Insurance

Does Oscar Insurance Cover Therapy? Here’s What You Need to Know

Mental health care has become as vital as physical healthcare for most Americans. Insurance makes it easier to access therapy, but it can often be challenging for people to understand their plan specifics, how to find providers, and determine their out-of-pocket costs.  To help provide clarity, this article will focus on the specifics of Oscar […]

derek lee grow therapy By Derek Lee, VP of Insurance Operations

Updated on Feb 22, 2024

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Mental health care has become as vital as physical healthcare for most Americans. Insurance makes it easier to access therapy, but it can often be challenging for people to understand their plan specifics, how to find providers, and determine their out-of-pocket costs. 

To help provide clarity, this article will focus on the specifics of Oscar Insurance and its role in helping members get the care they need. 

Does Oscar Health 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 in the top 10 leading causes of death. With these odds, Americans cannot afford to go without adequate mental health care. 

Types of Therapy Oscar Health 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: 

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. 

Therapy Oscar Health 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:

Additionally, any non-emergency services rendered when traveling out of the U.S. are not covered by Oscar health insurance.

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How to Check Your Oscar Health 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. 

oscar insurance

How Much Does Therapy Cost With Oscar Health 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 the classic 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

  1. 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. 
  2. 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

Regardless of physical or mental healthcare, the cost shouldn’t be so burdensome that individuals must take shortcuts or avoid it altogether due to price and availability.

Thankfully, finding a provider within your network who can accept new patients and who you will be a good match for you is easier than ever. Grow Therapy has therapists who accept Oscar insurance, making the process simple.

Get started today by finding a therapist based on your needs. 

Frequently Asked Questions

About the author
derek lee grow therapy Derek Lee, VP of Insurance Operations

Derek Lee is Grow Therapy's Vice President of Insurance Operations, overseeing payor relations and success, credentialing and enrollment, new payor launch, revenue cycle management and billing, and insurance operations data analytics.

This article is not meant to be a replacement for medical advice. We recommend speaking with a therapist for personalized information about your mental health. If you don’t currently have a therapist, we can connect you with one who can offer support and address any questions or concerns. If you or your child is experiencing a medical emergency, is considering harming themselves or others, or is otherwise in imminent danger, you should dial 9-1-1 and/or go to the nearest emergency room.

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