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Do group health insurance policies typically pay for drug-treatment facilities?

Yes, group health insurance policies typically do pay for drug-treatment facilities, but the coverage levels vary widely.

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Most states have laws that mandate mental health coverage in group plans. For group health plans for businesses with at least 50 employees, The Mental Health Parity and Addiction Equity Act of 2008 requires health insurance companies to put coverage limits for mental health and drug and alcohol treatment on par with medical treatment.

That doesn't mean all policies have to provide mental health insurance for addiction, but if a plan does cover substance abuse treatment, it must do so equally with other medical conditions.

Covered treatments under group health plans may include detoxification programs, day programs, inpatient hospitalization, longer-term residential treatment centers and individual and group outpatient treatment programs. The range of treatment varies according to the policy.

If you already suffer from a substance-abuse problem and enroll in a new group health insurance policy, you might be subject to a waiting period before coverage applies. If you're applying for an individual health insurance policy, your addiction would likely be excluded as a pre-existing condition.

When applying for an individual policy, it's very difficult to find affordable health insurance that includes drug treatment. Premiums for individual policies with such coverage tend to be very high.

Free 12-step recovery programs offer alternatives for people who don't have substance abuse health insurance coverage. The programs work for some people, but they don't provide medical monitoring and guidance.

Even if you think you or your family members will never suffer from an addiction, it could be beneficial to understand how a health insurance policy covers substance abuse treatment before signing up.

For more, see Gotta check into rehab? Health insurance may provide coverage.

Last updated: Mar. 25, 2011
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