HCSC Insurance Coverage for Gambling

Last updated on November 4th, 2019

gamblingGambling addiction is something that has a severely negative impact on the lives of those affected by it — both the addicts and those who care about them. In a 2007 study of internet gambling behavior, researchers found that nearly two-thirds of people who regularly engaged in online gambling were gambling addicts. Gambling addiction is a heavy burden and is often accompanied by other disorders; a survey conducted with members of the 12-step program, Gamblers Anonymous, found that 72 percent of participants had experienced a major depressive episode, and 52 percent had abused alcohol.

Does HCSC Insurance Cover Treatment for Gambling Addiction?

Gambling addiction is recognized as a disorder by the psychological community and, according to the Diagnostic and Statistical Manual V, it is a diagnosable mental health condition. As such, treatment for gambling addiction may be covered, either in part or entirely, by HCSC insurance plans. Since gambling addiction is often accompanied by other mental health diagnoses, such as depression, it may also be treated (and covered) in conjunction with these.

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

Gambling addiction is a condition that falls under the umbrella of behavioral health services. If your plan offers behavioral health coverage and you seek treatment for your gambling problem, you may have some or all of the costs associated with your recovery process paid for by insurance. Amount of coverage varies from plan to plan, so review your policy to see what services are available to you.

Types of Rehabs HCSC Will Pay For

Inpatient treatment for gambling addiction is not considered a medical necessity under most standard insurance plans. However, outpatient therapy will likely be covered by your insurance’s behavioral health benefits if you choose to seek treatment, and options that are free of charge, such as Gamblers Anonymous meetings and community support groups, are available if you need help.

How Much of the Cost of Rehab Is Covered by HCSC?

With gambling rehabilitation, some plans will cover more than others. Your insurance deductible and whether it and any “out-of-pocket maximum payments” have been met prior to your treatment also factor into your coverage. For example, if you have a comprehensive behavioral health plan and you have already paid your annual out-of-pocket maximum, you may be eligible to receive counseling sessions free of charge.

Can I Pay Above What My Insurance Will Provide to Receive Treatment?

If you feel that you need a form of treatment that is not fully covered by your insurance plan, you can still get the helping hand you need by paying whatever fees insurance will not cover yourself. This may seem daunting, but many treatment centers will work with you and finance a payment plan, so that you can get the help you need even if your insurance won’t pay.

Inpatient Addiction Treatment vs. Outpatient Therapy

“In a 2007 study of internet gambling behavior, researchers found that nearly two-thirds of people who regularly engaged in online gambling were gambling addicts.”Inpatient treatment (for example, in a residential treatment center) for gambling addiction is an option for those who feel the need for access to resources for help with their addictions around the clock, in addition to those who may feel the desire for direct supervision as they take their first steps into the realm of recovery.
Outpatient therapy is less restrictive than inpatient treatment, and allows you to continue to live your life as you normally do while attending therapy sessions intermittently. Outpatient therapy is a good option for those who are unable to take time off of work or do not wish to be separated from their families but still want help overcoming addiction.

Should I Choose a Residential Rehab Center?

Luxury Lakeside RehabIf you feel the need to take a step away from your daily life as it currently stands in order to begin the recovery process, a residential rehab center may be a viable choice for you. In a residential rehab center, you can get the help you need — not only from addiction specialists and psychologists who work there, but also from your fellow addicts who are there with you on the same road to addiction recovery.

Will HCSC Pay For Local Rehab and Out-of-State Treatment?

HCSC will usually cover any addiction treatment that it defines as a medical necessity, provided the treatment is covered under your behavioral health plan and is administered by a facility or doctor that is within its network of providers — whether the facility or doctor is in your state or outside of it.

Does HCSC Pay for Private or Luxury Treatment?

HCSC may cover some or all costs for treatment at a private facility, if the facility accepts your insurance. Many luxury treatment facilities do not accept insurance, and those seeking help in a luxury treatment facility often must pay the fees for their stays themselves. However, some private treatment centers do offer financing for clients who are unable to pay all of the costs at once.

What Does Executive Treatment Offer Over Other Rehabs?

So-called “executive treatment” is a form of intensive treatment that offers more freedom to its clients than traditional inpatient rehab. Designed with professionals and business owners in mind, executive treatment gives clients the rigorous therapy they need while still allowing them to conduct the day-to-day work that is necessary to keep their businesses running smoothly.

What Treatment Lengths Will HCSC Pay For?

HCSC covers up to 30 days of inpatient care for those for whom it is deemed medically necessary. Additionally, outpatient treatments for gambling addiction and related comorbidities may be covered by insurance, depending on the provisions of your health plan and the severity of your addiction and related mental illnesses.

What If I Have No Insurance?

If you do not have medical insurance, you may still be able to get the help you need with overcoming your gambling addiction. Many treatment providers offer an income-based sliding scale for their services, or are willing to finance their clients by providing a monthly payment plan for the services they provide. Some providers also offer scholarships for potential clients who are in financial need.

Using Our Helpline to Determine Your Options for Gambling Addiction Rehab with HCSC Insurance

If you are in need of help with your gambling addiction and don’t know who to turn to for answers about your insurance inquiries, there are people ready to help you only a call away. Call 1-888-716-9806 to speak with someone who can assist you in navigating your insurance plan and finding out what treatment options are available and covered by HCSC.

Questions and Answers

  • Will HCSC Cover Multiple Rehab Stays?

HCSC may cover up to 30 days of inpatient treatment, depending on your plan and whether you have other diagnoses that impact the severity of your plight.

  • Does Insurance Pay for Aftercare?

Aftercare, such as therapy and psychiatric medication, are often covered under HCSC’s behavioral health plans. Some or all of your costs associated with aftercare may be paid for by your insurance plan. Review your policy to find out which services are covered under your plan.

  • Could Rehab Make My Insurance Premiums Higher?

Insurance premiums do not tend to rise or fall due to one claim filed by one person; rather, they tend to increase or decrease based on how claims filed by groups of individuals are trending. Therefore, it is unlikely that rehab would cause your premium to spike.

  • Has The Affordable Care Act (Obamacare) Affected Substance Abuse and Mental Health Insurance Coverage?

The Affordable Care Act has caused sweeping changes to insurance coverage for mental health and substance abuse treatment. Mental health and addiction disorders are now on the same level as other medical problems, in terms of co-payments demanded and treatment visit limitations.

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