Navigating mental health care can feel complicated, especially when you’re trying to understand what your insurance actually covers. If you have Oscar insurance, knowing your benefits, costs, and provider options can make a big difference in how quickly and affordably you access care. Here’s what to know about Oscar therapy coverage and how to get started.
Key takeaways
- Oscar health insurance covers a range of mental health services, including individual therapy, group therapy, and medication management.
- Coverage details — including copays and deductibles — vary by plan tier (bronze, silver, gold), so it’s worth reviewing your specific plan before booking.
- Seeing an in-network therapist keeps your out-of-pocket costs lower; out-of-network care is typically more expensive and may not be covered at all.
- You can find therapists who accept Oscar on Grow Therapy — filter by insurance, specialty, and availability to see verified providers currently accepting new clients.
Does Oscar insurance cover mental health services?
Yes, Oscar insurance covers mental health. Oscar believes that mental health is just as vital as physical health; 1 in 5 adults in the U.S. have some mental illness, and suicide is among the leading causes of death in the United States, and the second leading cause of death for people ages 10 to 34. With these odds, Americans cannot afford to go without adequate mental health care.
Types of therapy Oscar insurance covers
Oscar health insurance plans cover many services targeted to help treat depression, anxiety, stress management, and other mental health conditions. With the advancements in technology and the always-evolving healthcare, treatment can look different for everyone. Some of the types of mental health benefits offered by Oscar health insurance include:
- Psychotherapy: People most commonly think of this when they think about mental health treatment. Psychotherapy can be considered talk therapy when you meet with a trained therapist to discuss symptoms, stressors, and other concerns, while also working toward developing healthy habits and coping mechanisms.
- Group therapy: Similar to psychotherapy, group therapy occurs in a group setting. This form of treatment is often seen in rehabilitation facilities and addiction clinics. Group therapy is a great tool, allowing people to realize they aren’t alone. Knowing and witnessing another individual with similar struggles is somewhat comforting to many.
- Medication management: As great of a tool as psychotherapy is, some mental health conditions require medication as an adjunct to their therapy and healing process. Conditions requiring medication may include depression, anxiety, attention deficit disorder (ADD/ADHD), bipolar, and more.
- Physical activity: There is much evidence demonstrating the benefits exercise and physical activity has on our mental health. With the release of endorphins, mood is known to improve. Some Oscar insurance plans reward you with Amazon gift cards upon meeting step goals on fitness tracking apps!
Oscar insurance recognizes that mental health care is healthcare. With a variety of plans to choose from, members can feel confident that their healthcare needs are able to be met.
Did you know?
More than 1 in 5 U.S. adults experience mental illness each year — yet fewer than half receive treatment. Cost and confusion about insurance coverage are among the most commonly cited barriers to getting care.
Therapy Oscar insurance doesn’t cover
Unfortunately, there may be specific services or specialties that your insurance plan may not cover. It is essential to familiarize yourself with what is and isn’t covered by your chosen plan. Typical services that Oscar Health insurance may not cover include:
- Life coaching
- Career coaching
Additionally, any non-emergency services rendered when traveling out of the U.S. are not covered by Oscar health insurance.
How to check your Oscar insurance coverage
Visiting the Oscar health website makes searching for your coverage plan easy. Click on the “find my plan” button, answer a few questions, and you will have plans offered in no time. You will also be given the opportunity to compare various plans, coverage options, and rates all at the same time. You can also look over your Summary of Benefits, which will look similar to the example below. This will help you better understand what Oscar will cover and what you’ll be responsible for. Please note, this is just an example and does not accurately represent the specifics of every Oscar plan.
How much does therapy cost with Oscar insurance?
Determining how much your Oscar health plan will be will depend on a few things. Will coverage be for an individual, family, or Medicare-based or employee-based plan? There will be differing costs depending on which option is chosen.
The bronze plans from Oscar carry the lowest premiums but also have the highest out-of-pocket expenses. These plans are often recommended for individuals who are generally healthy. Individual bronze plans may carry a monthly cost of around $550.
Oscar silver plans are labeled as great options for middle-range coverage and fees. A silver plan for an individual in California may cost upwards of $600 monthly. The gold plans have higher monthly costs but also carry the lowest out-of-pocket costs for medical care. The gold plans are good options for individuals who may incur many medical bills.
In-network vs. out-of-network
Providers who are in your network are providers who have contracted with your specific insurance coverage plan. By seeing providers inside your network, your out-of-pocket expenses are generally lower.
Out-of-network providers are people who are not contracted with your insurance plan. If you have to see a provider outside of your network, you may encounter higher healthcare costs. Depending on your circumstances, location, and insurance carrier, there could be exceptions to this.
Deductibles
A deductible is a set amount of money you may owe during your insurance coverage period before the insurance company pays on your behalf. For example, if your deductible is $500, your insurance company may only pay something once you first pay that $500. There may be deductibles set for both individual and family amounts.
The amount of deductible you may have to pay will depend on your plan specifics. Consider Oscar’s bronze coverage plan for an individual and family. The deductible may be over $4,000 for an individual but more than $8,000 for the family. This means that these amounts must be paid before your insurance plan will start to pay for services. Luckily, some health care fees for services, such as preventative care, may be exempt from needing the deductible paid in full before the insurance will cover it.
Copays
Similar to deductibles, your co-pay may vary depending on your coverage plan specifics. Your insurance card and documents will explain your co-pays for various services. Using the bronze plan again as an example, some prescriptions require a $70 co-pay, whereas preventative appointments have no copay.
How to find a therapist who takes Oscar insurance
- Visit the Oscar website: Oscar Insurance makes finding providers simple. If you are seeking a therapist or other specialists who accept your insurance, start at the Oscar homepage and click “member resources.” This will allow you to search for doctors or drugs in your area. Oscar will also direct you to other providers, pharmacies, mental health providers, and more within your coverage area.
- Use Grow Therapy: Using Grow Therapy’s marketplace makes it easy to find mental health care providers in your area who are contracted with Oscar. Visit the Grow Therapy website, fill out your specifications, including your insurance, and browse therapists profiles until you find the best fit.
Final thoughts
Understanding what your Oscar plan covers — and what it will actually cost you — is the hardest part. Once you know that, finding the right therapist is straightforward. On Grow Therapy, you can filter specifically for providers who accept Oscar, check their availability, and see your estimated cost before you commit to anything. Thousands of verified therapists accept Oscar across the country, and most clients are in their first session within two days.
