Oxford Health Insurance Coverage for Rehab and Detox

Does Oxford Health Cover Rehab or Detox?

Oxford Health insurance does offer coverage for detox, rehab, and other forms of inpatient and outpatient addiction treatment programs. Due to the 2010 passing of the Affordable Care Act (ACA), substance use treatment is now considered an essential benefit, and insurance providers are required to provide coverage for it.

However, the coverage your plan offers for drug and alcohol treatment depends on the specific plan you have. Plans can vary in terms of what type of coverage they provide or how long they will cover your drug or alcohol treatment.

Using Oxford Health Insurance for Addiction Treatment

The first step to using your Oxford Health coverage is to check your coverage. To determine if your Oxford Health plan includes coverage for a specific provider and rehab services, or to see the specifics of your plan, you can log into your Oxford Health account at myuhc.com using your member ID card information. Members can also speak with an Oxford Health representative to confirm whether a provider participates in the Oxford Health network. Alternatively, many rehab providers operate confidential hotlines where you can verify your coverage instantly.

Once you have verified your coverage details, the next step would be to select a detox or rehab center, provide them your policy information, and begin the admissions process.

Finding Rehabs that Accept Oxford Health Coverage

Oxford Health offers insurance plans in Connecticut, New Jersey, and New York. If your plan only supports in-network coverage, your choices may be limited to the state where you live. Additionally, you can log in to the Oxford Health website to find in-network providers.  If your plan offers out-of-state coverage and out-of-network providers, your choices extend well beyond the borders of your state. For more information about how to find rehab centers that accept Oxford Health, select your state below.

Prior-Authorization for Treatment

Oxford Health allows patients to see specialists without a referral from their primary care provider and to offer alternative addiction treatment therapies. No referrals are required. However, you will have to obtain a pre-authorization for treatment in order for your plan’s coverage to be used.

Please keep in mind that many services—particularly substance use treatment and mental health services—require preauthorization before receiving addiction treatment. Though you do not need a referral, preauthorization means that Oxford Health insurance will approve your addiction treatment based on a medical assessment that determines whether your care is medically necessary. This is often not required for outpatient addiction treatment but is required for inpatient addiction treatment, hospitalization, and intensive outpatient care.

Out-of-Pocket Treatment Costs

When you use insurance to pay for treatment, The number of covered rehab expenses will vary by plan type and the coverage you selected when you enrolled.

Your Oxford Health policy may have a set deductible and defined copays or coinsurance levels for different types of addiction treatment. This means you may still be responsible for some out-of-pocket costs for your care.

Treatment Types Covered by Oxford Health

The types of drug and alcohol treatment that Oxford Health covers and the level of coverage depending on your specific plan. Generally speaking, you can expect your Oxford Health plan to offer some level of coverage for the following types of treatment:

• Inpatient rehab takes place in a hospital or freestanding facility. In most cases, you live at this facility for 1 to 3 months and are under 24/7 medical supervision.
• Partial hospitalization program (PHP) requires several hours of in-person treatment during the day but doesn’t require overnight stays and is typically connected to a hospital rehab program.
• Outpatient rehab usually consists of 1 or 2 visits per week with no overnight stays. Outpatient programs typically take place after someone has completed an inpatient or PHP program.
• Mental health services including cognitive-behavioral therapy: Oxford Health plans generally cover these mental health services, even without being enrolled in a rehab program.
• Medication-assisted treatment (MAT): MAT is most often used in detox when a person experiences intense physical withdrawal symptoms. It is managed by competent and caring medical professionals who prescribe medications to help ease the detox process.
• After-rehab support: Sober living requires support. Many Oxford Health plans will cover ongoing sobriety support such as therapy.

Types of Oxford Health Insurance Plans

As a subsidiary of United Health Group, Oxford Health provides plans that cover detox or rehab for approximately 1.6 million people. Oxford Health offers several comprehensive health insurance plans, including Medicare and Medicaid coverage, to meet the needs of a diverse population.²

Within Oxford Health’s 3 networks (Freedom Network, Liberty Network, and Metro Network), they offer several different health plan designs to fit just about any small business. The types of plans offered include:

• Exclusive provider organization plans
• Preferred provider organization plans
• HMO plans
• Health savings accounts.