oscar’s Platinum plan has the highest premium and the lowest deductible. It offers 80% of covered health costs paid by Oscar and 20% paid by you.
• Gold: Like the Platinum plan, the Gold plan has a higher premium and lower deductible, with 80% of covered health costs paid by Oscar and 20% paid by you.
• Silver: The Silver plan has a moderate premium and deductible, with 70% of covered health costs paid by Oscar and 30% paid by you.
• Bronze: With the Bronze plan, 60% of covered health costs are paid by Oscar and 40% are paid by you. This plan has a low premium and high deductible.
• Secure: The Secure plan offers the lowest premium and highest deductible and is meant for emergency coverage.

How Much Does Alcohol Rehab Cost?

Besides your specific insurance plan, other factors contribute to the cost of alcohol rehab, such as the facility you choose and the services they offer. Seeking treatment in an outpatient program is often much cheaper than attending inpatient rehab. The type of inpatient rehab you choose will further affect costs. For example, if you choose a luxury facility that offers exclusive amenities, like room service and spa treatments, you’ll pay more than the cost of standard residential rehab.

The amount of time you spend in treatment, along with the intensity of the services you need affect how much rehab will cost. Based on the severity of your addiction and your specific needs, the time you spend in treatment will be unique to what works best for your long-term sobriety.^{3 p.5 #5} Costs will likely increase with the more time you spend in treatment.

The following are estimated based on reported costs from different rehab programs and facilities. To find out specific costs, contact the rehab center you’re interested in.

Cost of Inpatient Alcohol Rehab

The cost of inpatient alcohol rehab varies widely depending on factors like location, insurance coverage, and the type of rehab facility you attend. In 2008, a study found the average cost of standard 30-day inpatient rehab to be about $6,000. ^{7 p. 3.2 Cost band estimates table 2} Prices can increase to about $20,000 with well-known and luxury facilities. For longer stays, costs range between $12,000 to $60,000. ^{7 p. 3.2 Cost band estimates table 2}

Cost of Outpatient Alcohol Rehab

Outpatient alcohol rehab can often be more affordable than inpatient rehab. A standard 3-month program cost about $5,000 in 2008. ^{7 p. 3.2 Cost band estimates table 2}  Highly-acclaimed programs cost about $10,000. The price of outpatient rehab increases with the level of care you receive, the duration and frequency of your visits, and the type of program you’re attending.

Cost of Alcohol Partial Hospitalization Programs (PHP)

With partial hospitalization programs (PHP), you can attend treatment daily while still living at home. In 2008, the average PHP cost was between $375 and $500 a week but can vary based on how long you attend the program you choose. ^{8 results}

Cost of Medication-Assisted Treatment (MAT)

A combination of MAT and behavioral therapies is used to treat alcohol addiction. ^{3 p. 6 #7} Medications like acamprosate, disulfiram, and naltrexone are often administered when treating alcohol use disorder.^{3 p. 6 #7} The cost of MAT can vary based on the type of medication prescribed and the treatment duration.

Alcohol Rehab vs. the Cost of Alcohol Addiction

Anxiety can often arise when figuring out how to pay for alcohol rehab, causing many to push off finding treatment for another day. But the cost of alcohol addiction is much more expensive than the cost of seeking treatment. Alcohol addiction not only depletes your finances but can also ruin relationships with loved ones and cause you to put yourself and others in risky situations. Many irreversible health problems can occur from the excessive use of alcohol, like cancer, high blood pressure, heart disease, stroke, and liver disease.^{9 Long-Term Health Risks}

At first, the cost of alcohol rehab may be overwhelming, but compared to the cost of addiction, seeking treatment is an investment in a happier, healthier life. Knowing what’s covered under your Oscar Health Plan insurance can offer peace of mind when choosing the best rehab.

What Length of Alcohol Rehab Does Oscar Health Plan Cover?

Even though everyone has unique needs and no one treatment will work for all, mental health professionals agree that longer treatment times are generally considered the most effective. ^{3 p.5 #5} Addiction recovery is often a long progress that is typically most successful when treatment is maintained over longer periods.^{3 p.5 #5}

Because there are so many different types of policies and tiers of coverage, the length of time covered under your insurance depends on your specific plan. To find out how long your Oscar Health Plan insurance will cover alcohol rehab, call the number on the back of your insurance card or reach out to AAC for assistance.

Choosing between Oscar Health Plan Inpatient vs. Outpatient Alcohol Rehab Centers

When choosing the best treatment, important factors like the severity of your addiction and your specific needs should be considered. Mental health providers design individualized treatment plans, constantly monitoring and adjusting them to provide a care plan that is most beneficial for you. ^{3 p.6 #8}

For those with mild to moderate alcohol addiction, outpatient programs are often a good place to start. Inpatient programs are particularly beneficial for people with more severe substance use disorders. For severe alcohol addictions, quitting drinking without proper support can be dangerous. Inpatient and residential programs provide 24/7 support and supervision from medical professionals who can provide medications and tend to withdrawal symptoms as you recover.^{3 p. 32 Types of Treatment Programs}

Inpatient alcohol programs also give you the chance to connect with others in recovery and hold each other accountable through hard times through support groups like Alcoholics Anonymous. With inpatient rehab, you’ll have more opportunities to fellowship with people on a similar journey and use the lessons and skills you learn to focus completely on your recovery.

How to Use Oscar Health Plan Insurance for Alcohol Rehab?

You can use Oscar Health Plan insurance for alcohol rehab by consulting your primary care physician or a mental health professional in your network to assist you with finding a suitable program. Once you find a program, contact the rehab to determine your ability to use Oscar Health Plan insurance for coverage. The rehab will be able to determine the level of coverage you’ll receive based on your specific plan.

How to Find Alcohol Rehabs That Accept Oscar Health Plan Insurance

AAC can assist you in verifying your coverage. Contact our helpline to speak directly with an admissions representative who can check your benefits while you’re on the phone. You can also reach out through online chat for assistance from one of our agents. Every year hundreds of people go into rehab financed through Oscar Health Plan.

AAC is home to some of the best treatment centers nationwide. We provide top-notch, evidence-based addiction treatment services with various options in inpatient and outpatient settings. Our facilities offer exclusive amenities and have specialized therapeutic services to best fit your needs. You’ll receive treatment in a comfortable environment where you can feel at peace and focus on getting better. If you or a loved one is ready to seek treatment for alcohol addiction, AAC is here to help you along the way.