Rehab Coverage for Substance Abuse a Badly Needed Insurance Reform

Although shopping to find cheap health insurance is considered one of the major ways for virtually everyone to pay less for their coverage, that's not true if you have pre-existing conditions. And it's especially not the case if the condition is substance abuse. By law, many group policies must include benefits for treatment options for addicts including rehab, but people who are forced to shop the private insurance market are either denied or quoted exorbitant rates beyond all reason.

The Law Regarding Addiction and Insurance

In 2008, Congress passed the Mental Health Parity and Addiction Equality Act which compels insurers to include coverage for a range of treatment options for addiction in some group plans. This extends rehab benefits to roughly 100 million workers. The real hope for comprehensive help for addicts, however, is the 2010 Patient Protection and Affordable Care Act currently undergoing judicial review by the United States Supreme Court.

The basis for the review is the questioned constitutionality of the individual mandate clause of the law, which would require all Americans to carry health insurance by 2014 or be forced to pay a federal fine. The justices, however, have the option to throw out the entire legislative package. If that happens, many benefits of the reform law that would become active over the next two year will disappear.

One of those is the stipulation that by 2014, no insurer may exclude an applicant on the basis of a pre-existing condition. This would open the door for thousands of addicts to seek coverage they've been previously denied, and something the insurance industry does not want to see happen because those benefits will represent a profit loss. It is estimated that on an annual basis, the families of alcoholics alone spend $94 billion caring for their addicted loved ones.

Rehab Coverage as an Aspect of Preventive Care

Health reform advocates are increasingly calling for an overhaul not just of the American medical system, but rather the national medical philosophy. Currently, the norm is to seek treatment when an illness appears. This reactive model is extremely expensive, and creates a situation in which severe long-term disease is often present before intervention takes place.

This pattern can be particularly serious with long-term addiction. The presence of the offending substance and the behaviors that accompany its use lead to ancillary conditions ranging from cardiovascular disease to liver failure and respiratory damage. Even obesity is a concern, as one addiction quite typically leads to another.

Addicts need help before their disease reaches those levels, and in doing so, millions of dollars would be saved. Each year, the American economy loses approximately $223.5 billion to healthcare costs related to alcoholism, much of which is passed on to taxpayers through various public programs. In addition, more than 60 percent of all personal bankruptcies in the U.S. list medical debt as a primary cause of the action.

Rehab and treatment programs typically cost $7000 per month with a three-month stay being the norm. Since addicts frequently fall into a pattern of relapse, it's not unusual for the total expense to exceed $75,000. Some examples of exclusive treatment programs. Filling this massive gap in available insurance benefit options is a badly overdue reform. Providing rehab coverage for substance abuse patients would not only save the healthcare system literally millions of dollars, but it would help to alleviate the suffering of both the addicts and their families.