Finding a doctor to treat addiction and ensuring that it is covered is often an uphill battle. Eligibility for treatment does not mean that you will receive it. While diabetes, lung cancer and myriad other diseases are routinely covered by health insurance, people who suffer from substance use disorder (addiction) are often denied coverage or are offered inadequate treatment options.
Between 70-80 percent of people with diabetes receive treatment, but only about 10 percent with alcohol or drug addiction receive any form of treatment (see Addiction Medicine). And even when individuals with addiction receive treatment, the treatment provided is rarely on par with treatment for other medical conditions in terms of being evidence based or scientifically proven.
The biggest obstacles to getting adequate treatment are as follows:
- Many insurance companies do not cover treatment for addiction.
Although Medicaid is the largest provider of mental health and addiction services in the country, not all Medicaid plans cover addiction treatment, and while the ACA requires addiction services to be covered by insurance, not all insurance plans are governed by the ACA.
- Even when treatment is covered by insurance, there might not be an accessible treatment center or provider. The number of qualified clinicians and treatment programs available pale in comparison to the number of individuals who need treatment for addiction. People are often turned away from qualified providers.
- Though addiction often accompanies other mental health issues, treatment facilities typically offer treatment for one or the other: Addiction treatment centers frequently do not offer mental health treatment and many mental health facilities do not offer addiction treatment. For most of the individuals seeking treatment for addiction, unless both illnesses are treated together, the likelihood of relapse is much greater.
- When a person does receive treatment for addiction, it is typically not the same intensity or duration as treatment for other serious medical conditions. Even when insurance covers addiction treatment, it usually will not cover it at the right level or for the necessary period of time. Very often people in treatment will be discharged because insurance stops paying, even though they continue to have symptoms, or can’t manage living with addiction on their own. The risk of death from untreated addiction can be very high.