Will health insurance help with alcohol addiction rehab?

Updated 18/10/2023

You will need to check your private health coverage policy but hospital cover may extend to private treatment in an alcohol addiction centre. Read more.

Will health insurance help with alcohol addiction rehab?

You will need to check your private health coverage policy but hospital cover may extend to private treatment in an alcohol addiction centre.

Compare the Best Private Health Insurance Policies For Drug & Alcohol Rehab

Addiction is a part of life for many Australians. It’s a complex condition that requires comprehensive treatment – not just medical intervention but also emotional and social support. Recovering from addiction can also involve ongoing mental health treatment. Getting out of the grips of addiction is only the first step. For many, covering the cost of rehab can be overwhelming.

But the right level of private health cover can help offset some of these costs. Whether you’re grappling with addiction or you’re looking for treatment options for a friend or loved one, it’s important to be across the impact of addiction and the potential avenues for rehabilitation.

In this article, we’ll explore the very important role that private health insurance plays in helping people overcome addiction, and how some health cover benefits can offset the costs of drug rehabilitation, alcohol addiction counselling, and more.

Key Points

  • Having private health insurance can greatly reduce the financial burden of treatment for addiction.

  • Addiction has far-reaching consequences not just for addicted individuals, but also for their families.

  • Treatment options for addiction include detoxification, in-patient and out-patient rehab, medication-assisted treatment, therapy and support groups, and more. Health insurance can help make  treatment more accessible and affordable.

Understanding addiction and its impact

Addiction is a chronic disease that many people experience in their lives. Addiction is not explicitly reserved for drugs and alcohol. However, in the context of health cover, we’ll only refer to addiction in these terms.

Many addictions are characterised by drug seeking and compulsive behaviour – sometimes to extreme ends – despite the threat of harmful physical and mental consequences. It’s a complex condition that ends up damaging the body and brain. People with addiction (also known as ‘severe substance abuse disorder’) often have an intense focus on using their preferred substance or substances (such as alcohol and/or drugs) to the point that it becomes all-consuming.

But addiction doesn’t just affect the individual. It also affects family and friends. Addiction can result in a range of physical and mental health problems, including:

  • liver disease

  • heart disease

  • stroke

  • depression

  • anxiety

It can also lead to social and financial problems, including job loss, family breakdown, social isolation, and homelessness.

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).

What treatments are available for addiction?

Given the serious consequences of addiction, it’s important that those suffering from the disease are able to get the help they need in a timely manner. The right treatment can be a life-saving resource that helps them stop the use of drugs – and stay drug-free. The type of addiction treatments needed will depend on the substance involved, the length of use and other social factors. Let's take a look at some of the treatments available for alcohol and drug addiction.

Alcohol addiction treatments

Alcohol-addiction treatments range from detox to in-patient treatment, therapy and more. Here’s a brief rundown of some of the most common treatments you’ll come across in Australia:

Treatment

Description

Detoxification

The process of removing alcohol or other drugs from the patient’s body. This is often the first step in treating alcohol addiction.

In-patient rehabilitation

An intensive residential treatment program. These programs can last from a few weeks to several months, and provide a structured environment to help patients overcome their addiction/s.

Out-patient treatment

Involves the patient living at home while receiving treatment for their addiction/s. This can be a good option for those with a mild addiction or those who can’t take time away from their daily responsibilities (i.e. family or work).

Medication-assisted treatment

Uses medications in combination with counselling and behavioural therapies. This can help individuals manage withdrawal symptoms and reduce substance cravings.

Counselling and therapy

Therapies such as cognitive-behavioural therapy and family therapy fall within this treatment category. This can help individuals understand the root cause of their addiction/s and develop healthier coping strategies.

Support groups

Peer-led groups such as  Alcoholics Anonymous and SMART Recovery can provide a welcoming environment for those experiencing addiction to learn from others who have gone through similar struggles.

Drug Addiction Treatments

Much like those suffering from alcohol addiction, drug addiction treatments can range from medical detoxification to in-patient/out-patient drug rehab, support groups and more. Here's a brief overview of each:

Treatment

Description

Medical detoxification

The process of safely managing physical withdrawal symptoms under medical supervision. This is usually the first step in treating most drug addictions.

In-patient drug rehab

Treatment where patients live on-site at the treatment facility. These programs are set in a structured environment where intensive care is available to help individuals overcome their addictions.

Out-patient drug rehab

Ongoing treatment that often occurs at a rehab facility while the patient continues to live at home. This can be a good option for those with a mild addiction or those who can’t take time away from their daily responsibilities (i.e. family or work).

Medication-assisted treatment

Combines prescribed medications with counselling and behavioural therapies, which together can help people manage their symptoms of withdrawal.

Behavioural therapy

From cognitive-behavioural therapy to contingency management and more, behavioural therapies can help people recognise the cause/s of their addiction/s and subsequently develop the most appropriate coping strategies.

Support groups

Peer-led groups like Narcotics Anonymous give those suffering from drug addiction a safe, supportive place to tell their stories and learn from others in a similar situation.

The role of health insurance in addiction treatment

It might not be the first thing on your mind, but health insurance can actually play a vital role in treating addiction/s because it can help offset the costs of different treatments. 

Outpatient rehab is not covered by private hospital cover. It is important you are aware of this before selecting a policy based on addiction treatment benefits.

However, the extent of this cover depends on the policy you choose, so it’s recommended you thoroughly review your policy information documents to understand exactly what is – and isn’t – covered.

