Do American Family Insurance Health Plans Cover Gambling Addicitions

Last updated on November 4th, 2019

Gambling Addiction has become a serious problem in the United States. Between 2 percent and 3 percent of American’s meet the definition of gambling addiction. That equates to nearly half a million teens and around 6 million adults. In 2013, the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition) created a new category of diagnosis for gambling addiction and other disorders. Physicians use this manual as a reference in diagnosing patients.
This is good news for individuals who want to seek gambling addiction treatment, because the new healthcare law recognizes gambling addiction as a treatable disorder. It also requires insurance companies to offer a minimum standard of coverage.

What Kind of Coverage Does American Family Insurance Offer for Gambling Addiction Treatment?

Normally when your doctor or therapist diagnoses you with a gambling addiction, they will help you determine what type of treatment will be most effective. There are several types of coverage that they may recommend, including;

  • Private or group therapy
  • Outpatient treatment
  • Inpatient treatment
  • Follow up care

What Portion of My Treatment will be Covered?

The amount of your treatment that is covered is related to how your health insurance policy covers other medical events. For instance, if your policy has a $2,500 deductible and covers 50 percent of your medical costs once you’ve met your deductible, that’s how gambling addiction treatment will be covered. If you want the best coverage for gambling addiction treatment, it’s best to choose a policy with a low deductible that covers a high percentage of your medical costs afterward.

Can I Pay for Continuing Treatment When My Insurance Benefits Have Been Exhausted?

Yes. Once your insurance benefits are exhausted you can continue treatment and pay for it out of your own pocket.

Inpatient Treatment vs. Outpatient Treatment

Inpatient treatment requires and allows the recovering addict to spend 24 hours a day in a recovery setting. Outpatient treatment is treatment that happens during certain hours of the day and allows you to sleep at home and even continue working. If you use American Family Insurance for Gambling Treatment, it’s best to have your doctor or therapist work with American Family to determine what type of program they’ll pay for.

Should I Use a Residential Treatment Center?

Residential treatment centers are an expensive option that requires a significant time commitment. In fact, according to, 30 days of standard inpatient treatment costs between $18,000 and $32,000. However, to their credit, they are effective in helping patients overcome a disorder. Talk to your doctor or therapist to determine the best treatment option for your situation.

Will American Family Pay for Local Treatment and Out-of-State Treatment?

Different health insurance plans offer different networks. Typically your American Family health insurance plan will pay for any treatment center that’s in the network. Depending on what state you live in, you may have access to a national network. If that’s the case, you’ll have several out-of-state treatment options to choose from. Best of all, in this scenario, you’ll receive in-network benefits. You can still use treatment centers that aren’t in the network, but you’ll likely get a lower benefit and be charged for the difference in price that’s allowed by American Family and the price the treatment center charges. In other words, if American Family Insurance only allows $600 per day for gambling disorder inpatient treatment but the out-of-network treatment center you choose charges $700 per day, you’ll be charged and expected to pay the extra $100 per day. If you use an in-network treatment center, you won’t run into this problem, because the treatment center has a contract with the insurance company that requires that they only charge up to the allowed amount.

Does American Family Pay for Private or Luxury Gambling Disorder Treatment?

American Family, like most insurance companies, won’t pay for private or luxury treatment. Private treatment is simply rehabilitation in a private setting, as opposed to group therapy. Luxury treatment is rehabilitation in a posh facility with the comfort of home, extra amenities or all of the above. It’s possible that American Family Insurance will approve abnormal treatment arrangements. But your doctor or therapist will have to make the case to your insurance company as to why it’s medically necessary for you to have special treatment.

What Does Executive Treatment Offer Over Standard Treatment?

executive rehabExecutive treatment is a type of treatment often used by CEO’s and celebrities. It allows them to continue running their businesses and daily lives while they recover from their disorder. Executive treatment also offers a level of privacy and exclusivity that is often needed by high profile patients.

How Many Days of Gambling Disorder Treatment Will American Family Pay For?

Coverage for gambling disorder treatment is limited to 30 days, if medically necessary. Unfortunately, American Family’s health plans don’t cover 60, 90 or 180 day treatments.

I Don’t Have Insurance. What are My Options?

Of course, if you need treatment, it’s a good idea to have American Family Insurance for gambling rehab(s). If you find yourself without coverage and need treatment, there are some effective options to consider:

  • Open a credit line with the treatment center.
  • Explore local support groups, like Gamblers Anonymous (GA).
  • Research if your state has any programs to help you recover from gambling disorders.
  • If your gambling is causing problems for you, call our helpline at 1-888-716-9806 now.

FAQ’s about American Family Insurance Coverage

Does your insurance cover addiction treatment?

Use our free and confidential online insurance checker to see if your insurance covers treatment at an American Addiction Center facility.

See if you’re covered