Oxford Health Detox & Rehab Benefits Guide
Founded in 1984, Oxford Health Plans is an American healthcare company that sells various health insurance benefit plans. In 2004, Oxford Health became a subsidiary of United Health Group, the largest healthcare company in the world. Oxford Health/UnitedHealth is among the first health insurance companies to allow patients to see specialists without a referral from their primary care provider and to offer alternative medicine treatments. Oxford Health provides coverage for individuals, families, and employers. They offer point-of-service plans including the Freedom Plan and Liberty Plan. Health maintenance organization (HMO) and third-party administered group insurance plans are also available through Oxford Health.
Today, Oxford Health serves approximately 1.6 million people. The network includes close to 73,000 physicians with 104,000 healthcare locations.1 The company’s size allows it to offer a wide range of health insurance plans to meet the needs of most people. This page will help readers learn how to use their Oxford Health insurance plan to access detox and rehabilitation for alcohol and drug addiction. Let’s explore the various plans offered by this provider.
Does Oxford Health Cover Detox?
Detoxification is generally the first step in recovery. Oxford Health Plans covers various inpatient and outpatient programs to help patients detox and overcome addiction. However, the coverage depends on the specific plan you have. No referral is required for coverage offered by Oxford Health but you must obtain pre-authorization to be admitted for inpatient care.
In detox, the patient clears the substance(s) from their system with the support of healthcare professionals. Oxford health provides coverage for outpatient and inpatient detoxification. When a patient is at risk of severe withdrawal symptoms or has medical conditions that require medical oversight, then inpatient/residential detoxification is often required. Oxford also covers this, but call your provider to learn details about copays and coinsurance before being admitted.
In addition to covering detoxification services, Oxford Health plans also cover other alcohol and drug rehab services, including:
- Inpatient (residential) rehab: 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. Inpatient rehab involves individual and group therapy, medical care, and a number of amenities, depending on the location you are receiving treatment.
- Partial hospitalization program (PHP): This type of treatment is typically connected to a hospital rehab program. It requires several hours of in-person treatment during the day but doesn’t require overnight stays. Most PHPs meet 5 days a week and many require daily attendance.
- Outpatient rehab: A standard outpatient program usually consists of 1 or 2 visits per week with no overnight stays. People in outpatient rehab programs work with a counselor both individually and in a group setting. 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: This 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.
Most Oxford health plans also cover services related to addiction and detox, including:
- Physical and mental health assessments.
- Dual diagnosis treatment for co-occurring disorders.
- Medications used in treatment or prescribed for use at home.
- Room and board.
- Therapy and counseling.
Some plans have a maximum threshold that will be covered, so be sure to understand the details of your Oxford Health plan and the number of days and/or sessions you can attend that will be covered by insurance. The amount you will spend out-of-pocket on expenses for drug and alcohol rehab largely depends on your plan.
Please keep in mind that many services—particularly substance abuse treatment and mental health services—require preauthorization before receiving treatment. Though you don’t need a referral, preauthorization means that Oxford Health will approve your treatment based on a medical assessment that determines whether your care is medically necessary. This is often not required for outpatient treatment but is required for inpatient treatment, hospitalization, and intensive outpatient care.
Additionally, your Oxford Health policy may have a set deductible and defined copays or coinsurance levels for addiction treatments, including detox and rehab. Deductibles are the fees that you pay before your insurance coverage starts paying. A copay is a predetermined amount that you pay for a covered healthcare service. Coinsurance is the percentage of the cost of a service (such as detox or inpatient rehab) that you pay.
Be sure to check with your provider on any plan-specific questions related to providers. If you are considering a UnitedHealthcare Choice Plus provider outside the Oxford service area, it is important to understand that there are specific restrictions with some providers and specific health plans.3
How to Check Your Oxford Health Insurance Benefits
Most health insurance plans will cover treatment for addiction and mental health disorders. With the passage of the Affordable Care Act, Americans have access to these forms of treatment. Plans can vary in terms of what type of coverage they provide or how long they will cover treatment, so it is important to check with your provider to ensure the rehab program you’re interested in attending is covered by your insurance policy.
To determine if your health plan includes coverage for a specific provider and 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. Check with the provider’s office prior to your appointment or call the toll-free phone number on your health plan ID card.
Types of Oxford Health Insurance Plans
Oxford Health Plans can generally be purchased in 3 states: Connecticut, New Jersey, and New York. The company offers a number of comprehensive health insurance plans to meet the needs of a diverse population.2
Oxford offers over 100 health plans within their 3 networks: Freedom Network, Liberty Network, and Metro Network. Each network offers several different health plans designed to be flexible to fit many needs.
Within Oxford’s 3 networks, 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.
Oxford also provides Medicare and Medicaid plans. Oxford covers addiction and mental health treatment, though coverage varies based on your plan. Oxford Health prioritizes mental health care and addiction treatment. They offer a substance use treatment helpline that gives members 24/7 access to a team of treatment specialists.
If you want to find out whether or not rehab and detox services are covered by Oxford Health, you can do so by searching on the Oxford website.3 Members can simply use the provider search tool on www.oxfordhealth.com to find rehab and detox centers in their area.
Members can also call a customer service representative at 800-444-6222 to confirm whether a provider participates in the Oxford Health network. American Addiction Centers is in-network with Oxford Health.
Oxford Health Insurance and American Addiction Centers
American Addiction Centers is the leading provider for addiction treatment nationwide, specializing in evidence-based treatment and mental health care. Our mission is to provide quality, compassionate, and innovative care to adults struggling with addiction and co-occurring mental health disorders. Through comprehensive and customized treatment plans, we instill hope that long-term recovery is possible.
Our treatment program and curriculum are research-based. We strive to provide the best care possible by rooting our program in scientifically proven therapy modalities. Our licensed counselors are trained to “meet our clients where they are” and use research-based treatment practices.
Besides providing you and your loved ones with customized addiction therapy from our research-based program of best treatment practices, we incorporate the 12-step philosophies into our program. The support and fellowship gained by attending 12-step meetings can be beneficial not only during treatment but post-rehab while living a sober life.
At American Addiction Centers, our purpose and passion is to empower you, your family, and your community by helping you achieve recovery and optimal wellness of the mind, body, and spirit. We aim to treat the whole person and offer unique amenities for our patients that help aid in recovery. We have centers nationwide and we are in-network with many different insurance providers throughout the country, including Oxford Health.
Ready to learn more about our treatment options? Call our helpline—open 24/7—at 1-888-935-1318 to speak to someone on our addictions team. We look forward to hearing from you and helping you or your loved one on the road to recovery. A sober, healthy life is possible.