Wellcare Dual Liberty (HMO D-SNP) (009): Screening and Counseling to Reduce Alcohol Misuse

Once per year screening for adults who misuse alcohol but are not alcohol dependent.  Both alcohol misuse and alcohol dependence are commonly thought of as “alcoholism,” though they are not the same thing.  Both fall on the spectrum of alcohol use disorder (AUD), though differ in symptoms and severity.

Alcohol misuse is consuming too much alcohol, too often.  Those who misuse alcohol will commonly take advantage of most or all opportunities where alcohol is made available to drink to excess—gatherings, parties, sporting events, weekends, dining out—so that the appearance of social acceptability is maintained (even if only in the drinker’s perception). 

Alcohol dependence is the inability to quit drinking that is driven by both physiological and psychological factors resulting from consistent, heavy use.  Dependence is considered severe alcohol use disorder (AUD), wherein there is a powerful craving to drink and an inability to stop drinking once started.  Also, when drinking stops, there are associated physical symptoms that are unpleasant and can even be dangerous (uncontrollable shaking, sweating, intestinal problems, fast heart rate, high blood pressure, headache, and vision problems).  Dependence usually results in drinking every day, throughout the day, whether or not impairment is apparent.

Alcohol dependence is frequently associated with addiction, which is when drinking continues regardless of negative personal, professional, or collateral (i.e., other people or property) consequences and is prioritized above everything else.

The plan covers one alcohol misuse screening for adults who misuse alcohol but are not alcohol dependent.  Those with positive screenings are eligible for up to 4 in-person counseling sessions per year, provided that they are competent and alert during counseling.  Counseling must be provided by a qualified provider in a primary care setting.