Not having insurance is not the same as having no options. Texas has a publicly-funded treatment system designed specifically for residents who cannot afford private care, and there are specific steps for navigating it. This page explains the pathways available for DFW residents without insurance who need addiction or mental health treatment.
OSAR: Texas’s Front Door to Public Treatment
OSAR — One Stop Access to Recovery and Health — is Texas’s statewide intake and navigation system for publicly-funded substance use and mental health treatment. When you call OSAR, a trained intake specialist assesses your situation, determines what publicly-funded programs you may be eligible for, and facilitates placement. In the DFW area, OSAR services are administered by the North Texas Behavioral Health Authority (NTBHA). The NTBHA number for DFW is 1-800-621-8504. This number is answered by clinical staff who can assess your needs, determine eligibility for state-funded programs, and connect you to treatment — including detox and residential treatment — through the public system. Waitlists exist for some programs, and bed availability varies, but OSAR represents real access to real treatment for uninsured Texans.
Texas Medicaid Eligibility
Texas has not expanded Medicaid under the ACA, which means adult Medicaid eligibility is more restrictive than in states that did expand. Texas Medicaid currently covers: adults who receive Supplemental Security Income (SSI); adults with dependent children below specific income thresholds; pregnant women; and some other specific categories. If you think you might be eligible, apply through the Texas Health and Human Services portal or call 211. If you are eligible, Medicaid covers behavioral health treatment including detox and residential programs through Medicaid managed care organizations like Superior Health Plan, Magellan, and others.
The 988 Crisis Line and Emergency Access
If you are in immediate crisis — suicidal ideation, overdose, or severe psychiatric emergency — call 988 (Suicide and Crisis Lifeline) or 911. The 988 Lifeline connects you to trained crisis counselors and can facilitate access to emergency services and stabilization that may open a pathway to further treatment. Crisis stabilization does not require insurance.
Ready to take the first step? Promises DFW is located at 400 Highland Dr, Lewisville, TX 75067. Our admissions team is available 24/7. Call (469) 546-9303 or verify your insurance online — all calls are free and confidential.
What Promises DFW Can Do
If you are uninsured and exploring options, call (469) 546-9303. Our admissions team will be honest about what Promises DFW can offer for self-pay patients, help you understand whether OSAR or Medicaid pathways might be accessible, and make referrals to the NTBHA and OSAR system when the public system is the most appropriate pathway. Getting you to care matters more than which door you come through.
Frequently Asked Questions
What is OSAR in Texas?
OSAR stands for One Stop Access to Recovery and Health — Texas’s intake and navigation system for publicly-funded substance use disorder and mental health treatment. OSAR connects uninsured and underinsured Texans to state-funded treatment programs across the state. In the DFW area, the North Texas Behavioral Health Authority (NTBHA) administers OSAR services for Dallas, Tarrant, and surrounding counties. Call NTBHA at 1-800-621-8504 for OSAR access in the DFW area.
Can Medicaid cover addiction treatment if I don’t have insurance?
If you qualify for Texas Medicaid (Supplemental Security Income recipients, adults with dependent children below income thresholds, pregnant women, and some others), Medicaid covers behavioral health treatment including detox and residential programs. Texas has not expanded Medicaid under the ACA, so adult eligibility criteria are more restrictive than in many other states. Our admissions team can help assess whether Medicaid eligibility might apply to your situation and connect you with the appropriate resources.
Does Promises DFW offer payment plans for uninsured patients?
Promises DFW can discuss self-pay and payment arrangement options for uninsured patients. Call (469) 546-9303 for a confidential conversation about financial options. For patients who are completely uninsured, the OSAR system is typically the most accessible pathway to treatment, and we help facilitate that connection.
What is the difference between OSAR and a private pay rehab?
OSAR navigates access to state-funded treatment programs, which serve individuals regardless of ability to pay — typically at no cost or on a sliding scale. These programs may have waitlists and different admission processes than private pay programs. Private pay at a facility like Promises DFW involves paying the facility’s rates directly, without the state-funded bed system. Our admissions team helps identify which pathway is clinically appropriate and financially feasible for each specific situation.
Can I get naloxone (Narcan) in Texas without a prescription?
Yes. Texas has a statewide standing order that allows pharmacies to dispense naloxone without an individual prescription. Naloxone is available at most major pharmacy chains in DFW. See our naloxone access guide for details on how to get it and how to use it.