Can I be denied health insurance for abusing alcohol?

UPDATED: Aug 14, 2013

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UPDATED: Aug 14, 2013Fact Checked

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Asked August 14, 2013

1 Answer

If your medical exam reveals a high level of alcohol consumption or abuse, it could definitely affect whether or not you will be accepted for individual health insurance coverage. If you are applying for group insurance, such as what you'd get through an employer-sponsored health plan, you cannot be denied coverage for preexisting conditions, including alcoholism and alcohol abuse. Actually, this portion of Obamacare does not become effective until January of 2014, but most large insurers have already implemented the rule.

If you are told that you have an alcohol abuse problem by your spouse or friends, it does not mean that you have serious enough problem that it could affect your insurance, but if you have sought medical attention, have been advised by your doctor to seek treatment, or have been ordered to get treatment by the court, then you may have a problem that could affect your insurance coverage.

In a majority of situations, the person with an alcohol abuse problem may be charged higher rates rather than being denied coverage entirely. In group insurance, you cannot be denied coverage for any preexisting condition, nor will your rates vary dramatically when compared to a non-drinker. This is because group insurance policies use risk schedule for the entire group, rounding out the premiums to be more uniform among most members of the insured group.

Do not lie on your policy application. If you do and the insurance company finds out, your policy could be immediately canceled and you may have a hard time finding another company that will offer coverage to you. Keep in mind that alcohol abuse can be detected through a blood test in many cases, and your deceit will be found out.

If you are already in recovery, you will not be denied coverage. Since you have already begun treatment for the condition, your perceived risk is lower than someone who has not yet sought help. Similarly, the risk of insuring continues to go down the longer you are in recovery, so you could see your rates drop after a period of time.

Answered August 14, 2013 by Anonymous

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