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Reviewed by Medicaid is an insurance plan provided by the United States government. Every 1 out of 5 low-income Americans in the country are covered by it. Many people turn to this plan as a source of funding when they experience health challenges, including addiction. It may be the only means for many to enter rehab for alcohol, drug, and substance abuse.
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Because of this, some individuals find themselves looking for rehabs that accept Medicaid. Those with the plan should learn what their insurance plans cover for them and which rehabs around them accept it. This article will discuss these aspects in detail, including eligibility for this insurance cover and information on the criteria required for rehab.
Does Medicaid Cover Drug Rehab?
Yes, the coverage does extend to substance abuse rehab and detox. However, precisely what is covered can vary between states. It can be problematic as nearly 12% of adults insured under this plan have a substance use disorder. The result is that some of these individuals will have access to comprehensive treatment, while others living elsewhere will have their options severely restricted in comparison.
However, anyone with this insurance will have access to some form of rehab insurance coverage. According to the Affordable Care Act, it covers substance abuse. It gives those dealing with substance abuse the chance to search for detox centers near me that accept Medicaid.
Who Is Eligible?
Not everyone with a substance use disorder will qualify for coverage. This coverage is available in all 50 states and Washington D.C.
The Following Populations Can Use It:
- Low-income people, with the threshold for “low-income” being determined by the state
- Families and children, depending on income
- Pregnant women
- The elderly
- People with qualifying disabilities
In some regions, coverage for drug rehab and other health concerns is expanding to allow more people to enroll. In these states, information on income and family size are used to determine who qualifies based on income, with the threshold being raised to include those in higher income brackets.
Users can find out if they are eligible by either going to their state’s Medicaid website or filling out an application with the Health Insurance Marketplace. Coverage starts immediately for those who qualify, making it a good option for uninsured individuals who need help quickly. In these cases, they can begin to look for rehabs near me that take Medicaid.
Criteria For Medicaid Drug Rehab Coverage
For substance use disorder to be covered, the patient needs to have a diagnosis from a medical professional who works with this insurance. They need to provide a diagnosis and referral, stating that the patient needs treatment. Even with this, Medicaid drug rehab coverage may not be as complete as a person requires.
Many states fail to offer comprehensive rehab coverage, severely restricting coverage for drug rehab. It has a significant negative effect on low-income populations who rely on this system to get treatment.
States have been encouraged to offer better coverage for drug addiction, alcohol addiction, and behavior disorders in general. Slowly, change is being seen. However, for some, it will come too late.
Rehabs Near Me that Take Medicaid
If you have been searching for rehabs near me that take Medicaid, it is understandable how that information can sometimes be challenging to come across. The list below provides various options spread across the United States.
Aegis Treatment Center, Bakersfield, CA
The Aegis Treatment Center in Bakersfield, CA, is a center that has multiple awards declaring it as one of the best in the city. There are two clinics in Bakersfield, one on 21st Street and the other on Columbus Street.
Both of these clinics offer outpatient treatment. Patients with opioid addictions may find this rehab that takes Medicaid to be the most optimal choice for them, as they also provide medication-assisted treatment with methadone and suboxone.
There are several other Aegis centers available in California, so patients who may be located too far from Bakersfield can locate those closest to them to start treatment.
MedMark Treatment Centers, El Paso, TX
Located in El Paso, TX, MedMark’s clinic is one rehab that takes Medicaid out of its many locations. It is located on Alameda Avenue, and beyond this insurance, they accept many other payment types.
This center focuses on patients who are dealing with addiction to opioids. Their services are tailored to enable these patients the best medical care possible and the fastest route to recovery.
It is an outpatient clinic, so it provides individuals who can’t get time off their jobs the flexibility to receive treatment. They offer medication-assisted treatment for opioid abuse, using methadone and buprenorphine. In addition, they have other clinics available in 11 other states of the country, which means you can get help even if you live miles away.
