Oxford Health Rehab Coverage 

 

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Oxford Drug Rehab Insurance FAQs

Where does Oxford Health Operate?

Oxford Health is a branch of United Healthcare Group.

They serve customers in Connecticut, New Jersey, and New York

The majority of Oxford Health’s health plans have been awarded NCQA Health Plan Accreditation.

Does Oxford Health Cover Rehab?

Oxford Health usually will cover drug rehab. They base coverage on a number of factors which vary based on your plan. Oxford has HMO’s, PPO, and POS plans. They label their plans Bronze, Silver, Gold, and Platinum.

Oxford Health coverage ranges from partial to full. You are responsible for whatever they do not cover. If your plan has a deductible, you have to pay the deductible amount before your insurance coverage takes over.

For inpatient or outpatient drug treatment, you may need a doctor’s evaluation and recommendation, and you may need prior authorization from Oxford Health. Copayments may also be required.

Most Oxford Health plans have coverage for the following:

Detoxification
Inpatient Treatment
Partial Hospitalization
Intensive Outpatient Programs (IOP)
After-Care Program
Mental Health Programs
Behavioral Health Programs

 
To manage your Oxford Health plan, or learn more about it, you can visit their Website.

How Long Will Oxford Health Cover Addiction Treatment?

Oxford Health coverage length varies. Typical coverage lasts from 3 days 90 days. You

will need to contact them to determine coverage.

Are out of network providers allowed with Oxford Health?

It depends on the plan:

HMO Plans (Health Maintenance Organization) usually have coverage for network doctors only.

  • POS Plans (Point-of-Service) –may let you choose providers who are out-of-network.
  • PPO Plans(Preferred Provider Organization) – often allow you to choose any doctor or specialist without a referral, in or out of network.
  • Contact Oxford Health to confirm your level of coverage, if any, for out-of-network providers, and to determine any additional costs.

Does Oxford Health Allow for Treatment at Luxury Rehab Facilities?

It depends on your plan. Luxury (private) drug rehabs are often where wealthy people and celebrities will go for addiction help. They are often as nice as any hotel or resort you may use for a vacation spot. They usually have massages, acupuncture, hot-tubs, pools, and quality dining, in addition to other exclusive privileges.

 
Premier Settings

Premier Settings

Private Gyms

Private Gyms

Massage Therapy

Massage Therapy

Yoga

Yoga

Inpatient Addiction Treatment vs. Outpatient Treatment

This is one of the biggest and most important choices that a patient or their family will make when looking for addiction help. Where you go, and what you do from here on matters and can determine your level of success.

Both options are better than not seeking treatment and could save your life. They each have their own strengths and weaknesses.

An outpatient facility is usually a local option. They give you the chance to meet with Oxford Health professionals like doctors, alcohol and drug counselors, or therapists, attend group sessions, and go to recovery meetings while being able to head home afterwards. Co-pays may be required for each visit.

Inpatient facilities, also called residential programs, are most often 28 day programs. They provide structure and are typically remote destinations where you stay in the facility for the duration of the program.

Do I need Insurance to go to Rehab?

You are not required to have insurance to get addiction treatment. However, without insurance, the cost of drug rehab facilities is usually very expensive and impractical for most people. You would need to pay out of pocket. You can certainly pay with a credit or debit card, work out a payment plan, or use other methods that each facility accepts.

Typical inpatient rehabs may cost anywhere from $6,000-$20,000 for a 28 day program.

Outpatient Rehab can range from $4,000-$10,000 for 90 days. The cost of outpatient rehab will vary and is mostly based on how many visits are made.

How does Oxford Health Decide my Claim?

Oxford Health makes decisions about their coverage based on your health plan. Each claim decision is reviewed on a case by case basis and varies by state. In general, Oxford Health will look at services you use. They then follow national guidelines and other policies to determine if you’re covered. Services that may be covered can include drug addiction rehab, blood-tests, surgeries, or hospital stays.

If your claim is denied, Oxford Health will notify you. You DO have the right to appeal.  To start an appeal with Oxford Health, call their Member Services number on your Oxford Health ID card. They typically allow 60 days from the date of the initial payment or denial notice to file. If Member Services doesn’t resolve your issue, ask for an appeal.

All Oxford Health appeals are responded to compliance with state, federal and NCQA guidelines. It is possible to get appeals expedited.

What Else Does Oxford Health Provide?

Oxford Health has a host of health, wellness options, and discounts.

A variety of plans and the ability to manage and adjust your plan.

Per HIPAA laws, anything that you say is kept confidential. You don’t have to worry about anyone knowing you may have trouble with alcohol or drugs.

Get Approved For Oxford Health Rehab Coverage

Verifying what insurance will cover can be a time-consuming process. This hassle usually involves lots of waiting and multi phone calls back and forth. Our knowledgeable staff can verify your coverage for you and take the stress and annoyance out of this already difficult time. You have enough to worry about already. Verifying insurance coverage for rehab shouldn’t be an additional burden.


NOTICE: Step One Rehab works hard to make sure our information is accurate. Due to constant changes in insurance company policies, we suggest you contact your insurance company with your member ID ready to confirm your particular coverage or submit our free verification form to verify benefits.


Give us a call now and let us handle this step, at no cost to you! We are totally confidential. Our number is 877-348-7494