Medicaid Health Insurance Coverage for Addiction Treatment

Discover how Medicaid covers drug rehab and addiction treatment, including inpatient and outpatient options. Find out how to enroll today.

Medicaid Health Insurance Coverage for Addiction Treatment

Discover how Medicaid covers drug rehab and addiction treatment, including inpatient and outpatient options. Find out how to enroll today.

You may know Medicaid as the government health insurance program for people and families with low income. Medicaid was created by the federal government in 1965.

While federal law sets guidelines about what Medicaid programs need to look like they’re ultimately run by state governments. If you’re looking to get Medicaid you would need to sign up through your own state. Many states have specific insurance companies that provide their Medicaid plans and that insurer can answer questions about the details of your plan.

Does Medicaid Cover Drug Rehab & Addiction Treatment?

Yes. The Affordable Care Act and Mental Health Parity and Addiction Equity Act oblige all Medicaid plans to cover mental health and substance use and to cover it at the same level as they cover medical treatment. It applies to Medicaid. Therefore if you have Medicaid you have access to addiction treatment.

Each state can decide within federal guidelines what addiction treatment coverage will look like and who will administer it. You will need to make sure that the treatment center you’re considering takes Medicaid as many don’t. If they do take it keep in mind you may also need prior authorization from Medicaid or the company managing it before you can go.

There are also substance use rehab programs specifically for those with Medicaid. They may be run by nonprofits, the county, or the state. Often these programs will include additional support through community services and resources that benefit lower income individuals and families.

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Addiction Centers That Accept Medicaid

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425 Main St Chester, NJ 07930
5.0
(100 reviews)
Check iconClaimed
1
Top 10 Rehab In New Jersey
Rolling Hills Recovery Center is a state licensed outpatient drug and alcohol rehab facility in Chester, New Jersey. Providing a continuum of treatment from partial hospitalization care to intensive outpatient programs, their interdisciplinary team looks at addiction from all angles. This includes the whole person, the community around that person,
This program is amazing! It’s hard to explain the impact they’ve had on my life and my family’s life. I really feel like me again. I need to say Caroline and Jose were so helpful. They always made me feel better. If anyone who reads this needs help just call here and go for it. Thanks you guys so much.
Ronald lightman
1 week ago
Rolling Hills is a place that helps you heal. It’s not just a paycheck to these people. They are devoted to what they do because they have been where you are. It’s a place that gives you your life back. If there was ever a time and place to get better, it’s now.. and here.
James Faulkner
1 week ago
Rolling Hills has been a wonderful experience with my recovery! The staff have been so amazing so knowledgeable ! If you or someone you know who are struggling with addiction and highly recommend rolling Hills!
Victoria Clark
1 week ago
The facilities at Rolling Hills Recovery Center in Chester, NJ 2
5
5
The facilities at Rolling Hills Recovery Center in Chester, NJ 1 The facilities at Rolling Hills Recovery Center in Chester, NJ 3 The facilities at Rolling Hills Recovery Center in Chester, NJ 4 The facilities at Rolling Hills Recovery Center in Chester, NJ 5
24745 S Lindsay Rd Chandler, AZ 85249
4.8
(47 reviews)
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Top 10 Rehab In
A rehab facility run by professionals in the field of mental health and substance abuse, we provide the highest-quality treatment based on evidence-based therapies and best practices. Legacy Recovery Center is owned and operated by two psychiatrists with over four decades of combined experience, as well as two other individuals with two decades of
Legacy Recovery Center showed me that I deserve help and healing. They guided me through one of the darkest periods of my life. I'm eternally grateful to their dedicated team for the support they provided.
Duc Phuc Tran
1 month ago
I am so thankful to Legacy for my life! Last summer my life was spiraling out of control and I needed help. The entire staff was so helpful and caring. All the sessions and assignments were so worth the outcome. I felt like I could talk to Any one of them and ask any question without feeling like a loser. I even had a good experience with the other residents (for the most part). We watched movies, played games, crafted, visited and talked things out amongst ourselves. I even discovered a few new things about myself from others there! Tanja is the best. Could talk to her about anything and she was supportive, to the point and caring. Oh and she is an animal lover❤️❤️❤️❤️❤️❤️❤️
Donna Bowman
1 month ago
The staff here is incredible!!! They go above and beyond for the patients in their care. Their facility is stunning and makes you feel at home when you walk through their doors. They are fabulous!!
Laura L
2 months ago
The facilities at Legacy Recovery Center in Chandler, AZ 2
5
5
The facilities at Legacy Recovery Center in Chandler, AZ 1 The facilities at Legacy Recovery Center in Chandler, AZ 3 The facilities at Legacy Recovery Center in Chandler, AZ 4 The facilities at Legacy Recovery Center in Chandler, AZ 5
2985 Brunswick Road Memphis TN, 38133
5.0
(1 reviews)
For over 55 years, Lakeside Behavioral Health System has been an addiction treatment center for adults. You'll find 'em located out in Memphis, Tennessee. Services include residential (IP), partial hospitalization (PHP), and intensive outpatient programs (IOP). They also offer medically supervised detox. The Patriot Support Program helps members of
Lakeside Behavioral Health System – Dual Diagnosis has no reviews yet. Leave a review.
427 W Eads Pkwy #1139 Lawrenceburg, IN 47025
1.4
(8 reviews)
They offer residential care providing long term support for addiction recovery, as well as flexible outpatient or online addiction therapy allowing patients to live at home while receiving regular treatment. Additional levels of care offered include relapse prevention and 12-step therapy. Specialty rehab programs at Community Mental Health Center I
They take the time to listen to you on what you have to say and they do what they thinks best for you
kristen greive
9 years ago
505 2nd St Vanceburg, KY 41179
They offer flexible outpatient addiction therapy allowing patients to live at home while receiving regular treatment. Specialty rehab programs at Comprehend Inc Lewis County CMHC include tailored care focusing on women’s specific needs and experiences and gender-specific addiction treatment addressing unique challenges faced by men.
Comprehend Inc Lewis County CMHC has no reviews yet. Leave a review.
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Does Medicaid Cover Methadone and Suboxone Treatment?