Detoxification, for example, which is typically the first step on the road to recovery, can be pricey without insurance support. In-patient rehabilitation which provides structured, round-the-clock care, is another expensive treatment option – but one that might be covered by your chosen health policy.

While some insurance policies might cover all avenues of addiction treatment, others might have limitations, such as a maximum number of days you can stay in-patient, or a set number of sessions for therapy. Deductibles, co-payments and out-of-pocket expenses (or gap fees) can further affect the overall cost of treatment.

How much does rehab cost?

The cost of rehab depends on the type of treatment, the length of the stay, the chosen facility and a few other factors. On average, you can expect to pay the following for private and public rehab facilities:

Service

Public Cost

Private Cost

Detox

$1000 – $1500

$2000 – $4000

In-patient rehab

Covered by Medicare

$2000 – $7500 per week

Out-patient rehab

Covered by Medicare

$100 – $500 per session

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Addiction Statistics

Like most parts of the world, addiction remains a widespread issue in Australia, affecting people of all ages and backgrounds. The statistics vary by state, but both drug and alcohol abuse are significant public health concerns.

According to the Australian Institute of Health and Welfare (AIHW), “the majority of Australians aged 14 years and over consume alcohol” with the proportion of those drinking to excess hitting 16.8% as of 2019. Alcohol was responsible for nearly three in five drug-related hospitalisations in 2020–21, and most worryingly was a rise in alcohol-induced deaths in 2021, up 7.4% from the year prior to 1559.

The AIHW also records incidents of illicit drug use in Australia. According to their latest figures, around 9 million people (43%) aged 14 and over have illicitly used a drug at some point in their lifetime, with 3.4 million (16.4%) doing so in the previous 12 months. In 2021, 1,704 deaths were drug-induced, which was the fourth-consecutive yearly rise on this statistic. Aside from cannabis, the following drugs saw an increase usage over the same reported period:

  • Cocaine

  • Ecstasy

  • Hallucinogens

  • Inhalants

  • Ketamine

The role of counselling in addiction treatment

Counselling can be the most important post-recovery treatment option for addiction. It can help people understand why and how their addiction/s manifested in the first place, as well as develop healthier coping strategies and build a strong support network for years to come. In Australia, the term ‘counselling’ can mean a few different things.

It might mean intensive individual counselling, group counselling sessions, or counselling for you and your family. Beyond helping to cover the costs associated with addiction rehabilitation, private health insurance cover is also available for mental health services such as counselling. These costs can vary, but below is a set of average costs you can expect:

Type

Cost

One-hour session

$60 – $180

One-hour couple session

$120 – $250

Specialised trauma counselling session

$150 – $350

One-hour group therapy session

$40 – $80

Source: Lifeskills Australia - How much does counselling cost in Australia

The benefits of health insurance for drug rehab

Private health insurance makes drug rehab more affordable and, depending on the extent of your cover, might allow for you to choose from a number of different treatment options. Private health cover may also give you and your loved ones peace of mind during a difficult time.

Knowing you’re financially covered not only reduces stress, but also streamlines associated care services like medical assessments, medications and mental health support. Ultimately, health insurance may help simplify the drug rehabilitation process to make it easier on yourself and your loved ones.

Choosing the right health insurance for addiction treatment

Despite all these benefits, choosing the right health insurance policy for addiction treatment can be time consuming. There are many factors to consider, including the cost of your policy, the extent of your cover, whether there are any gap fees, the limitations on treatment and more.

That’s why it's important to do your research. Comparing health insurance policies can help you find the best cover for your needs, allowing you to make the most informed decision and ensure you get the best possible value for your money.

Compare different health policies with an easy-to-use online service like Compare Club. We can help you find the policy that best fits your needs and budget.

Does Medicare pay for alcohol addiction treatment?

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.

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.

Does Medicare cover rehab?

Medicare can cover some aspects of rehab, such as in-patient care in a public hospital, out-patient care with a registered healthcare provider, and some medications. However, it may not cover all costs associated with drug and alcohol rehabilitation.

Additional Resources

There are a number of Australian resources for anyone looking for support with alcohol or other addiction/s. Here's a list of helpful resources: 

Frequently Asked Questions

Does private health insurance pay for rehab?

Yes, some health insurance policies do cover addiction treatment, including detox, in-patient rehab and counselling services. However, the extent of your cover varies depending on the policy and your preferred insurer. Make sure you read the policy information documents to know what is and isn’t included.

Can I use private health insurance for addiction treatment?

Yes, private health insurance can be used for addiction treatment. In fact, private health policies will give you access to a wider range of treatment options than Medicare, including private rehab facilities.

How can I compare health insurance policies for addiction treatment?

The easiest way to find private health cover that works for you is with an online comparison tool like Compare Club. Make sure you always consider the cost of your policy, the level of cover you need and any out-of-pocket expenses.

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 comparison of your health insurance before you commit yourself.

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Sources

#Compare Club compares selected products from a panel of trusted insurers. We do not compare all products in the market.

A word of caution

This guide is opinion only and should not be taken as medical or financial advice. Check with a financial professional before making any decisions.




Chris Stanley is the sales & operations manager of health insurance at Compare Club. With extensive experience and expertise, Chris is a trusted leader known for his deep understanding of health insurance markets, policies, and coverage options. As the sales & operations manager of health insurance, Chris leads a team of dedicated professionals committed to helping individuals and families make informed decisions about their health insurance needs.

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Chris Stanley

Sales & Operations Manager for Health Insurance