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Oxford Healthcare Insurance Coverage for Drug and Alcohol Rehab

Written by: Goeffrey Andaria, Mental Health Writer

Reviewed by: Dr. Carl Williams, Ph.D., LCADC

It can be challenging to obtain the care you need if you don't have the financial resources to pay for drug abuse treatment. Thanks to the work of healthcare financial assistance organizations and insurance providers like Oxford HealthCare, you may begin your journey to recovery without worrying about the cost involved.

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Co-Insurance

Deductibles

Co-Payment

Typically, co-insurance percentage range from 20% to 40%, and the insurance company clears the rest.

The amount you pay out-of-pocket for treatment before the health plan starts helping with payments.

Co-pay is a fixed amount you must clear (usually when you receive treatment) for covered treatment services.

Is detox and rehabilitation covered by Oxford Healthcare plans?

Understanding the terms of your Oxford Health insurance policy coverage

The cost of rehab with the Oxford Healthcare plan

Getting the most out of your Oxford Healthcare Insurance

Is Detox and Rehabilitation Covered by Oxford Healthcare Plans?

Oxford Healthcare Plans covers inpatient and outpatient detox and rehabilitation services. The Affordable Care Act (ACA) makes substance abuse treatment an essential service, so insurers that take on clients with a high risk of developing an addiction must provide this benefit to their clients.

However, the scope of your plan's support for substance use disorders and alcohol rehabilitation services will vary depending on the details of your particular policy. The length of time that different plans cover drug and alcohol treatment might also vary widely.

Medical Detox

The detoxification phase of addiction therapy is when a doctor helps you safely stop taking substances. Because your body has been used to the presence of drugs, you will most likely experience withdrawal symptoms during detox. To ensure that your withdrawal symptoms are adequately controlled, a drug detox expert at a treatment center will keep an eye on you 24/7.

Avoid going "cold turkey" while attempting a detox. Detoxing at home has several dangers. It can be exceedingly painful and dangerous and increases your chances of relapsing.

Inpatient Programs

Residing at a treatment center is among the main requirements of inpatient programs (also known as residential care). This entails having a specialist supervise your care and watch you around the clock until you complete the program.

Partial Hospitalization Programs (PHP)

This kind of therapy, which is less intensive than inpatient treatment, requires that a patient checks into the institution for most of the day, seven days a week. You'll return to your house and your loved ones in the evening.

Outpatient Programs (OP)

You won't be required to spend much time in an outpatient program. After attending your treatment sessions for a few hours during the day, you will finally make it back to your house, school, or work. You do not need to attend therapy sessions daily if you are receiving OPs. These programs generally require a time commitment of 10 to 12 hours per week.

Intensive Outpatient Programs (IOP)

An intensive outpatient program (IOP) requires patients to commit to lengthier and more frequent therapy sessions than those found in traditional outpatient programs.

Aftercare

Aftercare programs support people in sustaining sobriety after completing a more rigorous treatment program. Aftercare may take many forms, including psychotherapy, support groups, and community activities.

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Understanding the Terms of Your Oxford Health Insurance Policy Coverage

There are many finer points and intricacies to consider when purchasing insurance, so familiarity with some of the terminology used in this field is crucial. Here we define some of the most common insurance terminology used by Oxford Healthcare.

Out-of-Pocket Cost

The phrase "out-of-pocket costs" refers to any payments that must be paid but are not covered by your Oxford Healthcare plan.

Deductible

The deductible is the out-of-pocket amount the policyholder must pay throughout the policy year before the insurance company begins to pay for covered expenses.

Premium

The premium is the regular (monthly) cost of keeping your Oxford Healthcare plan in effect.

Claim

A bill sent to Oxford Healthcare insurance to be reimbursed for medical services rendered is referred to as a "claim."

Co-Insurance

Co-insurance occurs when Oxford Healthcare pays for a portion of your covered expenses, and the policyholder pays for the remaining amount (e.g., Insurance policies may cover services at 80 percent, and individuals must pay the remaining percent).

Co-Pay

A copayment is the portion of a service's total cost that the patient is responsible for paying at the delivery time.

Out-of-Network

To be "out-of-network" means that a doctor or hospital is not affiliated with any particular Oxford Healthcare network. Costs like deductibles and co-insurance may increase when you see a doctor who isn't in your insurance network.

In-Network

A doctor or facility is deemed in-network and can bill you at a discounted rate if they have a contract with Oxford Healthcare insurance. Oxford Healthcare in-network providers often provide reduced co-payment and co-insurance rates for their patients.

SBC (Summary of benefits and coverage)

SBC is documentation that outlines Oxford Healthcare coverage as it relates to specific medical requirements. You may estimate your out-of-pocket costs and your insurance's share of those costs from your SBC.

Medically Reviewed:

Dr. Carl Williams Ph.D., LCADC

Rolling Hills Recovery Center

Executive Director

Dr. Williams presently serves on the board of Directors for two non-profit service organizations. He holds a Master’s degree in Human Services from Lincoln University, Philadelphia, Pa and a Ph.D. with a concentration in Clinical Psychology from Union Institute and University. In Cincinnati, Ohio. He is licensed to practice addictions counseling in both New Jersey and Connecticut and has a pending application as a practicing Psychologist in New Jersey.

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The Cost of Rehab With the Oxford Healthcare Plan

Different plans have different costs for treatment under Oxford Healthcare, but most co-pays are below $50 if you see a therapist who is in-network. Note that Oxford Healthcare offers many different plan options, including:

Freedom plans
Liberty plans
Preferred Provider Organizations (PPOs)
Exclusive Provider Organizations (EPOs)

Plan details are region-specific because Oxford Healthcare Insurance has members in many states. Considering all the variables in play, it's not surprising that coverage varies widely.

Expect to spend roughly $50 for each treatment session you get from an in-network physician under most Oxford Healthcare plans. Therefore, you will be responsible for paying your therapist $50 every time you see them.

Without your therapist being a part of the Oxford Healthcare provider network, you will be responsible for paying the total price of each session out of pocket. Depending on the circumstances, this might cost as little as $50 or as much as $250.

Consult your doctor or rehab support team about sliding scale fees if you're worried about how to pay for treatment. In some instances, you may be able to pay a reduced charge per session if your rehab accepts payment on a sliding scale.

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Get The Most Out Of Your Oxford Healthcare Insurance Right Now.

Most treatment facilities in New Jersey and elsewhere in the country work with insurance companies so that people like you don't have to worry about how to pay for the care you need. As a result, most inpatient and outpatient services, including medical detox, will likely be wholly or partly covered by your Oxford Healthcare insurance plan.

Don't hesitate to contact Rolling Hills Recovery Center, an Oxford Health Plans insurance agent, or visit their website now to learn more about their plans and how they may assist you in paying for drug and alcohol addiction treatment.