Does Insurance Cover Gambling Addiction?

You probably know that many private insurance companies provide some form of coverage for substance abuse – the excessive use of psychoactive drugs, such as alcohol, pain medications, or illegal drugs. In fact, insurers are now required by the Affordable Care Act (ACA) to offer indeterminate (varies by plan, state, etc.) substance abuse treatment coverage to their members. Furthermore, the ACA regards substance abuse treatment as an essential health care benefit for Americans, which means that private insurance companies cannot outright deny substance abuse disorder coverage.

However, you’re wondering about insurance coverage for another concern – gambling disorder. With an estimated 3.3 million Americans living with a severe gambling problem, and another 4 to 6 million exhibiting mild or moderate problematic behavior, you’re not alone in your question. Does insurance cover gambling addiction under your plan, or any plan for that matter? Let’s find out.

How to Know if Your Insurance Covers Gambling Disorder Treatment and Therapy (and what else to consider)

Confirm Treatment Provider is in Network with Your Healthcare Provider

Not that long ago, those suffering from gambling disorder had little recourse as far as insurance coverage was concerned. While most insurance plans covered substance addiction, few covered gambling related concerns. Even to this day, matching policies to direct treatment (for gambling disorder) is hard to find. However, a number of insurance plans may cover treatment as part of mental health services. Some organizations can help you tap into this channel – with Kindbridge Behavioral Health Services leading the way in that capacity.

Kindbridge has developed a network with the top insurance providers in most U.S. states. In doing so, we have facilitated a process to help you find out how much reimbursement you are likely to receive from your health insurance plan. If you are a member of any of the following, you may qualify for partial coverage for gambling disorder treatment:

  • AETNA Managed Health Care
  • Blue Cross Blue Shield Association
  • Centers for Medicare & Medicaid Services (CMS)
  • CIGNA Managed Health Care
  • OPTUM Health Services

Unsure? Contact a Kindbridge Care Coordinator

If you’re not a member with one of the above, you may still have options to have insurance (or similar plans) cover gambling addiction. For instance, if you have a Preferred Provider Organization (PPO) plan, you may be able to receive 60-80% reimbursement (post-deductible) for each counseling session. Furthermore, the company or organization you’re employed with may have a wellness allowance for mental health therapy that can be applied to gambling disorder treatment. In addition, you may have a health savings (or other) account that allows you to apportion funds for online therapy sessions.

As an out-of-network provider, Kindbridge has fostered an environment where which gambling addicts gain access to all the information needed about coverage for therapy. Better yet, you don’t need to do any of this research on your own (beyond reading this article). All that you need to do, is contact a Kindbridge Care Coordinator to find out if you qualify to have insurance cover your gambling disorder. Call 1+ (877) 426-4258 to ask.

No Coverage? Compare Against the Cost of Not Getting Help

If you’ve exhausted all avenues (and contacted our Care Coordinators) and found that there is no coverage available to you, we encourage you to ponder this – what is the cost of not getting help? We’re not even referring to the intangible costs (social and familial struggles), as the financial implications of continuing on your current path far exceed the cost of therapy. The average debt generated by a gambling addict is between $55,000 and $90,000. When you compare that against the prices of virtual therapy for gambling disorder, the economics are clear. Whether or not insurance covers you for gambling disorder treatment is beside the point. Simply put, you cannot afford to go without help any longer.

Whether you want further verification that your insurance covers gambling addiction, you’re unsure, or you have any other questions about costs and possible reimbursements, we’re here for you. Contact Kindbridge today.

Email [email protected]


CALL +1 (877) 426-4258