Coverage of Drug and Alcohol Dependencies

Effective for plans issued or renewed on or after Jan. 1, 2018, SB 41 amends the Insurance Code’s provisions on coverage of serious mental illness. The new law requires insurers that provide major medical coverage to provide inpatient coverage for the diagnosis and treatment of drug and alcohol dependencies and unlimited medically necessary treatment for drug and alcohol dependencies provided in residential settings. A plan that provides prescription drug coverage must provide coverage for the treatment of alcohol and drug dependencies that includes immediate access, without prior authorization, to a five-day emergency supply of medicines covered under the health plan when a medical emergency exists (such as the management of opioid withdrawal or stabilization, or reversal of an opioid overdose). Coverage may be subject to the plan’s normal cost-sharing provisions.

Additionally, an insurer may not impose precertification, prior authorization, pre-admission screening or referral requirements for the diagnosis and medically necessary treatment, including in-patient treatment, of drug and alcohol dependency.

This new law doesn’t contain any new employer compliance obligations. However, Delaware employers will want to be aware of the changes to the insurance laws in Delaware should employees have questions regarding health insurance coverage.

SB 41 »