Barry Robinson Center, Norfolk, VA
The Barry Robinson Center, located in Norfolk, VA, is a specialist clinic that focuses on youth. While substance abuse is not their entire focus, teenagers struggling with drug or alcohol problems are welcome at this center.
The Barry Robinson Center is a Medicaid inpatient rehab center that effectively treats troubled adolescents as the temptation of drug use is no longer available. The 32-acre campus is secure and allows struggling teenagers to recover in a serene, peaceful environment.
They provide dual-diagnosis treatment, which offers the most holistic form of Medicaid rehab and helps patients whose mental illness leads them to drug abuse or vice versa.
Broward Addiction Recovery Center, Fort Lauderdale, FL
Located in Fort Lauderdale, FL, the Broward Addiction Recovery Center is run by Broward county. This center provides care for adult patients who have a substance abuse disorder and the mental conditions that accompany it.
Apart from being one of the rehabs that accept Medicaid, the Broward Addiction Recovery Center offers a selection of options for patients. For instance, while they have residential services for patients who find it more convenient to be inpatients, many find the process tedious. In this case, they also offer outpatient services.
Tully Hill Corporation, Tully, NY
For those who reside in New York, Tully Hill provides a means of treatment for drug and alcohol abuse. It is a beautiful treatment center that provides patients with the opportunity for both Medicaid inpatient rehab and outpatient programs.
The outpatient care allows patients to receive solo therapy sessions, and some are performed in groups. There is also an Intensive Outpatient care structure with patients completing at least nine hours of treatment every week.
Some patients may want the best outcome from their rehab and opt for inpatient treatment instead. It allows them to be supervised at all times and significantly reduces the risk of danger from withdrawal. This rehab that takes Medicaid can be a great option.
HUGS Recovery Center, Atlanta, GA
The HUGS Recovery Center in Atlanta provides care for adolescents. Their treatment is offered to patients with alcoholism, substance use disorders, and mental health conditions such as depression and anxiety.
This center provides Medicaid rehab for inpatients alone. Residential treatment occurs in their private community setting, which can help keep patients calm when receiving treatment.
There are also programs for telehealth and teletherapy. These solutions may be helpful for patients who would rather not be admitted for residential treatment.
Louise Landau Health Center, Chicago, IL
The Louise Landau Health Center, located in Chicago, IL, provides multiple services, some of which are specifically tailored toward women. This center offers outpatient rehab programs for patients, including same-day appointments.
This center is one of the rehabs that accept Medicaid. It provides the opportunity for treatment for patients with substance abuse issues who otherwise would not be able to afford treatment.
Substance Abuse Services Covered
Given that policies vary by region, coverage of medications for the treatment of opioid use disorder, rehabs, and other forms of treatment will vary.
Some Services That Are Commonly Covered Include:
- Detoxification
- Inpatient treatment
- Outpatient treatment
- Dual diagnosis treatment
- Drug testing
- Family counseling
- Interventions
- Mental health treatment
Anyone in need of detox coverage or other services should verify what is available to them in their state.
Does It Cover Opioid Treatment?
Yes, it does cover opioid treatment, from safely detoxing from these substances to using medications to prevent cravings and relapse. As with all Medicaid coverage, what is covered may vary from state to state, with restrictions preventing truly comprehensive access. If a user feels that they will need medication to stay clean, they need to check to see the coverage limits.
Does It Cover Alcohol Treatment?
Medicaid mental health coverage includes alcohol rehabilitation. As with opioids, it covers detox, rehabilitation, and maintenance. What restrictions apply to this coverage will vary between states, and users should always verify coverage before assuming they will have access to a specific treatment or medication.
What Is Not Covered?
Medicaid drug rehab coverage certainly has its limits, and some things simply are not covered.
