Medicaid for Drug Rehab

Medicaid, like Medicare, is a government health insurance program. This program is available for low income individuals and families; individuals whose resources are not sufficient enough to pay for proper healthcare. Medicaid is the largest source of funding for health and medical services for low income individuals and families in the United States. Each state has its own parameters for determining eligibility and coverage. States are not required to participate in this program, though all of them currently are. Currently, Medicaid will change starting January 1, 2014. Under the new law, citizens and families making up to 133% over the poverty line will qualify for coverage in any Medicaid participating state. The United States Supreme court ruled that states do not have to agree with this expansion in order to continue to receive Medicaid funding (National Federation of Independent Business  v. Sebelius). As Medicaid is a health insurance program, it is possible that Medicaid cover drug rehabilitation treatment services.

Medicaid Qualifications

Qualifications for Medicaid vary from state to state. All states, though, cover mental health treatment. Guidelines for drug abuse treatment fall under the same as those for mental health, and conditions such as depression and schizophrenia may be covered under this program. It is imperative that you contact the Medicaid office in your state to find out more details about the qualifications, if you are seeking drug treatment services.

Medicaid covers inpatient treatment for drug rehabilitation if a physician or other treatment provider deems it appropriate. In example, for conditions such as suicidal tendencies or psychosis as a result of drug abuse, a physician may see inpatient detoxification and treatment as a medical necessity, in which case they will write out their recommendation to be presented to the Medicaid office and any other relevant service provider.

Outpatient treatment falls under the same stipulations as outpatient mental health services. Though the exact degree of coverage varies from state to state, a wide range of services might be covered. These services include, but are not limited to:

  • Group counseling
  • Individual Counseling
  • Marriage Counseling
  • Educational programs
  • Family Counseling
  • Case Management
  • Social Services

Medical treatment related to drug abuse may also be covered under Medicaid and outpatient programs, such as self-help groups (Narcotics Anonymous) are also possible coverage options.  In regards to the various treatment centers, it is important to ask that a particular program fits the needs of the person requesting services. Some centers offer only in or outpatient programs, some hospitals offer inpatient – especially in cases where the person needs to be medically supervised during detoxification. Some centers offer mental health and substance abuse treatment and others. Before choosing a center, make sure its services meet the needs of the person or Medicaid might not cover the costs.

There are many centers that do not accept Medicaid, so anyone hoping to have Medicaid cover costs of rehab might have a tedious task. Call us and we will be happy to do all the legwork for you.  We can provide you with a list of programs that accept Medicaid. 

Some states may require a copayment for drug treatment services. In Florida, for example, drug rehabilitation treatment does qualify under Medicaid, but a $2 per day copayment is required for coverage. For more information on State Medicaid on things such as reimbursement and coverage limitation, contact your state Medicaid office.

If you already have Medicaid and are looking for help, call one of our licensed counselors at 1-888-540-2776 to receive a customized and confidential referral to a drug rehab that takes Medicaid.

Drug Rehabs that Take Insurance

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