Let’s talk about mental health: A guide to your Oscar resources and more | hioscar Blog | Oscar
Let’s talk about mental health: A guide to your Oscar resources & more
From traditional talk therapy to telemental health visits, here are your mental health resources at Oscar.
Mental Health Oscar Health Insurance
5 min read
Share article
We consider mental health (opens in new tab) to be just as important as physical health. That’s why we’ve built affordable mental health benefits into every one of our plans. From traditional talk therapy to tele-mental health visits, we want to help you understand how your plan can support your mental wellbeing.
Mental health benefits at-a-glance
Your Oscar plan covers a range of affordable benefits that can help you manage anxiety, treat depression and other mental health issues, and learn productive ways to cope with stress. With your Oscar plan, you have access to:
Primary Care Providers who can assess treatment options and prescribe medication for mental health needs (like mild to moderate anxiety, depression, and emotional distress).
Psychiatric Nurse Practitioners who provide assessment and therapy, as well as prescribe and monitor medication.
Psychiatrists aka medical doctors who specialize in mental health. Psychiatrists can prescribe medications that help treat anxiety, depression, and chronic and more serious mental health issues.
Psychotherapy counseling (aka talk therapy) with mental health providers, including psychologists, therapists, social workers, and counselors. There are a variety of therapy techniques they may use to treat you, including cognitive behavioral therapy (CBT), interpersonal therapy, and dialectical-behavior therapy. They’re subject to the same copayments or coinsurance as visits to your primary care doctor or specialists, depending on your plan.
Group counseling for certain mental health conditions. This type of care is often used to treat addiction or as a follow-up to inpatient rehabilitation. It’s a great option if you prefer talking it out with people going through something similar to you.
Inpatient and outpatient rehabilitation. This kind of treatment is usually used for things like drug and alcohol detox or eating disorders. It’s available for members looking to treat addiction. And the Oscar network offers a variety of treatment program options and settings.
Prescription coverage for medications used to treat a variety of mental health conditions, such as depression and anxiety. Most generic versions of many medications are covered by a majority of Oscar plans with a small copayment.
Some mental health services, like depression screening and alcohol misuse counseling, are considered to be preventative care – which means they may cost you nothing.
Our mental health network for Individual and Family Plans
We’ve partnered with Optum (opens in new tab) to curate our network of mental health doctors and open doors to additional resources for our members. Our partnership gives you access to a wide selection of physicians, clinical resources, and mental health support.
So what does that mean, really? In addition to your Oscar benefits, you’ll also get:
Provider availability assistance to help you find a provider who’s taking new patients and accepts your Oscar/Optum plan. Many mental health providers don’t have the administrative staff support that most other doctors do. With help from Optum, you’ll be able to more easily find a doctor who can actually see you.
Access to virtual therapy sessions if you live in a remote area, can’t easily access a mental health provider, or feel more comfortable at home.
Hands-on case management for those with complex mental health issues that require coordination between multiple providers or follow-up care after a hospital stay.
Crisis support for when things are especially tough. Optum has clinical support staff to help you cope when you’re facing a mental health crisis.
Claims assistance to help you navigate your mental health claims.
Mental health resources available through Optum for Oscar members
Crisis Support Helpline: Optum’s toll-free helpline is open 24/7 at 877-855-1317.
Substance Use Disorder Helpline (855-780-5955): This is a free Optum service for Oscar members who are struggling with substance use. Members can speak anonymously with substance use recovery advocates for immediate support. We know it can be difficult for individuals struggling with addiction to seek help, but Optum provides this supportive resource for members wanting to explore treatment options. Because the Helpline does not require eligibility verification, Optum can also provide coaching and support to family members who are concerned about a loved one. When you call this number, Optum will explain that the first step is an assessment and individualized treatment strategy provided by a licensed clinician. When you are ready to engage in care, an advocate can guide you to an in network virtual or in-person SUD provider.
Virtual Substance Use Disorder (SUD) Support: WeConnect provides peer and contingency management support for members who aren’t able to access in-person support.
Virtual Mental Health Visits: We partner with Doctor On Demand to provide virtual mental health visits. Register here (opens in new tab) using your Oscar ID and selecting “Oscar” as the Health Plan option on the drop-down menu. Costs vary based on your plan.
Stay in-network if you can
Remember that like with most care, you’ll likely pay less out-of-pocket if you work with an in-network provider. Not all mental health providers accept insurance, or maybe you’ve been looking into a provider that’s outside of Oscar’s network. If you’re currently seeing a mental health provider that you love, be sure to confirm they take your insurance and let them know that you have coverage with Optum through Oscar.
Helpful billing tips
Every provider has a different billing process. Some may bill you up front for the full cost of the visit and then submit a claim to Oscar, while others may wait to bill you until after they’ve submitted a claim. Check with your mental health provider to verify how they plan on billing you before your first visit so there are fewer surprises. Keep in mind that if your plan has a deductible, you may be responsible for the cost of office visits, group therapy, and rehab services until you've reached your deductible amount. Just be sure to have your provider submit your mental health claims to Optum.
Occasionally, claims are denied because they’ve been sent to the wrong place. If you receive a claim denial for mental health services you received, contact the Care Team for clarification. It may be possible for your claims to be reprocessed with Optum so you’re not stuck paying for the entire bill.
*Oscar’s Virtual Urgent Care offerings are not available in US territories or internationally. If you have an HSA-compatible high-deductible health plan or a Secure plan, you won't be eligible for $0 visits. Prescriptions, visits and services may be limited per provider discretion.
