Drug addiction is a disease that affects millions of Americans, and it’s one that can be very costly to treat. If you or someone you know has an addiction problem, and you are looking for an insurance plan that can help you out, Oxford Health Insurance is an excellent choice.
When it comes to putting rehabilitation services on your insurance policy, it can be difficult to know where to start. Many people are unsure of how to go about getting the coverage they need.
This article will help you understand what is covered and what isn’t when it comes to obtaining drug rehabilitation under the insurance provider Oxford Health Insurance, including a bit of history and information about the insurance company in general.
Let’s get started!
What Is Oxford Health Insurance?
Oxford Health Insurance was founded in 1883 as a mutual life insurance company. It has grown into one of the largest health insurers in America, serving more than 10 million members nationwide.
The company offers both individual and group plans that cover a wide range of medical services, from primary care to specialty care.
In addition to its traditional business model, Oxford also offers an HSA-qualified plan called Oxford Flexible Spending Account (FSAs).
Oxford Health Insurance is part of the Oxford Health Alliance, which includes Oxford Health Plans, Inc., Oxford Health Plans of New York, LLC, and Oxford Health Plans of Pennsylvania, LLC.
Who Does Oxford Health Insurance Cover?
Oxford Health covers individuals, families, and small businesses throughout the United States. It provides coverage through two main types of plans: Individual and Group.
Provides coverage for individuals who do not have access to other insurance or who want to purchase their own private insurance. Individuals must pay out of pocket for any expenses related to treatment.
Offers coverage to employees and retirees of large employers. These plans usually offer benefits such as vision, dental, and prescription drugs at no cost to the employee.
Employees may choose to add additional benefits like life insurance and long-term disability.
Does Oxford Health Insurance Cover Rehabilitation Treatment?
Yes! Oxford Health Insurance does provide coverage for inpatient and outpatient drug addiction treatment programs.
Oxford Health Insurance And Rehabilitation Treatment
When it comes to paying for rehab, there are three options available to you depending on whether you have an individual, family, or group plan.
If you have an individual plan, you will have to pay for all of your rehab costs out of pocket. You will not receive any reimbursement for these expenses from Oxford Health Insurance.
However, if you qualify for financial assistance, you may still be able to use this money to pay for your rehab.
If you have a family plan, you will only be responsible for 50% of the total cost of your rehab. Your employer will pick up the remaining amount. They will then reimburse you for half of the cost of your rehab after taxes are taken out.
If you have an HSA-qualified group plan, you will be reimbursed for 100% of your rehab costs. This means that you won’t have to pay anything towards your rehab.
All the funds used to pay for your rehab will come directly from your HSA account.
What Rehab Treatment Is Covered By Oxford Health Insurance?
The following treatments are considered medically necessary and are covered under your plan.
Inpatient Rehab Programs
These programs take place in hospitals and provide patients with 24/7 supervision. Patients can stay here for weeks or months while they recover from addiction.
Outpatient Rehab Programs
This type of program takes place outside a hospital setting and allows patients to continue living their lives during recovery. Outpatient programs typically last between 30 days and 90 days.
Oxford Health covers up to 50 visits per year for outpatient counseling programs. Eligible patients receive $1,500 per visit.
Intensive Outpatient Programs
This option is similar to outpatient rehabilitation, but requires patients to attend classes five days per week. Intensive outpatient programs are most often offered in a residential setting.
Oxford Health Insurance covers up to 100 days of residential treatment.
Eligible patients receive a $3,000 per month benefit for each day spent in treatment. Patients who qualify for this benefit can expect to spend anywhere between 30 and 60 days in treatment, depending on the type of facility they attend.
Residential Rehab Programs
Patients live in a facility where they receive medical care and counseling. Residential programs typically last longer than outpatient programs. The length of time varies based on the specific program and the needs of the patient.
Some programs require patients to remain at the facility for several months. Others allow patients to leave after they’ve completed the program. Oxford Health Insurance pays up to 100 days of coverage for residential treatment.
Eligible individuals receive $4,000 per month for each day spent in a residential program.
Oxford Health Insurance covers detoxification services as part of an intensive outpatient program. These services help patients prepare themselves for the transition into a drug-free life.
Detoxification programs are generally offered before the start of an intensive outpatient program and last one to two weeks.
Medication-Assisted Therapy (MAT)
This method involves prescribing medications to help patients overcome their drug cravings. MAT also includes behavioral therapy and counseling.
Oxford Health Insurance covers MAT benefits when provided within an inpatient or residential program, as well as when it’s prescribed by a doctor.
It also covers MAT when it’s provided by a certified substance abuse counselor. Medications like Suboxone and Methadone are examples of MAT.
Cognitive Behavioral Therapy (CBT)
This form of therapy teaches patients new ways to think about problems, so they can solve them without turning to drugs. CBT is used to treat anxiety disorders, depression, eating disorders, phobias, post-traumatic stress disorder (PTSD), and other mental health conditions.
This type of counseling provides support to family members during recovery. Family counseling may be required when a patient has been using drugs or alcohol with another person in his/her home.
