Gaming disorder is a thing now. Does insurance cover it?

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Gaming disorder is a thing now. Does insurance cover it?

The World Health Organization recognized gaming disorder as a disease this year, but don't expect health insurers to cover treatment any time soon.

The WHO recently added gaming disorder to the International Classification of Diseases. Medical practitioners and countries use the ICD to diagnose conditions and plan public health strategies. According to the ICD definition, people with gaming disorder give priority to gaming — to the extent that it negatively affects their relationships, education or job.

But before covering it, most health insurance companies are waiting for gaming disorder to be included in the fifth edition of another obscure medical manual: the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association.

"We're still reviewing the evidence being presented and believe further studies are needed before this disorder is finalized into the DSM V," said Cathryn Donaldson, a spokeswoman for America's Health Insurance Plans, a health insurance industry group.

Health insurers use the DSM as a guide for coverage decisions, Donaldson said, though the level of coverage will vary depending on the market, provider and health plan.

As of now, insurers generally don't cover treatments for gaming disorder provided by organizations like Restart Life, a treatment center outside Seattle specializing in gaming and internet use disorders. Hilarie Cash, chief clinical officer for Restart, expects it could take years for insurance companies to adopt a new DSM and begin covering gaming disorder.

The cost of treatment

Cash is looking forward to that day. If insurance companies cover treatment, it could make help more accessible to people who can't afford it.

"The insurance companies might be unhappy this is happening because I think the problem is so widespread, they're going to be paying out," Cash said.

Treatment is costly. At Restart, the eight- to 10-week program for young adults costs $35,000 to $45,000. For adolescents, the first 60 days costs $35,000, then $16,250 per month after. Students staying longer pay less. They're expected to stay a minimum of three months, and stay on average about five months.

Young adults board at one of Restart's Washington campuses during the course of treatment, and a typical day includes physical fitness, chores, outdoor activities and mindfulness training. Restart awards scholarships to people who need financial help when it has the resources to do so, Cash said. For people who can't afford Restart, the organization refers people to other therapeutic programs that may cost less.

"There are a few others coming on board who are trying to address this specific population," Cash said.

Cash suggests speaking with an educational consultant familiar with internet addiction and video addiction to find treatment options. A family therapist can also help. Cash also suggested finding a 12-step program.

Not every city will have a program designed around gaming addiction, but people may be able to find a compatible group in Gamblers Anonymous or Sex and Love Addicts Anonymous programs. The key is to get support from others, Cash said.

"It is extremely difficult to recover from any addiction without having a recovery community supporting you," Cash said.

The future of gaming disorder treatment

At any given time, Restart treats 25 to 30 adults and up to 16 adolescents. The organization started with one client back in 2009. Restart is still growing, with plans to expand to a ranch where clients can work with animals, Cash said.

Even with widespread medical recognition, it may be a struggle for many people to pay for gaming disorder treatment. Insurance typically covers up to 28 days of inpatient treatment for widely recognized diseases like drug or alcohol addiction, which isn't enough, Cash said. The typical client stays much longer at Restart.

Cash believes it will take a push from patients and legislators until treatment is widely covered.

"The insured need to apply pressure and demand coverage, however they choose to do that," Cash said.

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