Employers Addressing Substance Use Disorders Save By
Offering Equitable Coverage
Do you offer health insurance coverage for substance treatment that is comparable to that for other medical conditions and illnesses? Are the copays and deductibles the same as for other illnesses?
People needing treatment for substance problems put it off or drop out quickly if they feel they cannot afford treatment. A company that has a health insurance benefit that inhibits substance treatment may be penny wise and pound foolish. For example, a study by the RAND think tank found that one-third of patients with a copay of $25 or more for outpatient alcohol treatment did not follow up for outpatient treatment. Dropping copays to $10 increased follow-up more than 30 percent, and dropping copay completely increased outpatient use by more than 50 percent. The cost of lowering barriers can be as low as $5.00 per employee per year.
Where state insurance laws require that substance treatment coverage be the same as that for other illnesses, a practice known as parity, people are much more likely to get services they need. In 2008, Congress extended the mandate for parity by passing the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act which requires that employers who offer mental health and substance abuse benefits do so at a level commensurate with other medical and surgical benefits. Plan elements such as copayments, deductibles and treatment limitations for substance abuse and mental health services can be no more restrictive than the terms attached to general medical services. Most plans with 50 or more members will be required to meet these guidelines by January 1, 2010.
For more information about parity in health plans, see Workplace Solutions: Treating Alcohol Problems Through Employment-Based Health Insurance.
Improve Alcohol Treatment Health Insurance
- Expecting Value: Monitoring Health Plans' Provision of Treatment for Substance Use Disorders
- Offering State-of-the-Art Treatment