Does Insurance Cover ER Visit for Illegal Drug?

Question by Meringue: Does insurance cover ER visit for illegal drug?
Does health insurance typically cover trips to the ER for treatment related to using an illegal drug?

Basically, I had a bad trip on shrooms, so they took me to the ER. They put me on IV fluids and did some blood tests. Also, I was transported via ambulance. I didn’t have my insurance information on me at the moment and I need to file a claim now with my insurance company. I’ve read my companies’ policy online and it doesn’t say it DOESN’T cover such treatment, but it’s still not clear to me. I have Anthem Blue Cross, if that helps.

Best answer:

Answer by Katie
Yeah–it’s still a medically necessary service, which means it will be covered just like it would be covered if you had a random heart attack. 🙂

Answer by Ms K
More than likely this will fall under the services of substance abuse which may be different than if you were treated for a medical condition (example, stroke). When the claim is submitted to your health insurance company they will look at the diagnosis code to determine if the treatment was medically necessary. It the diagnosis is a “substance abuse” type of diagnosis than it will fall under that however if it is diagnosed as a medical condition than it could fall under your medical benefit. Either way I dont see any reason why it would not be covered. If you have to file a claim make sure that you are getting a claim that has all the information that is required such as diagnosis code, cpt code or revenue codes, your id number, name, etc. If it does get denied you can always send in a letter appealing the decision.

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