Does Obamacare pay any part of in-patient alcohol treatment ?
Mental health, including substance abuse disorders (drug and alcohol) are covered on all non-grandfathered plans as part of ten essential health benefits. These services include treatments such as psychotherapy and counseling. They also include mental and behavioral health inpatient services and substance use disorder treatment. So yes, under ObamaCare inpatient addiction services are covered, as are other addiction services, but as we will discuss below they are often subject to cost sharing.
Under the ACA you can no longer be denied or charged more for care (due to receiving addiction, mental health, or behavioral services) and can no longer be barred from care due to annual or lifetime dollar limits... but not every plan covers this services to the same extent and plans can offer different cost sharing on each.
Mental, behavioral, and addiction services are not covered at no out-of-pocket cost on most plans. Rather you will owe the cost sharing amount determined by your plan for treatment considered in-network. You'll want to check with your insurer to see networks, what is covered, allowed dollar amounts, allowed number of services, and under what cost sharing amounts things are covered. The above being said as a rule of thumb insurers must offer "parity protections for mental health services".
Parity protections for mental health services
Non-exempt plans must provide certain “parity” protections between mental health and substance abuse benefits on the one hand, and medical and surgical benefits on the other.
This means that in general, limits applied to mental health and substance abuse services can’t be more restrictive than limits applied to medical and surgical services. The kinds of limits covered by the parity protections include:
- Financial, like deductibles, copayments, coinsurance, and out-of-pocket limits
- Treatment, like limits to the number of days or visits covered
- Care management, like being required to get authorization of treatment before getting it
This may seem less attractive then it simply "covering everything", but remember before the ACA it was very common for addicts not to be able to get the help they needed due to lacking insurance. Before the ACA you either needed a good health plan or you needed to be on Medicaid to get help with addiction through a medical provider. This left millions of addicts hiding their addiction and not getting the medical help they needed. Coverage may still be lacking today, but by keeping a focus on the importance of treating substance abuse disorders and expanding health care reform it can continue to improve.
Each year, untreated addiction costs the country 420 billion dollars due to health care, criminal justice, and lost productivity costs. The ACA helps to reduce the cost of healthcare spending and federal spending by addressing mental health and substance disorders.
Or learn about what is covered from HealthCare.Gov