Forty-four states require health plans to cover alcohol treatment in some fashion, with some laws requiring more expansive coverage than others. If companies choose to self-insure, or administer their own health plans, they are exempt from state insurance laws. Just under half of all workers who have health insurance through their jobs are covered by self-insured plans.

Equal Coverage

Under laws passed in these states between 1985 and 2001, alcohol treatment is covered under private insurance plans. No exemptions.

Connecticut, Delaware, Indiana, Kentucky, Minnesota, New Jersey, Vermont, and Virginia

Mandated Minimum

Many state laws mandate coverage for substance abuse that is less than that for physical illnesses, including different visit limits, copayments, deductibles, and annual and lifetime limits. Any health insurer that sells a health insurance benefit must meet or exceed these legal requirements for coverage.

• Alaska. Passed in 1997. Limits are unspecified; lifetime dollar maximum.

• Hawaii. Passed in 1988. No less than two treatment episodes per lifetime for inpatient and outpatient; copay must be comparable.

• Illinois. Passed in 1995. Limits are unspecified.

• Kansas. Passed in 1998. Limits on inpatient days and outpatient visits; other unspecified.

• Maine. Passed in 1984. Limits are unspecified; may place maximums on copay and lifetime.

• Maryland. Passed in 1994. Different copay for outpatient; day limit on intensive outpatient.

• Massachusetts. Passed in 1991. Day limit inpatient; dollar limit outpatient; other unspecified.

• Michigan. Passed in 2001. No inpatient; visit limit outpatient, other unspecified.

• Mississippi. Passed in 1975. Limits are unspecified.n Missouri. Passed in 2000. Limits on inpatient days and outpatient visits; possible lifetime limit.

• Missouri. Passed in 2000. Limits on inpatient days and outpatient visits. Specified lifetime maximum.

• Montana. Passed in 2001. Dollar limit on inpatient and outpatient; other unspecified.

• Nevada. Passed in 1997. Dollar amount limits on inpatient, detoxification, and outpatient; lifetime maximum unspecified.

• New Hampshire. Passed in 2002. Reasonable charges for outpatient and partial hospitalization may have dollar limits for copay, and annual and lifetime maximums.

• North Dakota. Passed in 1995. Limits on inpatient and intensive outpatient days, and outpatient visits; other unspecified.

• Ohio. Passed in 1985. Dollar minimums for inpatient, outpatient, and intensive outpatient; copay subject to deductibles and coinsurance.

• Oregon. Passed in 2000. Dollar limit placed on inpatient, outpatient, and intensive outpatient; different dollar limits for adults and children.

• Pennsylvania. Passed in 1989. Limit on inpatient and detoxification days, and outpatient visits; copay same for first treatment.

• Rhode Island. Passed in 2002. Limit on number of hours in detoxification; everything else must be equal.

• Texas. Passed in 1981. Limited to three treatments in lifetime for inpatient, outpatient, and intensive outpatient for self-insured plans of 250 or less. Must be sufficient to provide appropriate care.

• Washington. Passed in 1990. Limits are unspecified.

• Wisconsin. Passed in 1985. Dollar limits on inpatient, outpatient, and
  trasitional treatment. Dollar amount for lifetime limit.

Mandated Offering

Mandated offering laws do not require that any benefit be provided at all. However, they do require that the insurer afford companies the option of selecting a plan that includes alcohol treatment. Sixteen states require health insurance companies to include at least one plan with a minimum alcohol benefit among the choices that employers can buy—or can decide not to buy.

• Alabama. Passed in 1979. Limitations on inpatient days and outpatient visits; copay is different but unspecified.

• Arkansas. Passed in 1987. Coverage generally on par with physical illness; limitation on dollar maximum, biennial and lifetime.

• California. Passed in 1990. Limits are unspecified.

• Colorado. Passed in 1994. Limitations on inpatient days; outpatient dollar limit; copay percentage limit.

• Florida. Passed in 1993. Limits unspecified except in outpatient visit and dollar limit.

• Georgia. Passed in 1998. Limits on inpatient days and outpatient visits.

• Louisiana. Passed in 1982. Limits are unspecified.

• Nebraska. Passed in 1989. Limits on inpatient days and outpatient visits.

• New Mexico. Passed in 1987. Limits on inpatient days and outpatient visits.

• New York. Passed in 1998. Limits on inpatient days, detoxification days, and outpatient visits.

• North Carolina. Passed in 1985. Limits on dollar amount for inpatient, outpatient, copay, and dollar maximum lifetime.

• South Carolina. Passed in 1994. Dollar limit on inpatient, outpatient, and lifetime maximum. Copay may be different.

• South Dakota. Passed in 1979. Limits on inpatient days and outpatient visits.

• Tennessee. Passed in 1982. Must be equal.

• Utah. Passed in 1994. Limits are unspecified.

• West Virginia. Passed in 1998. Limits on inpatient days; outpatient unspecified; dollar amount lifetime maximum.

No Laws

These states don't have any laws about health insurance coverage of alcohol treatment.

Arizona, Idaho, Iowa, Oklahoma and Wyoming

Places Where Public Employees Have Parity

Government employees must have, by law, equal coverage for alcohol treatment as for treatment of other illnesses, but there are separate laws that cover non-government workers' health insurance.

Throughout the U.S., all federal employees.

North Carolina, South Carolina.

Source: National Conference of State Legislatures, Health Policy Tracking Service, “Mandated Benefits and Mandated Offerings for Mental Health and Substance Abuse Treatment,” July 1, 2002.

December 2002