The team at My Recovery works with addiction treatment programs across the United States. Our work with each individual rehab means we have done most of the research for you. Let us help you find a rehab in your area that accepts Medicaid benefits, where you can begin your treatment journey free of any stressors related to paying for rehab.
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An Introduction to Paying for Rehab With Medicaid
When someone decides it is time to seek addiction rehab, one of the biggest concerns they may have is how to pay for treatment. Depending on the type of treatment (outpatient, inpatient, etc.), duration of treatment and the types of services, location of the rehab, and amenities offered at the treatment center, the cost of addiction treatment can vary widely. Some people choose to forego addiction treatment due to concerns about the financial impact treatment may have. While treatment may have an associated cost, in the long run, it is far less costly than ongoing addiction in so many ways. Each year in the United States, there are thousands of people who struggle with addiction; however, only a small percentage of those will ever seek or receive addiction treatment. While there are several reasons for this, including fear and stigma, financial concerns surrounding the cost of treatment and how to pay for treatment play a significant role. There are many ways to pay for addiction rehab, including using Medicaid benefits. While not all rehabs accept Medicaid, many programs in each state do.
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Does Medicaid Pay for Drug Rehab?
Medicaid is a commonly used method used to pay for drug and alcohol treatment services. Medicaid is an insurance program funded through federal and state monies. Medicaid insurance programs can provide free or reduced-cost drug and alcohol addiction treatment for those who meet specific eligibility guidelines. While each state has different rules for treatment coverage and unique financial eligibility guidelines, Medicaid does cover addiction treatment for those who qualify. Some statistics show that nearly twelve percent of adults who receive Medicaid benefits have a substance use disorder, underscoring the need for addiction affordable addiction treatment services regardless of the ability to pay for private insurance. While not everyone will qualify for Medicaid, it is important to note that Medicaid guidelines change annually, so if someone in need of treatment has been declined benefits in the past, they may be eligible now.
Learning about insurance coverage
What Does Medicaid Cover for Rehab?
Most people are familiar with Medicaid insurance, but not everyone understands what it is and what benefits it provides. Medicaid is a public insurance program specifically for low-income families. Eligibility for Medicaid is determined based on elements related to household composition and household income. To be eligible for Medicaid (in most cases), applicants must be:
- Over the age of 65
- Under 19 years of age
- A parent (state-specific age guidelines pertain to the age of the “child” living in the home)
- Within a specific income eligibility bracket
Each state has its own unique rules for Medicaid eligibility, so even if someone meets income guidelines, they may not be eligible for benefits.
When the Affordable Care Act (also known as Obamacare) was passed in 2010, insurance providers were required to cover essential basic elements of drug and alcohol addiction recovery. In most states, Medicaid recipients who attend addiction treatment do not have required co-payments. For those states that do require a co-payment, there is an out-of-pocket maximum for anyone who is a Medicaid recipient attending rehab. Medicaid covers all or most of the following services while someone is enrolled in an addiction treatment program.
- Initial screenings and drug testing throughout the rehab and aftercare process (when necessary)
- Intervention services
- Medications to help reduce cravings and maintain sobriety during and after detox
- Family counseling services
- Inpatient care services provided at a hospital or residential treatment center
- Long-term residential treatment services as part of an inpatient addiction treatment program
- Detox services including medically assisted detox
- Outpatient visits (both after completing an inpatient rehab program or as part of an outpatient rehab program)
- Other mental health services including treatment of co-existing mental health conditions
How Long Does Medicaid Pay for Rehab?
Rehab is not covered by state insurance for most people. While Medicaid insurance does offer rehab coverage, there are restrictions and limitations on the type and duration of coverage provided, which are set forth by individual state policy. The Medicaid program is operated at the state level, and therefore, each state has its own unique eligibility requirements and offers varying coverage levels for addiction treatment services. In some states, limitations may be placed on services covered, whereas in other states, prior authorization may be required before services of any kind will be covered. The duration of covered treatment often varies by state and by service provided.
Medicaid Inpatient Rehabs
Medicaid covers inpatient rehab services in treatment centers across the nation. Most rehabs that accept Medicaid benefits provide services, including medical care and substance rehabilitation. Their programs include essential treatment services, including group therapy, individual therapy, 12-step meetings, nutritional services, and 24-hour care and monitoring in a structured, safe setting. Medicaid will generally cover both short and long-term inpatient programs. Most short-term programs last between three and six weeks, while most long-term programs last between six and twelve months.
Medicaid Outpatient Rehabs
Like inpatient options, outpatient programs that accept Medicaid insurance benefits are also available in most states. Outpatient rehab options provide a wide range of therapies in both group and individual settings. Programs often found in an outpatient setting include behavioral therapies (such as cognitive-behavioral therapy), skills development, support groups and meetings, psychoeducation, and in some cases, assistance with employment needs. Unlike inpatient rehab, patients in an outpatient setting do not live at the treatment facility. This means, outpatient rehabs sometimes offer different services due to the non-residential nature of the program. The team at My Recovery can help you determine if an outpatient program is suitable for your addiction treatment needs.
There are different types of outpatient programs covered by Medicaid benefits. These include intensive outpatient services and partial hospitalization programs. Medicaid covered intensive outpatient programs offer at least nine hours of therapy each week in sets of three-hour sessions. Several studies indicate this treatment model is similar in both service and effectiveness levels to that of inpatient and residential rehab programs. Partial hospitalization programs or PHPs provide rehab and addiction treatment for those who need care above that provided in traditional or intensive outpatient programs.
Medicaid partial hospitalization programs often require approximately twenty hours per week of treatment. These programs may also include vocational counseling, educational services and counseling, family therapy, medically supervised medication management, and treatment of co-occurring mental health disorders. Some intensive outpatient programs also offer similar services; however, the time commitment at a partial hospitalization program is greater, and the treatment model is designed to treat addictions of greater severity.
As with any insurance-covered service, Medicaid limits the amount of covered addiction treatment services in a calendar year. Understanding benefit limits can be challenging, especially since each person’s treatment needs and treatment program are unique. At My Recovery, we understand the challenges you may experience when trying to understand your insurance coverage. We can work with you to help you understand your benefit coverage and how you can use Medicaid to pay for addiction treatment at a rehab in your area that accepts Medicaid benefits.
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Find a Drug Rehab That Takes Medicaid
Struggling with an addiction to drugs or alcohol is challenging. Unfortunately, fear related to going to rehab and worry about paying for rehab often results in a reluctance to seek much-needed addiction treatment help. With so many different ways to pay for addiction treatment, there is something out there for everyone. Even if you do not have Medicaid today or have been denied in the past, eligibility requirements change each year. If you were not eligible in the past, you might be today.
At My Recovery, our team is here and ready to help you. We are ready to listen to your story so we can understand your needs and help you determine the right steps on your addiction treatment journey. The most important thing is to know that you have options when it comes to paying for rehab, and Medicaid benefits are one of those options. If you are a Medicaid recipient ready to seek addiction treatment services, contact My Recovery today. Let our caring and knowledgeable staff help you find a rehab near you that accepts Medicaid insurance benefits. There are various inpatient, outpatient, and partial hospitalization programs within each state that will work with Medicaid benefits.
Our goal at My Recovery is to help you find a program that meets your unique treatment needs, provides a treatment model that you are comfortable with, and a program that will work with your insurance. Ensuring all of these elements are met can help you start down the path to sobriety and recovery without the added stress of wondering if treatment will be successful or how you are going to pay for treatment. If you are ready to defeat addiction, contact My Recovery today. Let us help you find the best rehab near you.