Does insurance cover alcoholism?

Alcoholism is an addiction that can be very hard to beat without help, but treatment can be expensive. In some cases, insurance can cover alcoholism. To find out more about health insurance and alcoholism, read on.

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Insurance coverage for alcoholism

Many health insurance companies do cover treatment for alcoholism. However, some insurance companies only cover certain types of treatment, while others don’t cover any type of addiction treatment at all (this is changing with the new Affordable Care Act).

Typically, alcoholism treatments such as detox and outpatient counseling are covered by most insurance policies. Inpatient or residential alcoholism treatments are covered by some insurance companies, but not all. Finally, rapid detox services are typically not covered by insurance companies at all, since they are considered to be experimental services.

Does insurance cover alcoholism?

Although your insurance covers alcoholism treatment, there’s a good chance that you’ll still have some out-of-pocket costs. Most insurance companies require policyholders to pay a co-pay, or coinsurance, which is a portion of the cost of treatment.  An insurance co-pay may be a fixed amount for each service or a percentage of the cost. On average, you can expect to pay between $10 to $150 for each day of alcoholism treatment.

If you’re denied insurance coverage for alcoholism treatment, you can usually appeal this decision. Insurance companies have specific protocols that must be followed in order to appeal a decision. For instance, you may be required to fill out forms, write a letter, or provide evidence that alcoholism treatment is a necessity for you. You’ll need to investigate your insurance company’s appeal process to determine exactly what you need to do.

Alcoholism treatment with no insurance

If you have no insurance, but need alcoholism treatment, you still have a couple of options.

1. You may qualify for public healthcare run by the government, specifically SAMHSA Block Grant recipients, Medicaid ,and Medicare. Low-income individuals will usually qualify for Medicaid, which is an assistance program that usually covers the cost of addiction treatment. If you’re 65 or older, your Medicare should cover at least a portion of your alcoholism treatment. To learn more about treatment centers that benefit from subsidized payments for providing low cost addiction treatment, call 1-800-662-HELP.

2. Non-profit groups also sometimes offer alcoholism treatment at little or no cost. Two examples of these types of groups include the Salvation Army and Alcoholics Anonymous (AA).

3. Most facilities that offer alcohol addiction treatment understand that recovery can be too expensive for some. This is why many of these facilities try to ease the financial burden of treatment. Sliding scale treatment facilities, for instance, offer reduced costs based on an individual’s ability to pay. Alcoholism treatment facilities may also offer financing or payment options for individuals who are unable to pay for the full cost of treatment up front.

Medical insurance for alcoholism questions

Medical insurance for alcoholism can help ease the financial burden you may face during recovery, but this may not always be the case. Questions about medical insurance and alcoholism treatment can be left below in our comments section. We look forward to helping you with every step of your recovery journey.

Reference Sources: Wisconsin Department of Health Services: Benchmark Plan-Covered Services and Co-pays
Blue Cross and Blue Shield FEP
Health Insurance: What If Your Health Insurance Doesn’t Cover a Test or Procedure? What Can You Do?
ASPE: Affordable Care Act Expands Mental Health and Substance Use Disorder Benefits and Federal Parity Protections for 62 Million Americans
Treatment Solutions: Does Health Insurance Cover Drug Treatment or Rehab?
Legislative Analyst’s Office: Review of Health Coverage for Substance Abuse Treatment
SAMHSA: Acceptance of Private Health Insurance in Substance Abuse Treatment Facilities
About the author
Lee Weber is a published author, medical writer, and woman in long-term recovery from addiction. Her latest book, The Definitive Guide to Addiction Interventions is set to reach university bookstores in early 2019.
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