Some Items That the Program Will Not Pay For Include:
- Any treatment not backed up by the diagnosis of a doctor
- Any treatment offered by centers not affiliated with Medicaid
- Any medications that are not on the approved prescription list
- Alternative therapies, such as art and equine therapy
- Additional services, such as massages and saunas
- Inpatient rehab stays that exceed the maximum number of days covered
- Outpatient sessions that exceed the maximum number of sessions covered
For many, the coverage limits mean that it is difficult, if not impossible, to rely on it for substance use disorder treatment fully. As a result, many people carry additional insurance.
How To Apply
Anyone eligible can apply for Medicaid insurance coverage at any time of year; there is no open enrollment period. It can be done online through the state’s website or the federal health insurance marketplace. Certain documentation will be needed to support the application.
It Can Include:
- Birth certificate
- Driver’s license
- Pay stubs
- Tax returns
- Bank statements
- Proof of address
- Medical records
Once an application is filed, the state is given 45 days to process it, or 90 if eligibility is related to disability. If someone does not qualify for coverage, they can still seek affordable coverage through the public marketplace.
Can One Apply For Both Medicare And Medicaid?
It is possible to apply for both Medicare and Medicaid. Some people fall into dual eligibility, meaning they qualify for both programs. For example, those over the age of 65 who have low income will be eligible for both, as will many people with disabilities. There is no law preventing people from being enrolled in both and using whichever program best meets their needs at a given time.
Find Rehabs That Accept Medicaid and Start the Recovery Journey
Finding information on Medicaid drug rehab centers can be difficult for addicts who cannot afford help in any other way. This article serves as a guide for patients seeking out Medicaid rehab for addiction.
No matter where one lives in the United States, they will always find rehabs that accept Medicaid near them. This insurance plan helps remove one of the barriers that prevent people from getting treatment and brings them one step closer to recovery.
Frequently Asked Questions
Does Medicaid Cover Therapy?
The insurance covers a number of mental health services, part of which include therapy related to addiction. Whether it is one-on-one sessions or group therapy, patients can benefit from this insurance plan in cases where their substance abuse treatment warrants therapy.
Does Medicaid Cover Counseling?
Most centers that offer detox and rehab for patients with drug addiction also provide counseling services. Medicaid covers several mental health services that patients might need, including counseling. It is a major step towards recovery, and this insurance plan doesn’t deny them that chance.
Does Medicaid Cover Methadone?
It should be noted that due to the partially state-funded nature of Medicaid, what is offered differs depending on the state. Forty-one states cover medication-assisted treatment with methadone under this insurance plan. The excluded states include Arkansas, Idaho, Kansas, Kentucky, Louisiana, Nebraska, North Dakota, South Carolina, Tennessee, and Wyoming.
Does Medicaid Pay For Suboxone?
Medicaid programs in all states cover medication-assisted treatment with suboxone. It provides a very accessible means for those looking to treat their opioid abuse with this insurance plan.
Does Medicaid Pay for Sober Living?
Sober Livings Homes provide a great transitional platform for patients leaving rehab. However, there is no general rule as to whether sober living facilities accept Medicaid. It works on a case-by-case basis, depending on the facility. Interested individuals should contact the sober living facility for more information on the accepted insurance plans.
Page Sources
- Substance Abuse and Mental Health Services Administration, Medicaid Coverage of Medication-Assisted Treatment for Alcohol and Opioid Use Disorders and of Medication for the Reversal of Opioid Overdose, 2018, https://store.samhsa.gov/sites/default/files/d7/priv/medicaidfinancingmatreport_0.pdf#page=106
- U.S. Department of Health and Human Services, Who is eligible for Medicaid?, 2017, https://www.hhs.gov/answers/medicare-and-medicaid/who-is-eligible-for-medicaid/index.html
- DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services, Medicare Coverage of Substance Abuse Services, 2016. https://www.cms.gov/outreach-and-education/medicare-learning-network-mln/mlnmattersarticles/downloads/se1604.pdf