5 Things You and Your Family Need To Know About Alcoholism, Addiction and Your Health Insurance

5 Things You and Your Family Need To Know About Alcoholism, Addiction and Your Health Insurance

Alcoholism and Addiction is a widespread epidemic affecting millions of American’s nationwide.  We reported in a previous article America: The World’s Leader in Prescription Drug Abuse Part 1 that Americans utilize 99% of the worlds’ hydrocodone supply, 80% of its oxycodone supply, and 65% of its hydromorphone (Dilaudid) supply. More Americans have abused prescription drugs than have tried cocaine, heroin, and hallucinogens combined

A 2013 Study estimated that 24.6 million Americans aged 12 or older had used an illicit drug in the past month.  Another study showed the 88,000 people die as a result of alcohol related causes each year. In 2010 alcohol misuse problems cost the United States $249 Billion Dollars.

Check My Benefits
Check My Benefits

#1 – Affordable Care Act and Substance Abuse Disorders

The Affordable Care Act (ACA) colloquially known as Obamacare has put in place health insurance reforms which includes substance use disorders as one of the ten elements of essential health benefits.  With this inclusion of benefits in health insurance packages for Drug Rehab and Alcohol Rehab Treatment health care providers and drug and alcohol treatment centers can now be reimbursed for these services provides access to treatment options.

#2 – Pre Existing Conditions

Alcoholism and Addiction follow the disease model for which there is no known cure. It is a progressive disease that often can be fatal if left untreated. For individuals that have had a history of substance abuse or alcoholism this would be considered a pre-existing condition. Under the Affordable Care Act (ACA) No insurance plan can reject you, charge you more, or refuse to pay for essential health benefits for any condition you had before your coverage started. Once you’re enrolled, the plan can’t deny you coverage or raise your rates based only on your health.

#3 – Choosing the Right Treatment Options

There are a variety of options available for Substance Abuse and Alcoholism.  This includes drug rehab and treatment options that include faith based programs, 12 steps programs, men and women’s only programs, holistic treatment options, and a variety of other substance abuse programs. Often times, it can dependent on the individual circumstances to find the best fit. In almost all cases, getting removed from their environment is crucial to success to allow for a medically supervised detox and to provide a setting where the addict or alcoholic can focus on themselves. Typically these involve 30 day inpatient drug treatment center which often includes addresses any dual diagnosis issues such as depressions.

 #4 – After Care

In patient drug rehab only addresses the disease short term. It provides the ability for you or your loved one to start to heal. However, that healing process will continue long after they leave an inpatient drug and alcohol facility. For most, drugs and alcohol where not their problem. Instead it was the solution to thier problems. Aftercare is crucial be it 12 steps meetings, Intensive Outpatient programs and building a support network.

#5 – Checking Your Health Insurance Benefits.

While the Affordable Care Act has a provision for Substance Abuse the extent of what is reimbursable widely varies across Health Insurance carrier policies and states. Factors such as EPO, HMO, PPO, and Out of Network benefits play a large role in finding a center that can work with your insurance carrier. For the loved ones such as parents of the person suffering from addiction and the spouses this can be a frustrating processes. In addition, there may be other out-of-pocket expenses from travel arrangements to co-pays. It is important to check your benefits to find out what your insurance will cover.

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