Does Oscar Insurance Cover Drug & Alcohol Rehab?

What Are Typical Deductibles and Copays for Oscar Rehab Coverage?

Exact cost-sharing figures depend entirely on the specific Oscar plan you hold, whether it’s an HMO, PPO, or EPO plan, and whether you’ve met your deductible for the plan year. Here are typical ranges Oscar members encounter for in-network addiction treatment:

• Annual deductible$500–$3,500 (individual), depending on metal tier (Bronze, Silver, Gold)
• Inpatient copay or coinsurance10%–40% of allowed charges after deductible, or a flat daily copay
• IOP / outpatient copay$20–$75 per visit, or coinsurance after deductible
• Out-of-pocket maximumFor 2024 ACA-compliant plans, the federal maximum is $9,450 (individual), once reached, Oscar covers 100% of in-network covered services
• Prior authorizationMost inpatient and IOP levels of care require pre-authorization from Oscar before treatment begins. Nova’s admissions team handles this process on your behalf

According to NIDA’s treatment research, addiction treatment is cost-effective relative to the societal costs of untreated substance use disorder, making it important to use your insurance benefits fully rather than delay care due to cost uncertainty.

How Do I Use My Oscar Insurance at Nova Recovery Center?

Using your Oscar benefits at Nova is straightforward. Our admissions process is designed to remove every friction point between you and treatment:

1. Call or contact us: Reach our admissions team 24/7 at (512) 605-2955. You can also submit the benefits verification form below.
2. We verify your benefits: We contact Oscar directly to confirm your in-network coverage, deductible status, and any prior authorization requirements.
3. We explain your costs: Before you commit, we give you a clear picture of expected out-of-pocket costs. We also review financing options if needed.
4. We handle prior auth, Our clinical team submits documentation to Oscar for authorization of the appropriate level of care.
5. You begin treatment, Once authorized, you focus entirely on recovery. We handle the paperwork.

Nova Recovery Center serves clients across Texas from our Austin-area and other locations. Oscar Health coverage is generally available to Texas residents enrolled through the ACA marketplace or employer-sponsored Oscar plans.

Verify Your Oscar Insurance Benefits

Complete the form below and a Nova admissions counselor will confirm your Oscar coverage, typically within one business hour.