Federal Medicaid rules do specifically mention coverage of methadone treatment and other medications for treating opioid addiction. All Medicaid programs will cover medications for opioid use disorder including methadone, buprenorphine and naltrexone. They will also cover the other aspects of medication assisted treatment (MAT) such as counseling and therapy groups.

As with other drug rehab options it’s important to ensure the MAT program accepts Medicaid coverage before you commit to treatment.

Who Does Medicaid Cover?

Medicaid eligibility rules vary by state, but there are some commonalities. In general, Medicaid covers children, adults, and people of native origin. All Medicaid programs have income limits based on household size and some may have asset limits as well.

Every state has a Medicaid program for children. Your children may be able to qualify for Medicaid even if you can’t, which can help them get essential healthcare as they grow and attend school.

In many states you can qualify for Medicaid as a low-income adult without children. The Affordable Care Act offered funding to states that chose to expand their Medicaid eligibility. Many states chose to accept the funding. In those states you can qualify for Medicaid if your annual income is 138% or less of the federal poverty level. In some states, you can also qualify for Medicaid if you’re elderly or disabled and have a lower income.

Some states have a program that will allow you to get Medicaid if you’re the parent or caretaker of someone who gets Medicaid. To qualify, your income would need to be below a certain annual amount that the state determines.

If you’re an American Indian or Alaska Native, the same criteria for Medicaid eligibility applies to you as to people who aren’t tribal members. One important thing to note is that you don’t lose your IHS health services if you get Medicaid. You can still go to see the care team you know if they accept Medicaid coverage. With Medicaid, you’ll be able to get other health services as well, like drug rehab outside your IHS clinic.

How Can I Sign Up for Medicaid?

If you want to sign up for Medicaid, you need to follow the instructions specific to your state. Some states run their Medicaid programs themselves. Others rely on private companies to manage their benefits.

When a private company manages Medicaid benefits, it’s referred to as “managed Medicaid”. If you’re in a state that uses managed Medicaid, you might have to qualify for Medicaid through the state and then sign up for benefits with a company. You can find a state by state guide for how to sign up on the federal Medicaid website.

What Types of Inpatient Rehab Does Medicaid Cover?

When you focus fully on your rehab in a hospital or home like setting that’s known as inpatient or residential treatment. Medicaid generally covers this treatment when your doctor says it’s necessary. There might be limits to the length of stay or specific benefits depending on your plan.

Inpatient and residential treatment facilities often offer medical detox with medication assisted treatment (MAT), using FDA approved medications including methadone buprenorphine and naltrexone. MAT detox is usually done in an inpatient setting or residential setting when the patient is at risk for severe withdrawal symptoms or has other medical or mental health issues that might complicate treatment which makes the availability of 24 hour supervision and monitoring important.

Counseling and psychotherapy are usually part of inpatient or residential treatment. Medicaid covers evidence based therapies such as cognitive behavioral therapy, motivational interviewing, and dialectical behavioral therapy.

What Types of Outpatient Addiction Treatment Does Medicaid Cover?

Outpatient treatment that takes place in a facility that does not provide overnight stays is covered by Medicaid. This can include regular outpatient, day treatment, and intensive outpatient treatment. But services differ according to the HMO provider. MAT treatment delivered as outpatient detox or as ongoing withdrawal medication management during outpatient care are covered. Individual, group, and family counseling are covered if these are delivered using evidence based therapies. Keep in mind that Medicaid does not cover alternative or unproven therapy.

Your Medicaid plan will take care of health screenings to diagnose you and drug and alcohol testing while you’re in rehab. If you have a mental health diagnosis along with substance use Medicaid will cover integrated care that addresses both problems at once.

Depending on your plan and the state you might also be able to get case management services such as assistance finding housing and skills training to prepare for a job. Aftercare peer support that is offered through peer coaching services may also be covered, depending on your insurance plan.

Can I Travel Out of State For Treatment With Medicaid

Medicaid benefits are generally not transferable out of state except that hospitals are required by law to accept patients and provide medical services during an emergency situation where the patient’s life is at risk and travel to their home state for treatment would not be possible.

For non emergency out of state Medicaid coverage you would likely have to get a referral from your physician and an authorization from your insurance provider. This is rare so it’s best to find treatment providers within the network.

What Can I Do if Medicaid Won’t Cover the Cost of Rehab?

Medicaid generally covers the cost of rehab fully in programs that accept Medicaid coverage. If you find that your service is being denied you can appeal. States and individual Medicaid HMOs have different appeal procedures so it is a good idea to check with a lawyer or an advocacy organization if you need assistance.

If you want to attend a treatment program that doesn’t accept Medicaid you’ll need to find another way to pay. Fortunately there are a lot of options. Some treatment plans have a sliding scale where they charge you less if you need assistance. There could be SAMHSA grants or scholarships available from the rehab center.

Also, your family might be able to help you out. The focus is to get the care you really need because once you’re in recovery you’ll be far better able to manage your finances.

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