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If you or someone you know struggles with alcohol abuse or addiction, you are not alone. Help is available, and your insurance may cover it.
Alcohol use disorder (AUD) affects 14 million adults in the U.S. It’s so prevalent that 1 in 10 children live with at least one parent who has a drinking problem. 10
AUD is a medical condition. It’s diagnosed when patterns of drinking cause a person distress or harm. Treatment for alcohol use disorder (AUD) is a covered medical condition under the Affordable Care Act (ACA).
Symptoms of alcohol use disorder range in severity. Severe alcoholism can be life-threatening, as alcohol can take a toll on your physical and mental health. But alcohol withdrawal can also be fatal if you try to quit a drinking addiction abruptly or alone.
That’s why seeking professional addiction treatment services is important. Fortunately, many treatments for AUD are considered essential health benefits.
Essential health benefits refer to the benefits that health insurance plans, including Medicaid, are legally obligated to cover under the Affordable Care Act (ACA).
These fall into 10 different categories:4
Alcohol rehab costs may be covered under mental health and substance use disorder (SUD) services. Associated treatment costs may also be covered, such as therapy.4
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While these benefits currently exist, in 2018, only 11 percent of people with a substance use disorder (SUD) received treatment. One in five people reported not knowing where to find help.7
The Affordable Care Act was implemented to offer United States citizens easier access to lower-cost and transferrable care (between jobs or residences). Anyone who is a legal resident and isn’t already covered under Medicare can apply for a health insurance plan.9
The Department of Health and Human Services (DHHS) determines which services are covered.9
All insurance plans must cover mental health and substance use disorder services, but your specific benefits will depend on the state you live in and the health plan you choose.9
In general, every treatment provider will cover:6
Specific examples of costs your plan may cover include:
It’s important to know plans within the Marketplace cannot deny you coverage or charge you extra for pre-existing conditions. They also cannot put yearly or lifetime limits on coverage of essential health benefits.6
Alcohol use disorder (AUD) is often linked to mental health issues like depression and anxiety. Your insurance plan may cover certain mental health treatments like therapy and medications.
Depression and AUD often go hand-in-hand. The presence of depression in alcohol-dependent people may influence the type of treatment they receive.5
For example, someone struggling with depression may drink to escape their problems. They might benefit from therapy to unpack their mental health issues, identify their triggers, and find healthier coping mechanisms.5
Anxiety disorders and AUD also commonly co-occur. While drinking can increase anxiety, anxiety can also cause some people to drink. The presence of anxiety in people with alcohol abuse problems also influences the course of treatment.8
People with both alcoholism and mental health disorders are more likely to have trouble maintaining abstinence. They’re also more likely to attempt or die by suicide.3
If you or someone you know is struggling with alcohol abuse or a mental health condition, seek help immediately.
The cost of rehab for alcohol and substance abuse treatment depends on multiple factors:
The cost will also depend on how much of your drug and alcohol addiction treatment your insurance covers.
You can see the complete list of covered services when you compare plans in the Marketplace. Call your insurance provider to confirm the full list of covered benefits.
Once you find a plan, take the following steps as you look for an alcohol rehabilitation center that accepts your coverage:
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