Health insurance for drug and alcohol addiction
Treatments for drug and alcohol addiction are available on gold hospital policies. Alternatively, there is some support available via Medicare or via support services that the government offers.
What different scores mean
9+
Excellent
These products offer a balance between low pricing and more features.
7+
Great
Competitive products within their group.
5+
Standard
Usually these products would either have fewer treatments covered or higher pricing.
0+
Basic
Offering basic cover with limited features or higher pricing.
Health insurance that covers drug and alcohol rehab
All prices are based on a single individual with less than $105,000 income and living in Sydney.
Finder Score - Hospital cover health insurance
Each month we analyse our hospital insurance products and rate each one on price and features. What we end up with is a nice round number out of 10 that helps you compare hospital cover a bit faster.
Before we start scoring, we need to make sure we're comparing like-for-like. Just as it doesn't make sense to compare a bicycle with a Ferrari, it doesn't make sense to compare basic hospital policies to top-tier Gold policies. Each policy is given a price score and feature score. These are then combined to determine each policies's Finder Score.
How health insurance for addiction works
Drug and alcohol addiction can be treated in a lot of ways, but it is generally classed as a psychiatric or mental health condition. Treatment generally requires a residential stay at a hospital or inpatient facility, generally from a few weeks to a month or so. In Australia, inpatient care is covered under private hospital insurance (as opposed to extras).
To get access to 'psychiatric care' you'll need a gold hospital policy. Residential care is expensive, so it tends to be only available in top tier policies. If you have a lower tier policy you might have what's called restricted cover on psychiatric care. You should consider this to not have coverage - you'd pay a lot out-of-pocket if you used it. However, there are waiting period exceptions for mental health that can help you.
It's important to note that outpatient rehabilitation is not covered by private health insurance. Even the treatments that are covered may still carry out of pocket expenses as every insurer has benefit limits that will apply. Additionally, a gold policy will typically have waiting periods of 2 months before you can access these services, however, there are some exceptions if you're eligible for the mental health waiver, which you can only use once in your lifetime. There's more information about that further down the page.
Drug and alcohol addiction treatments
| Treatment | Description | How a gold health insurance policy can help |
|---|---|---|
| Withdrawal or detoxification | Ceasing drug and alcohol use, while minimising side-effects and the risk of harm. | If this is taking place in a hospital, private health insurance can cover your in-patient costs (hospital bed, medications used while in hospital). |
| Pharmacotherapy | Substitution of a harmful drug with medication to reduce cravings and the risk of overdose. | If this takes place in a hospital, you'd be covered under 'in-patient' treatments. |
| Counselling | Different approaches include talking through your problems and learning how to change the way you think and deal with difficult situations. | Health insurance doesn't cover this unless it's in a hospital with a psychiatrist |
| Rehabilitation programs | A long-term approach to achieving a drug and alcohol-free lifestyle, with no further medication provided once withdrawal is successfully completed. | If this rehab is done in a hospital, you may be covered under 'in-hospital treatments', 'rehabilitation' or 'psychiatry'. |
| Complementary therapies | Treatments such as relaxation therapies and natural remedies, which can be useful in managing withdrawal symptoms. | Health insurance won't cover this. |
| Support groups | Support programs such as Alcoholics Anonymous and Narcotics Anonymous | Health insurance doesn't cover this. They're typically free community groups. |
Government support for drug and alcohol help
The Australian government has a range of support services available to help those who are struggling with drug and alcohol addiction. These services are also available to those who are affected by someone else's addiction.
Free support
If you or someone you care about is experiencing problems with drugs or alcohol, the below help lines are available for counseling, treatment, information and support.
- National Alcohol and Other Drug Hotline - 1800 250 015
- Counselling Online - this allows you to chat online or email a counsellor 24/7
- Family Drug Support - 1300 368 186
- Kids Help Line - 1800 55 1800
- Lifeline - 13 11 14
- Hello Sunday Morning - this is an app designed to assist people with changing their relationship with alcohol.
How Medicare can cover drug and alcohol support
Mental health services are available via Medicare, but this can be limited. Every Australian resident is entitled to 10 Medicare-rebated psychology (allied mental health) sessions per calendar year under a Mental Health Treatment Plan, which Medicare will cover a certain amount for. Psychiatrist appointments attract separate Medicare rebates and aren't included in this 10-session cap. However, oftentimes, the practitioner will charge more than what Medicare covers so you're still left with some out of pocket expenses.
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