The Oscar Health Insurance group is a technology-focused health insurance company, that was founded in 2012, and is situated out of New York City. The main focus of the company is on the health insurance industry through telemedicine, and other healthcare-focused technological interfaces, and transparent claim pricing systems. Oscar health insurance does currently offer individual health plans in Ohio, Texas, New Jersey, Tennessee, and California, along with small-group health insurance plans in New York. This particular insurance provider does offer all of its members free 24/7 telemedicine visits through their doctor-on-call services, and each member is assigned a team of three care guides and registered nurses who handle both traditional customer service questions and coordinate clinical care. The personalized health care plans include the simple bronze package, which is great for healthy individuals over 30 years of age. There is a simple silver plan, which is good for anyone who is generally healthy and has a few yearly doctor visits and takes generic prescriptions. Finally, there is the classic silver personalized plan, which is good for anyone who needs a little bit more coverage and for families with young children.

Drug and alcohol abuse can be covered under some plans, but this will depend on the type of plan, and what specific services are covered. Millions of American’s struggle with substance abuse each day and roughly 93% of the 20.3 million Americans with drug addictions do not get the help they need. When looking for treatment, it will be important to contact your insurance company or going through your employee assistance program. The only way to find out if you are covered for drug treatment is to call the insurance provider directly. There are also some other useful questions to ask the health insurance provider, such as does my policy cover the entire cost of treatment? Is there a list of treatment facilities I can select from? And, are there any limitations regarding treatment, and how long does my policy cover treatment for? Your insurance company providing care, such as Optum should be able to answer these questions and help you determine what will be the best level of care for your addiction.
Many families with a loved one who is battling addiction will have to turn to their insurance provider to see what type of help they can get. There is a cost involved with the majority of drug and alcohol treatment programs in the United States. Even state-financed treatment services can cost something; some addicts will go the way of trying to get a grant or some type of payment assistance. Unfortunately, there are millions of Americans, who do not have health insurance, despite the recent expansion of Medicaid and Medicare. Health insurance plans are not always affordable, but addicts who are covered should check with their insurance provider or contact the different drug and alcohol rehab programs they are looking at.
Ask a Professional
What is private health insurance?
Private health insurance is a form of insurance where the client pays a private entity for their choice of offered health plans. The plan’s cost is known as the premium, which can usually be paid monthly, bi-annually, or annually. These plans are among the most expensive options for healthcare coverage, but they generally offer superior benefits and provider networks than subsidized or free health insurance options. Some private health insurance plans allow clients to seek treatment wherever they choose, without being restricted to a particular region or network.
Does private health insurance pay for substance abuse treatment?
Private health insurance usually gives someone the best chance of getting complete coverage for quality treatment. However, it’s important to remember that private health insurance companies aren’t required to cover services they don’t deem necessary. You will not know the exact amount of coverage until an evaluation is done and the treatment center submits a claim. Make sure you talk to the intake counselor and fully understand how they handle insurance coverage. Doing so can ensure you do not have any unexpected expenses and that treatment will not get cut short.
How do I get private health insurance?
Private health insurance is available directly from the companies that provide it. Or a person may be eligible to join a “group” policy through their employment. Group policies are purchased by employers at special rates and may be offered to eligible employees for less than the same policy would cost an individual.
What if I don't have private health insurance?
Someone without private health insurance or cash payment may be eligible for Medicaid coverage. Or, they might find a free or low-cost treatment program with bed availability. Some programs provide sliding scale payment systems or allow patients to make payment arrangements. There’s almost always a way to find help if someone wants to recover from addiction.
Want to know more?
The questions from Addicted.org’s “Learn from our Experts” are answered by Michael Leach, CCMA. If you need further clarification on any of the questions above or have any other questions you can contact him directly at mike@addicted.org.