Health Insurance and Substance Abuse Treatment



sugstance abuseMany people fail to appreciate the terrible toll that substance abuse takes on American families. It is estimated that nearly 10 percent of all Americans suffer from a substance abuse problem, 90 percent of whom fail to seek help.

In total, this costs the American economy over $300 billion a year, a tremendous drain that destroys people's lives and weakens the foundation of the country through increases in crime and poverty.

The main reason that many people fail to seek treatment is insurance. Nearly 50 million Americans lack health insurance, which compels them to scrounge for whatever aid they can obtain from the government or from private charities. Unfortunately, these organizations are typically sorely lacking in funds for substance abuse treatment, which means that those people who are looking for treatment often receive only the most perfunctory care.

Especially for those people who do have low cost health insurance, they may have a difficult time in receiving the care that they desperately need. Insurance companies are loath to spend money for any treatment if they can avoid it. As such, they have been known to deny coverage for substance abuse treatment even when it is mandated by state law. They are counting on the fact that many people will fail to challenge them because of the indecipherable legalese of the insurance industry and the social stigma attached to drug problems.

This problem is only compounded by the failure of many people to understand their legal rights with respect to substance abuse treatment. Although the insurance industry may be reluctant to share such information with its customers, it is a fact that 43 states now require them to offer substance abuse treatment; the only states that have failed to offer such protection to their citizens are Georgia, Indiana, Iowa, Oklahoma, Wyoming, Arizona and Idaho.

In addition, the federal government is starting to recognize the problems associated with substance abuse treatment. Two years ago, the Mental Health Parity and Addiction Equity Act of 2008 went into effect, preventing group health insurance plans of at least 50 people from discriminating against substance abuse treatment with respect to the costs of coverage. This means that health insurance companies are required to offer the same copayments and deductibles for substance abuse treatment as they do for all other forms of medical treatment.

This law was designed to prevent health insurance companies from shirking the spirit of state laws that mandated coverage for substance abuse treatment by imposing additional costs on patients, which was used to discourage the use of insurance for such purposes. However, it should be noted that this law does not require insurance companies to offer treatment for substance abuse. In addition, the law will not apply to either group health insurance plans of fewer than 50 people or low cost health insurance plans for individuals until 2014.

Of course, this is of no help to people who have health insurance coverage that does not include substance abuse treatment; however, there are still some things that individuals in this situation can do to help themselves. For those who qualify, Medicare and Medicaid may be able to help defray the costs of substance abuse treatment. As well, many treatment programs will voluntarily provide some free services to those people who do not have insurance. By doing some research, many people may be able to find some services that are available to them in their area.

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