Will Addiction Affect My Health Insurance Status?

Drug and alcohol addiction impacts families around the globe. Dependence on drugs or alcohol can have wide ranging, damaging effects on both individuals and families, with negative impacts to family relationships, housing, health, and finances. When an individual is ready to seek treatment, paying for substance abuse treatment may be a concern. Individuals may fear that receiving treatment can impact their medical insurance.

With the Affordable Care Act, both mental health treatment and substance use treatment have become available to more individuals struggling with addiction. Health insurance providers are mandated to cover treatment for alcohol or drug addiction as essential health benefits, although the out of pocket cost can depend on a myriad of factors. Factors that may impact cost include:

  • Treatment Type: inpatient, outpatient Location of Treatment Insurance type: HMO, PPO Length of Treatment
  • Location of Treatment
  • Insurance type: HMO, PPO
  • Length of Treatment

Substance use and abuse can be a severe medical concern, and as such, is often including under laws to protect workers. While undergoing treatment for alcohol or other substance abuse issues, there should be no negative impact to your insurance status. The Family Leave Act of 1993 protects individuals from losing employment and related insurance benefits while tending to a family member with an illness, when having or adopting a child or when facing a personal medical crisis themselves. Since drug and alcohol abuse is a medical concern, participating in treatment for this is covered under this act, protecting you from job loss and insurance loss.

To be eligible for FMLA, there are a variety of factors, as follows:

• Employee must have worked at least 1,250 hours in the previous 12 months

• Employer must have at least 50 employees in a location or within 75 miles of one location

• Employee must have worked with the company for a minimum of 12 months

There are some employee responsibilities with this, as well. The Family Leave Act does not protect employees for time missed due to the use of substances, only for treatment for use. Also, it is imperative that as much notice as possible is given to employers so that they can make necessary arrangements. With this, employers agree to have another similar position open when the employee is able to return to work. There are other laws that provide protection for individuals seeking substance abuse treatment. The Americans with Disabilities Act (ADA) outlines these protections:

• Employers cannot discriminate against potential workers with disabilities

• Required to provide these individuals with reasonable accommodations so that they can complete their work.

Whether covered by private insurance, plans purchased through the insurance exchange, federally funded plans, such as Medicaid, there are options available for quality, life-changing treatments. A great first step would be to call the company to gather information on prospective cost, specific centers that would be covered, and tips for ensuring that treatment would be, at least partially paid through the specific policy held.

Substance abuse treatment often includes a combination of interventions. Individual therapy includes individual counseling with a licensed clinician, trained to understand the complexity of substance abuse, along with knowledge about trauma, mental illness and other concerns that also impact many using substances. Family therapy can also be important to help repair damage caused by substance use in relationships, which can include education about substance use, help on strengthening communication and assistance with other struggles that may be identified.

Group therapy provides a supportive environment in which others struggling with similar concerns can share ideas and issues. Research has shown this to be one of the most effective types of substance abuse treatment. These groups help lesson feelings of isolation and build a sense of hope through positive peer relationships, while also using these peers, those who have faced similar situations, to confront cohorts when they are refusing to accept responsibility for their choices.

Help is available for those struggling with drug or alcohol use, and laws, such as FMLA, help to protect your financial livelihood during this essential treatment. If the use of substances is a problem, take the time to care for yourself. No single treatment is effective for everybody, but with a variety of effective treatment options and protections provided, seeking help can be as easy as making a phone call. A better, happier, life awaits, so please, call us today at 833-846-5669.