Alcohol and Health Insurance – Who Pays for Treatment?

Alcohol and health insurance mix about as well as oil and water. Most standard health insurance policies specifically exclude alcohol-related claims for services such as addiction treatment. At least in terms of health insurance, most companies do not view alcoholism as a medical disease. They may classify it as a mental medical diagnosis, if their policies typically exclude mental health care. Alternatively, they may choose to view alcoholism as a self-inflicted condition and therefore ineligible for coverage under a standard policy. Whatever reason an insurance company uses as a basis to deny coverage, few pay for alcoholism treatments, therapies, medications, or inpatient care.

In terms of alcohol-related injuries, many medical insurance companies specifically exclude such injuries as covered under their standard policy. They may use language such as "accidents, injuries, or claims resulting from being under the influence of controlled substances" to exclude coverage for these type injuries. Similarly, automotive insurance policies that cover medical expenses as a result of an accident have the option of denying coverage for the entire event if it is determined the insured was driving under the influence of alcohol at the time of the accident.

In short, most medical insurance policies and plans will not cover any medical expenses related to alcohol consumed by the insured. In fact, some companies have been known, in the past, to go so far as refuse to cover health conditions brought on by extensive abuse of alcohol. For example, a patient who develops liver cirrhosis as a result of years of heavy drinking may find their health insurance company unwilling to pay for the required treatments. Similarly, many companies do not pay for certain types of organ transplants to prevent the insurance company from footing the bill for a liver transplant involving advance cirrhosis caused by drinking.

While many supporters of health plan covered alcohol treatment options claim alcoholism as an involuntary disease, so long as medical insurance companies based their coverage on acceptable risk, there will be little coverage available for alcohol-related medical care. Naturally, medical expenses arising from being the victim of an alcohol-related crime are typically covered by medical insurance companies. However, only when those injuries are sustained by a victim, not the drinker do the insurance companies pay. Additionally, there are a select few health plans which do offer coverage, either by way of a standard policy or an additional coverage rider, but this is by far the exception, not the rule.If you need assistance in locating particular coverages at a pre price -determined, we 've can help you Obtain a health insurance quote, and save up to 50% on your monthly premium.