Blog

Does Obamacare Insurance Cover Substance Abuse?

Update: President Obama issued a final rule on February 20, 2013 requiring insurers to cover the treatment of drug addiction and alcohol abuse. Insurance health policies will cover anywhere between 60-90 percent of costs, but minimal benefits will vary from state to state, reports the New York Times.

Will the new healthcare insurance cover treatment for mental health services, like outpatient and residential treatment for substance abuse? Last month, the U.S. Supreme Court ruled in favor of Obama’s health care reform, and already, the bill has saved over 5 million seniors on Medicaid nearly $4 billion on prescription drugs since it took effect in 2010. But the full effect of the Affordable Care Act (ACA) means even bigger advantages for alcoholics and addicts seeking addiction treatment and recovery.

Read more about how Obamacare affects both Insured and Uninsured Californians?

Treatment Will be More Affordable

Although treatment for addiction and mental illness is beneficial and necessary, insurance coverage for the treatment has traditionally been somewhat stingy.

According to SAMHSA’s National Survey on Drug Use and Health 2010, almost 90% of people needing substance abuse treatment aren’t receiving it. The study does not list the reasons these needs are not being met, but it is not hard to deduce that the cost of treatment might be a large reason people do not pursue treatment.

However, the Affordable Care Act is expected to close this gap in treatment needs as millions of previously uninsured Americans will now have healthcare coverage. Due to the requirements of the Wellstone/Domenici Parity Act (2008), insurance for companies with more than 50 employees must provide the same benefits for substance abuse treatment as for other medical conditions. With increased benefits for a greater population, more and more people should be able to afford treatment.

Choice in Service Programs

The law also changes what services will be available, which means Americans will have a wider menu of options when selecting the treatment program that best suits their needs. Benefit packages of various provisions include

  • substance abuse disorder services
  • prescription drugs
  • rehabilitative services
  • prevention and wellness services

These services will be available by fiscal year 2014.

Learn more about the Health Insurance Marketplace and Sample Insurance Plans for Substance Abuse?

Prevention and Early Intervention

Substance Abuse researchers and national surveys have always emphasized the importance of prevention and early intervention as the best way to treat substance abuse–and any other disorder for that matter. Now that prevention services are covered by the new bill, we should see an increase in

  • medical screenings
  • education campaigns
  • patient referrals
  • community prevention activities
  • and various other early intervention strategies.

What Does This Mean For Alcoholics and Addicts?

Some of these changes are not yet in efffect, but that doesn’t mean you shouldn’t keep you from seeking help if you need it. Right now, your life or the life of your loved one is the most important thing: the cost of treatment is eclipsed next to the cost of untreated addiction. If your insurance company, Medicare, or Medicaid currently covers residential rehabilitation services, Duffy’s will submit an insurance claim for you to your insurance company after completion of your stay.

Should you have any questions about current insurance coverage or cost at Duffy’s, please call us at 888-717-9525 or chat online with a Duffy’s administrator today.