Chelsey Tucker graduated with a Bachelor of History degree from Metropolitan State University in 2019. She now writes about insurance with her specialty being life insurance and has been quoted on Help Smart Phone and MEL Magazine.

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Dan Walker graduated with a BS in Administrative Management in 2005 and has been working in his family’s insurance agency, FCI Agency, for 15 years. He is licensed as an agent to write property and casualty insurance, including home, auto, umbrella, and dwelling fire insurance. He’s also been featured on sites like Reviews.com.

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Reviewed by Daniel Walker
Licensed Auto Insurance Agent

UPDATED: Mar 19, 2020

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Bar with man whose health insurance coverage has been denied due to a DUI or alcohol abuse

Yes, you or a loved one may be denied health insurance coverage for a DUI or alcohol abuse. There are a lot of factors that go into determining the eligibility of someone for health insurance coverage.

If you have a history of alcohol abuse, your health insurance coverage can be denied, not because of the alcohol abuse, but because of the related issues such as liver disease and high blood pressure that can accompany alcohol abuse.

If you need to compare online health insurance rates for a new policy just enter your zip code now!

What negative issues in health insurance coverage arise from alcohol abuse?

Likewise, having a DUI will not in and of itself cause coverage to be denied. However, related injuries or health issues that result from the DUI can cause the coverage to be denied or claims to be denied. There are several negative issues that can arise in health insurance coverage due to alcohol abuse. The following article will provide additional information about alcohol abuse and how it affects health insurance.

There are many negative consequences for abusing alcohol including how it affects health insurance coverage. The first issue is higher premiums. If the insurance company learns either through your health insurance application, medical history, or a recent injury that you abuse alcohol, your premium amounts will be higher.

This is because it is more likely that the insurance company will have to pay a claim on you than someone who does not abuse alcohol. Premiums will increase with each alcohol related event. If you deny your alcohol addiction on your application and it can later be proven, the health insurance company will not pay any of your claims.

This leads to another consequence and that is denial of claims. Any injuries claims or illness claims related to alcohol abuse can be denied by the health insurance company, especially if this is part of a clause in your policy. This includes injuries that result from a DUI, alcohol overdose, alcohol poisoning, or injuries received while drunk.

This leaves emergency room doctors in a bind . They must either report just the injury, or the cause of the injury as well, knowing that coverage may be denied.

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What results from being labeled high risk?

Another consequence is that you may be classified as a high risk client. High risk clients are subject to higher premiums, higher deductibles, denial of coverage from other insurance companies in the future, and have access to fewer doctors and treatments. Some people try to get around this by lying about their alcohol use on health insurance applications.

As stated before, this will likely lead to denial of claims in the future as well as requests for reimbursement to the insurance company for any claims paid out in the past.

The last consequence to consider is the denial of recovery program fee payment by your insurance company. Some insurance companies include drug and alcohol recovery program fee payments as part of your overall health insurance plan.

If you are already abusing alcohol when you apply for insurance, the company may add a clause excluding recovery programs from being covered. If you truly are not an addict when you apply but become one while you have your policy, coverage may be available for a recovery program.

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What can you do about these consequences?

First of all, receiving treatment for any alcohol addiction is vital. Health insurance aside, dealing with an addition that affects you physically, emotionally, and relationally is very important. When you overcome your addiction, you will also overcome the negative consequences associated with health insurance when you abuse alcohol.

If you do have an alcohol related injury or illness and your health insurance company is denying the claim, you can fight it. This can be done by having a doctor diagnose you with the disease of alcoholism. Health insurance companies are required to cover diseases but are not required to cover addictions.

The law in many states is changing to reflect alcoholism as a disease instead of an addiction. If fighting a claim, be sure to check with your state law to see how it classified alcoholism and drug abuse.

Finding the right health insurance company, whether there is an alcohol abuse issue or not, can be done through an online comparison tool. Comparing what different companies have to offer can save you money on your policy. Using this type of tool will provide you with many insurance rates and quotes from different companies. Start with the health insurance quote tool above in order to secure the coverage you need today.