Insurance Coverage and Addiction Treatment

Addiction treatment is already a long and difficult process. Without insurance, it can be expensive as well. This is an overview of the insurance market, and its contribution to addiction treatment in the US.

Insurance Coverage in the US

As of 2014, the percentage of insured people in all states is over 80%. The states with the highest rates of insured people are Massachusetts, Vermont, District of Columbia, Hawaii, and Minnesota. In these states, the overall rate exceeds 94% of the population.

Alongside the well-insured, the unluckiest states are Texas, Alaska, Florida, Georgia, and Oklahoma. In these states, the share of insured people does not surpass 85%.

insurance coverage in US addictio treatment rehabilitation center

The Affordable Care Act

Recently, Congress adopted the Affordable Care Act (ACA). Known lovingly as Obamacare, the new law reformed health care and insurance. One of its main goals was to make health insurance more affordable to more people. ACA accomplished this goal not by reducing insurance costs, but by redistributing them among more payers. An additional result is that insurance covers the treatment of alcohol and drug dependencies, and most behavioral addictions.

Largest Insurance Companies

Several insurance companies divide the US insurance market. In the map below, we show the market share of the largest insurers (as of 2013).

insurance coverage market share of largest insurance companies US addiction treatment rehabilitation center

Blue Cross Blue Shield (BCBS) Insurance

Blue Cross Blue Shield is the most widely available. Since the 1970s it grew by buying and merging with smaller insurance companies. In 2014, the WellPoint Group changed its corporate name to Anthem, Inc. According to its company website, it is now the largest for-profit managed health care company in the BCBS association.

As of 2015, BCBS has an extensive presence in states like Illinois, Iowa, North Dakota, Idaho, Arkansas, Tennessee, Alabama. The map below is the BCBS plans market share as of September 2015.

insurance coverage bcbs blue cross blue shield distribution is the US addiction treatment rehabilitation center

The states where BCBS is least present are Oregon, Nevada, Utah, Colorado, Wisconsin, and Connecticut. However, even in these states, its market share is 20% to 29%.

Usually, BCBS plans can fully or partially cover detox, rehab, aftercare services, specialty alcohol and drug treatment. Covered programs might be either outpatient or inpatient. Interestingly, Blue Cross Blue Shield covers addictions such as internet, gambling, and porn.

Insurance Coverage of Addictions

Changes in the insurance market within the last few years made insurance more accessible. Insurance coverage under certain insurance plans has expanded. Covered addictions include: alcohol, cocaine, eating disorders, gambling, heroin, internet, opiates / opioids, sex, and video games. The insurance companies which cover addictions are:

  • Aetna,
  • American Family Insurance,
  • Cigna,
  • BCBS,
  • HCSC,
  • Coventry Insurance,
  • Health Net,
  • UnitedHealth Group,
  • Humana,
  • Highmark,
  • Kaiser Permanente

The current insurance marketplace covers the treatment of most kinds of addictions, bringing sobriety and thus a brighter future.

 

  1. http://kff.org/other/state-indicator/market-share-and-enrollment-of-largest-three-insurers-large-group-market/
  2. http://obamacarefacts.com/affordablecareact-summary/
  3. http://www.census.gov/popest/data/national/totals/2015/index.html
  4. https://www.census.gov/content/dam/Census/library/publications/2015/demo/p60-253.pdf
  5. http://www.markfarrah.com/healthcare-business-strategy/Blue-Cross-and-Blue-Shield-Market-Share-Snapshot-2015.aspx

Nelly Botezatu

Gettreatment.com

Nelly Botezatu is a doctoral student in Economics. She enjoys learning new subjects, discovering trends, insights and data relationships. After studying the fundamentals of graphic design, she now presents her data analysis via infographics. She strives to add to the body of online knowledge for our clients.

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