Networks change. We verify your specific Oxford Health Plans plan before your first visit; call with your member ID and we will confirm benefits, copay and any referral or authorization requirements.
Also appears on cards as: Oxford, Oxford UHC, Oxford Freedom, Oxford Liberty, UnitedHealthcare Oxford.
Oxford Health Plans is a UnitedHealthcare company that insures employer groups and individuals in New York, New Jersey and Connecticut. Many Palm Beach County, Treasure Coast and Lowcountry residents carry Oxford cards because they relocated from the Northeast, split the year between homes, or work remotely for a tri-state employer. Oxford's Freedom and Liberty plans typically give members access to the UnitedHealthcare national network when they are outside the tri-state area, which is how our Florida and South Carolina offices can be in network. Behavioral health for Oxford members is administered by Optum Behavioral Health. Most Oxford plans cover outpatient psychiatry and medication management for a specialist copay or coinsurance, and referrals are not required for mental health visits even on gatekeeper plans.
Telehealth psychiatry is typically covered at parity with office visits, and you must be physically located in Florida or South Carolina during the appointment so that our provider is licensed where you are. For Deep TMS, Oxford applies UnitedHealthcare's medical policy and requires prior authorization through Optum, with documentation of major depressive disorder, failure of at least two antidepressant trials at adequate dose and duration, and a current severity score. Spravato typically requires prior authorization under the medical benefit or through OptumRx, with treatment-resistant depression, a concurrent oral antidepressant and REMS-certified administration documented. Initial approvals usually cover the induction phase or a standard TMS course, with continuation reviewed on documented response. Our staff submit both requests through Optum's provider portal.
What we check before your visit
- Whether your plan is in network at the office you chose and for telehealth
- Your copay or coinsurance for an evaluation and for follow-ups
- Whether a primary-care referral is required (common with HMO plans)
- Prior-authorization criteria for Deep TMS and Spravato, if those are being considered
Frequently asked questions
Can I use my Oxford plan at Stedfast Psychiatry in Florida or South Carolina?
Most Oxford Freedom and Liberty plans include access to the UnitedHealthcare national network outside New York, New Jersey and Connecticut, which typically makes our offices in network. Oxford Metro and some HMO products are limited to the tri-state network. Call the number on your card or let our front desk confirm your plan before you schedule.
What will I pay for a psychiatry visit with Oxford?
Most Oxford plans charge a specialist copay or coinsurance for in-network outpatient mental health visits, the same as a comparable medical specialist visit. High-deductible plans charge the contracted rate until the deductible is met. Your plan's summary of benefits lists the outpatient behavioral health line, and our staff can confirm your cost share in advance.
Does Oxford cover telehealth with a Stedfast psychiatrist?
Yes, for most plans. Oxford covers video psychiatry visits at the same benefit level as office visits when you see an in-network provider and are physically located in Florida or South Carolina during the appointment. If you spend part of the year in the Northeast, your visit must take place while you are in a state where our provider is licensed.
How does Oxford handle prior authorization for Deep TMS and Spravato?
Requests go to Optum Behavioral Health, which applies UnitedHealthcare's clinical criteria. Both treatments typically require prior authorization and documentation of treatment-resistant depression, prior medication trials and current symptom scores. Our Palm Beach Gardens TMS team and our Spravato offices submit the records, follow up until a decision is issued, and arrange a peer-to-peer review if needed.