Does Medicaid Cover Alcohol Or Drug Rehab?

Finances and expenses are a common source of stress for those suffering from a substance use disorder. The potential cost of treatment programs acts as a barrier to entry, keeping those who would benefit tremendously from professional care away from addiction treatment providers.

However, the federal program Medicaid may, depending on your situation, pay for part or all of your alcohol or drug rehab costs.

What Is Medicaid?

Medicaid is a joint federal and state insurance program that provides health coverage for millions of financially vulnerable, low-income Americans. This includes children, pregnant women, parents, seniors, and individuals with disabilities. 

Medicaid is the single largest provider for health coverage in the United States currently, with over 74 million Americans enrolled in their state’s Medicaid or Children’s Health Insurance Programs (CHIP).

Medicaid is often confused with Medicare, a similar government program that provides coverage for people who are older or disabled, rather than those with limited income and resources.

What Addiction Treatment Services Does Medicaid Cover?

According to the Affordable Care Act (ACA) of 2010, all insurance providers, including Medicaid, must cover basic aspects of drug and alcohol addiction treatment, in part or in full, including:

• screenings
• interventions
• detox
• medications, including buprenorphine and methadone
• inpatient care 
• outpatient treatment
• long-term residential treatment
• family counseling
• other mental health services

However, not all treatment facilities accept Medicaid as payment for services rendered. 

You should confirm with your chosen treatment center or use the Substance Abuse and Mental Health Services Administration (SAMHSA) treatment locator before enrolling in a treatment center with Medicaid coverage.

Unfortunately, because Medicaid programs vary so much from state to state it’s hard to summarize what any particular Medicaid coverage will or will cover in regards to substance abuse treatment.

Check with your particular state’s program to learn more.

How Do I Qualify For Medicaid?

Financial eligibility for Medicaid is determined using your Modified Adjusted Gross Income (MAGI), or your household’s adjusted gross income.

Because states jointly fund and operate their programs with the federal government, and because certain states expanded Medicaid under the ACA while others did not, Medicaid eligibility requirements vary depending on where you live.

As a general rule, those who are pregnant, elderly, disabled, are a parent/caretaker, or are underaged qualify if their MAGI is 100% to 200% of the federal poverty level (FPL), which in 2021 was $17,420 for a family of 2. 

If you make less than 133% of the FPL, you may also qualify depending on your state.

You must also be a resident of the state you are applying in and must either be a citizen of the United States or a qualified non-citizen.

What Does Medicaid Cost?

Medicaid is designed to be a low-cost health plan. Out-of-pocket costs for Medicaid participants often include copays, coinsurance, and deductibles which vary from state to state and often according to a participants income level.

How Do I Apply For Medicaid?

If you are eligible for Medicaid according to your state’s requirements, you may begin the enrollment process at any point using your state’s Medicaid website or the federal health insurance marketplace HealthCare.gov. 

You can also print out paper applications and mail, fax, or return them directly to local government offices.

What You Need For A Medicaid Application

To complete your application for Medicaid you will need to provide certain evidence of your identity and financial status, which may include:

• your birth certificate or driver’s license/state id
• proof of address, often done using utility bills in your name
• current pay stubs or tax returns
• bank statements
• medical records

Find Covered Treatment Today

Ark Behavioral Health is a highly qualified and accredited network of rehab centers located in Massachusetts. We accept a wide range of insurance coverage, including Medicaid, and provide personalized alcohol and drug abuse recovery services that include:

• medical detox
• inpatient treatment
• outpatient programs, including intensive outpatient services
• support groups
• behavioral therapy
• aftercare

If you or a loved one struggles with a substance use disorder and are interested in learning more about your potential treatment options, please contact a representative today.