Many Drug Addicts, Alcoholics Lack “Equal” Coverage Under New Health Law


Insurance plans covering substance abuse treatment must provide the same level of care as they do for other medical issues, but treatment centers say disagreement over what this means leaves many alcoholics and drug addicts without the coverage they need, reports USA Today. The Mental Health Parity and Addiction Equity Act of 2008 required comparable cost sharing and treatment for major medical needs and mental health and substance abuse when employer-provided insurance included these benefits, and most large company plans do. As of Jan. 1, the Affordable Care Act added mental health and substance abuse treatment to its list of essential health benefits that have to be covered in all individual and small business plans.

“Many providers … report less days and more difficulty with reimbursement since the final rules were established,” says Michael Walsh of the National Association of Addiction Treatment Professionals. Many providers and insurers disagree “as to what the practical implementation of the rules should be and what should be covered.” Insurers are tougher on what they’ll allow than they were before the new rules, says Ben Brafman of Destination Hope treatment center in Fort Lauderdale. Addicts or alcoholics who the center’s psychiatrist or licensed addictions professionals say need at least 30 days of in-patient treatment are now often getting up to five days approved and the center has to fight for every additional couple of days, he says.

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