Does Medicaid Cover Addiction Treatment?

Posted on March 29th, 2021

  • What is Medicaid?
  • Medicaid Coverage Levels and Plans
  • Does Medicaid Pay for Substance Abuse Rehab?
  • Checking Your Insurance Benefits
  • Does Your Plan Cover Addiction Treatment?

Medicaid covers addiction treatment, but the amount of coverage depends on where you live and your coverage qualifications. This article discusses the types of Medicaid coverage and how they can help you get the care you need for substance use disorder (SUD). We also give you information about how to access your Medicaid benefits when you’re ready to take the first step on your path toward recovery.

Medicaid makes addiction treatment more affordable by offering insurance to low-income people based on specific eligibility requirements. Medicaid addiction treatment coverage includes long-term inpatient care, prescription drugs, and outpatient services.1

American Addiction Centers (AAC) strives to provide you with the most updated information on each carriers’ addiction insurance coverage, but policy changes and errors do occur. Please check with your insurance carrier directly to confirm coverage levels.


What is Medicaid?

Medicaid is a federal- and state-funded program that provides healthcare coverage to people who meet its income and other eligibility requirements. In most cases, you must qualify for Medicaid based on Modified Adjusted Gross Income (MAGI).2 This method determines Medicaid eligibility for children, pregnant women, and adults. If you are over age 65, you are exempt from MAGI rules.

If you have Medicare and Medicaid, Medicare pays first, and Medicaid pays second if the services are not covered.3 Different types of Medicaid also cover care for different people. The Medicaid Expansion CHIP, for example, covers healthcare for children.


Medicaid Coverage Levels and Plans

All states must cover certain medically necessary services for qualified people. Medicaid covers the following services as dictated by the Affordable Care Act (ACA): 4,5

  • Doctor visits
  • Inpatient care
  • Outpatient services
  • Mental health care
  • Prescriptions
  • Prenatal and maternity services
  • Preventative care

Substance use disorder (SUD) is included within these services. You can get coverage for these and other services based on your income needs. You can also get dual eligibility for Medicare and Medicaid in some circumstances to help you pay for additional services.3


Does Medicaid Pay for Substance Abuse Rehab?

Medicaid may or may not cover your full rehab treatment costs, but it can make treatment more affordable5 at rehab centers that accept Medicaid. Coverage includes:

  • Detox
  • Intervention
  • Screenings
  • Inpatient and outpatient care
  • Mental health services

Typically, you will have no co-payment for addiction treatment. However, some states do require a co-pay. There will be a maximum co-pay that cannot be exceeded.


Verify Your Benefits at an American Addiction Centers Facility

The cost of alcohol or drug addiction treatment may appear to be an obstacle, but we are here to help. Insurance may cover all or some of your rehab.

Find out if your insurance covers long-term addiction rehabilitation.

Check Online Now

Checking Your Insurance Benefits

When you sign up, Medicaid will send you information about your health coverage along with a directory of rehab centers that work with Medicaid. You can also verify your insurance benefits online or call the phone number on your insurance card.

To find state-specific coverage, visit your state’s official website. Log in and verify your coverage to find your details. You can also call American Addiction Centers and speak to one of our admissions navigators at +1 (888) 341-7785 . They can provide you with information about treatment coverage and answer any questions you have.


Does Your Plan Cover Addiction Treatment?

Find out how much your Medicaid plan covers before you enter drug rehab. Your coverage depends on your treatment needs, so you should talk to your rehab center for more information. AAC and other rehab centers often offer scholarships and financing if Medicaid doesn’t cover the cost. We can even help you talk to family members or friends about paying for treatment.

Medicaid makes it possible for many people to afford addiction treatment by making it affordable for those with low incomes. Your coverage may change based on where you go for treatment and where you live. Go online or talk to an AAC admissions navigator by calling +1 (888) 341-7785 to ask how we can help you get the treatment you need.


Sources

  1. Medicaid.gov. (n.d.) Benefits.
  2. Medicaid.gov. (n.d.) Eligibility.
  3. Medicaid.gov. (n.d.) Medicaid.
  4. Centers for Medicare and Medicaid Services. (2018.) Medicare and Medicaid Basics.
  5. Medicaid.gov. (n.d.) Behavioral Health Services.

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