This type of counseling focuses on helping patients understand what’s going on inside their heads.
Psychotherapists use different methods to accomplish this goal, including cognitive restructuring, psychodynamic therapies, and solution-focused interventions.
This type allows people who share similar experiences to connect with others who are facing similar challenges. Group therapy is often used to address issues such as addiction, trauma, grief, and loss.
This type of therapy works best when there is more than one person involved. Group counseling provides support for each patient as well as encouragement for others who are struggling with addiction
This type offers individualized attention from a trained professional. Individual therapy addresses a wide variety of concerns including coping skills, communication issues, relationships, self-esteem, and more.
Each patient receives one-on-one attention from a therapist. These sessions focus on helping patients understand their personal issues and develop new ways of thinking.
These groups provide mutual support for recovering addicts. They encourage participants to focus on their strengths instead of weaknesses. Support groups are available at many local hospitals, churches, and community centers.
What Type Of Addictions Are Covered By Oxford Health Insurance?
Let’s now take a look at what kind of addictions are covered by Oxford Health Insurance.
Substance Abuse Disorder
This condition occurs when someone uses substances repeatedly despite negative consequences.
People with substance abuse disorders have difficulty controlling their behavior and may experience withdrawal symptoms if they stop taking drugs or drinking alcohol.
Those with alcohol dependence don’t feel satisfied after just one drink. After repeated exposure to alcohol, these individuals begin to crave it even though they know that it will make them sick.
As a result, they need to consume larger amounts of alcohol to achieve the same effects.
People who suffer from drug dependence use addictive substances repeatedly. The most common types of drug addictions include alcoholism, opioid dependency, cocaine addiction, and heroin addiction.
A number of medical conditions can cause an individual to become addicted to drugs or alcohol. Some examples include:
Depressed people often turn to drugs or alcohol to help them cope with their feelings. Depression can also lead to other mental health problems like anxiety and substance abuse.
Many people suffering from anxiety disorders find comfort in consuming alcohol or drugs. In fact, some studies show that people who take prescription medications for anxiety are more likely to abuse alcohol or illicit drugs.
Those with bipolar disorder tend to be impulsive and erratic. They may act out in destructive ways because they’re unable to control their mood swings.
Many people with this condition try to relieve their stress through alcohol or drugs.
Post Traumatic Stress Disorder (PTSD)
Some people who’ve experienced traumatic events such as rape, assault, natural disasters, or car accidents struggle with depression and PTSD.
If you’re experiencing any of these symptoms, talk to your doctor about getting treatment.
Other Medical Problems
Some medical conditions can trigger substance abuse. For example, people who have diabetes, heart disease, cancer, HIV/AIDS, or hepatitis may abuse certain drugs or alcohol to manage their illness.
Using Your Oxford Health Plan To Help Pay For A Rehab Program
Oxford Health offers several different plans that allow members to pay for rehab programs. You should choose a plan based on how much money you’d like to spend on rehab. Each plan has its own benefits and limitations.
Here’s what you need to know about each type of plan:
Oxford Health Basic Plan
The Oxford Health Basic Plan is offered at four levels of coverage. It provides up to $5,000 per year for residential treatment and up to $1,500 per month for outpatient care.
Members must pay the full cost of their treatment before receiving reimbursement.
The Oxford Health Basic Plan includes:
- Up to $5,000 for residential treatment
- Up to $1,500 for outpatient treatment
- No lifetime limit on residential treatment
- Lifetime limits on outpatient treatment
- No deductible
Oxford Health Premier Plus Plan
The Oxford Health Premier Plus Plan is available at three levels of coverage. It covers up to $10,000 for residential treatment and up to $2,000 per month for outpatient care, plus additional expenses not covered by the Basic Plan.
Members must pay the full cost before receiving reimbursement.
This plan includes:
- Up to $10,000 for inpatient treatment
- Up to $2,000 for outpatient treatment
- Lifetime limits for both types of treatment
- No deductible for inpatient treatment
- A monthly premium fee
Oxford Health Platinum Plus Plan
The Oxford Health Platinum Plus Plan is available at two levels of coverage. It pays up to $20,000 for residential treatment, plus an extra $3,000 if you need intensive care.
This plan also covers up to $4,000 per month for in-home services.
Members must pay all costs before receiving reimbursement.
- Up to 20% off the cost of residential treatment
- Up t0 4% off the cost of in-home care
- Lifetime limits for residential treatment
- No deductible or co-payments for residential treatment
- A monthly membership fee
If you qualify for one of these plans, you can use it to help cover the cost of residential treatment. However, you won’t get reimbursed until you pay the full amount of your bill.
When it comes to using Oxford Health Insurance to pay for drug rehab, there are many factors to consider. The first thing you need to do is decide which plan will work best for you.
Next, make sure you understand the terms of each plan and how they apply to your situation.
Finally, be patient while waiting for your insurance company to approve your request. If you follow this advice, you’re more likely to succeed when paying for drug rehab with Oxford Health Insurance.