Oscar Health

Last updated: October, 2020

Oscar Health is the new kid on the block when it comes to insurance companies. It’s personable and dedicated to the value of “human touch” throughout the insurance process – so it makes sense that mental health care is just as important to Oscar Health as physical health care.

Read below for the most recent information on this insurance’s coverage for therapy. Find a therapist in-network with Oscar Health in New York and New Jersey when you're ready!

Does Oscar Health cover therapy?

Yes, Oscar Health covers therapy! Each one of the 11 Oscar Health plans offer coverage on therapy sessions. However, each plan covers a different amount, so it’s important to check out how much of the cost will be your responsibility.

That said, none of the Oscar Health plans cover out-of-network therapy sessions. This means that Oscar Health has pre-selected a list of therapists as being in-network. This group of in-network therapists will be the cheapest option for you!


How do I check if my Oscar Health plan covers therapy?

While all plans cover at least a portion of the therapy costs, it’s important to check the Summary and Benefits sheet for your particular insurance.

Here is a sample Summary and Benefits sheet, just for the line item relevant to mental health treatment:

Source

Something to keep in mind is whether or not you must reach your deductible before the insurance starts helping you pay. A deductible is an amount of money, written into your plan and found in the Summary and Benefits sheet, that you must pay out-of-pocket before the insurance kicks in with its coverage.

Find out how much you’ll pay per therapy session below, based on your plan!

How much does therapy cost with Oscar Health?

Oscar Health offers 11 different insurance plans, each with a different premium, deductible, copay, and coinsurance rates. As a quick reminder, the premium is how much money you’ll pay each month to have the insurance. The deductible is the amount of money you must pay out-of-pocket before insurance coverage begins. The copay is a cost-per-visit that you must pay. And coinsurance is the amount of a session bill that you are responsible for - Oscar Health will pay for the rest!

The below lists out the rates for in-network therapists - no out-of-network treatment is covered.

If you decide to see an out-of-network provider, you will not have coverage. Be sure to ask about sliding scale payment options.

What types of therapy does Oscar Health cover?

Oscar Health covers individual and group therapy. It also covers inpatient mental health treatment and outpatient substance abuse rehabilitation.

A few examples of therapy types covered by insurance include:

Any therapy that is evidence-based and relies on diagnoses for treatment is generally covered by health insurance.

What types of therapy does Oscar Health NOT cover?

Oscar Health will not cover services unrelated to a diagnosable mental health condition or those deemed unnecessary, such as:

Does Oscar Health cover couples therapy?

Unfortunately, Oscar Health does not cover couples therapy. A reason for this is in part because within a relationship, there is no reportable diagnosis for which the therapist can bill.

However, don’t let that deter you from seeking the help that you need! There are other ways to access couples counseling, even though it isn’t covered by insurance.

Do I need to see my doctor before visiting an Oscar Health therapist?

You do not need a referral from your primary care doctor in order to see a therapist. So you’re all set to start on your therapist search!

Does Oscar Health cover online therapy?

Yes, they do! Oscar Health, as a whole, has a huge emphasis on virtual care. They incentivize many types of online visits with providers, so it’s no wonder that they cover online therapy sessions!