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Will Health Insurance Help With Alcohol Addiction Rehab?

Sally Aquire May 2nd, 2012 0 comments
Health insurance and alcoholism

Many people like to drink alcohol but for some, it can lead to addiction. Over time, a tolerance for alcohol can develop. This means that more alcohol needs to be drunk to get the same effects. Alcohol addiction can lead to problems with physical and mental health.

You may assume that little or no support will be given for treating alcohol addiction, but this is not the case. Medicare offers limited support, and private health insurance covers more.

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How is alcohol addiction treated?

The ultimate aim is to get off alcohol and stay off it. Alcohol withdrawal is a key part of the treatment plan. This can happen at home, in hospital or in an inpatient clinic. Counselling can be prominent in treating alcohol addiction. Support groups can also be useful.

Medications are often used in withdrawal treatment. There are several different medicines that may be prescribed. This includes Diazepam, Thiamine, Acamprosate, Naltexone and Disulfiram. Some of these are on the Pharmaceutical Benefits Scheme (PBS).

Will Medicare help?

Alcohol addiction and mental health problems can be closely linked. Alcohol addiction is not specifically covered by Medicare, but you may still be able to get support. The Better Access initiative can help.

You will need to see your GP, who will assess whether you are eligible for support. A treatment plan will be devised to outline the treatment that you will need. You can then be referred to a psychologist or psychiatrist for treatment. For the former, you can receive up to 10 therapy sessions per calendar year. A further 6 sessions may be available in “exceptional circumstances”. It is up to your referrer to decide whether you qualify for this. These treatment limits are expected to be the same into 2013.

Although Medicare rebates are available, remember that out-of-pocket costs may still occur. This can happen if a psychologist charges above the Medicare schedule benefit. In this scenario, you must pay the gap between the two.

The PBS can help with medicine costs. Some of the drugs used for withdrawal treatment are on the PBS. The main exception is Disulfiram. This is not a first choice treatment, and is not subsidised.

How can private health insurance help?

Private health insurance can be more supportive than you might think. For example, hospital cover may extend to private treatment in an alcohol addiction centre. Check your policy to see how extensive your coverage is. You may be covered for a short stay or for an extended stay. If you need to stay longer than your policy covers you for, be aware of potential out-of-pocket costs.

Doctor’s fees may also be covered by private health insurance. If you need to access out-of-hospital services, some of this may be covered too.

A word of caution

Don’t assume that alcohol addiction treatment will always be covered by private health insurance. It may be restricted or excluded on some policies. Bear this in mind when you compare health funds, or you could later find that you are not covered by the policy you’ve chosen. Conduct a thorough health insurance comparison before you commit yourself.

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