Can you be denied health insurance coverage for a DUI or alcohol abuse?

If you have a DUI conviction or abuse alcohol, you may be wondering whether insurers will deny you health insurance coverage. 

Insurance companies won’t deny health insurance because of your driving record or substance abuse, but alcohol abuse can impact your body negatively.

Depending on how your alcohol abuse affects you, you could pay a lot for health care — even with your health insurance coverage.

Read on to learn more about how a DUI conviction or alcohol abuse could affect your health insurance.

Will health insurance companies deny coverage because of a DUI or alcohol abuse?

If you’re searching for private health insurance and have a DUI conviction, you don’t need to worry about coverage. Your health insurance won’t change, and insurers won’t deny coverage because of a DUI conviction.

Health insurance companies don’t consider driving records when determining whether to accept or deny policyholders. So your DUI or DWI conviction won’t impact acceptance for private health insurance coverage.

If you have group coverage through a work plan, you don’t have to worry about being dropped from your health insurance coverage. While your car insurance may drop you as a policyholder or increase your rates significantly, this isn’t the case with your health insurance.

Similarly, a health insurance company won’t deny a health-related claim because of a DUI conviction. However, your auto insurance company could choose to deny your claim as you failed to uphold your end of the contract when you got behind the wheel after drinking alcohol.

Due to the Affordable Care Act, insurance companies can’t deny coverage for pre-existing conditions, including alcohol abuse. Some of the most common pre-existing conditions include:

• Asthma
• Diabetes
• Pregnancy
• Alcohol or substance abuse
• Kidney disease
• Cancer
• Lupus

Before the Affordable Care Act, insurers could deny coverage or charge outrageous premiums if you had a pre-existing condition. Now, insurance companies can’t deny coverage based on pre-existing conditions.

Inspect any policy you’re considering to ensure there are no specific exclusions for coverage. Some companies use exclusions to avoid coverage for certain conditions or issues.

You can call prospective insurance companies to help you understand the policies well and ask questions about rates or coverage.

Read more: Can you be denied health insurance if you have herpes?

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How can alcohol abuse impact my health?

Occasionally driving alcohol is unlikely to impact your health negatively. However, if you abuse alcohol for years, you can expect your body to show signs of alcohol abuse. Some of the most common symptoms of alcohol abuse include:

• High blood pressure
• Heart disease
• Stroke
• Liver disease
• Digestive issues
• Different types of cancers
• Weakened immune system
• Dementia
• Depression
• Anxiety

Your health insurance company might see the long-term risks listed above as signs of alcohol abuse. Still, there are many risks related to short-term alcohol abuse, such as injuries and alcohol poisoning.

While your alcohol abuse may not cause you to pay more for coverage, you could spend a lot on health care if you’re constantly dealing with issues stemming from your condition. Consider pursuing healthy options and cutting back on alcohol consumption to care for your body.

Read More: Can you get life insurance with a digestive disorder?

How will health insurance find out about my DUI or alcohol abuse?

A health insurance company is unlikely to check your driving record or use it to prove alcohol-related issues. Health insurance claims are the primary way an insurance company would discover anything related to alcohol abuse.

If you’ve made several health-related claims centered around alcohol abuse, prospective health insurance companies will see this. However, insurers legally can’t deny coverage based on your condition.

You can report any company denying coverage as you search for insurance coverage. If you believe a company is refusing to cover you because of your condition, speak with a company representative to discover why you got denied coverage. You may want to seek legal help if the company is unwilling to answer your questions.  

How much is health insurance for someone considered high risk?

Private health insurance rates can be costly. The table below shows the average rates in each state for a private health insurance plan.

Average Private Health Insurance Rates by State

As you can see, some states have average rates of over $700 per month. In the past, people with alcohol-related health conditions may have found it difficult to purchase standard health insurance, causing them to pay up to twice as much for health insurance coverage per month.

Today, health insurance companies cannot deny coverage based on health history, so people with pre-existing conditions such as alcohol abuse can find coverage at a fairly reasonable price. However, some people want a group plan through their employer to save money on coverage.

Read more: Is private health insurance tax-deductible?

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What if health insurance companies won’t accept me as a client?

Health insurance companies won’t deny you based on your health history. If you’re part of a group health plan through your work, you’ll get the same health plan as others. You may be able to choose between a few options with different price points.

Most group plans also allow you to add supplemental coverage for cancer or long-term care. If these options are available through your workplace, you should be able to add them to your health plan.

If you recently lost your job, you may be able to get the same health insurance for a while through COBRA insurance. Depending on how much you’d be required to pay, this could be a good option. Most people can get coverage through COBRA for around 180 days after their employment ends.

What is underwriting for health insurance?

Health insurance companies that underwrite special policies are the only exception for health insurance and alcohol abuse. Anyone who seeks an underwritten policy and isn’t in good health will receive higher-than-average rates for coverage or exclusions on coverage.

If you drink alcohol but are in good health, an underwritten policy could save you money. However, if you’ve filed insurance claims based on poor health or your alcohol abuse is officially noted as a condition, you can expect your rates to be high with an underwritten policy.

Case Studies: Health Insurance Coverage and DUI/Alcohol Abuse

Case Study 1: John’s Denied Coverage

John, a 35-year-old individual with a previous DUI conviction, faced obstacles while applying for health insurance due to his past offense, despite being in good health. The insurance provider denied his coverage, attributing it to the higher risk associated with his history of DUI. As a result, John was left in a difficult situation, searching for alternative coverage options.

Case Study 2: Mark’s Limited Coverage

Mark, a 28-year-old individual, has a pre-existing condition that requires ongoing medical attention. He also has a history of alcohol abuse but has been sober for the past two years. When Mark applied for health insurance, he was offered coverage but was informed that any treatment related to alcohol abuse or any relapse in the future would not be covered under his policy.

While he understood the rationale behind this limitation, it raised concerns for Mark regarding his potential future healthcare needs.

Case Study 3: Lisa’s Specialized Plan

Lisa, a 50-year-old woman, was recently diagnosed with alcohol dependency and sought assistance through a rehabilitation program. Following her successful completion of the program, Lisa applied for health insurance coverage. Although her history of alcohol abuse presented a risk, she was able to secure a specialized insurance plan that specifically catered to individuals in recovery.

This plan provided comprehensive coverage for both her ongoing healthcare needs and any potential relapse situations, ensuring she could access the necessary support without undue financial burden.

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Alcohol Abuse and Health Insurance: The Bottom Line

Insurers won’t deny health insurance coverage if you’ve received a DUI. Similarly, if you abuse alcohol, you can still find a private health insurance option.

If you struggle with alcohol abuse, it’s vital to seek help for your condition. Speak with your doctor about options for treatment, and consider speaking with a mental health professional if you struggle with depression or anxiety associated with your condition.

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