What Are Medicaid And Medicare?

Some of the most commonly used methods for paying for drug and alcohol rehab, Medicaid and Medicare are federal- and state-funded health insurance programs. These insurance programs can provide free or low-cost drug and alcohol addiction treatment. Each program has different requirements for eligibility.

Medicare and Medicaid may cover part or all of your substance abuse treatment costs.

Every state has different rules for eligibility and treatment coverage. Rules for eligibility also change annually. If you were turned down for Medicaid or Medicare in the past, you could be eligible now.

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Medicaid For Drug And Alcohol Rehab

Medicaid is a public insurance program for low-income families. Under the 2010 Affordable Care Act (ACA), also known as “Obamacare,” insurance providers (including Medicaid) must cover all basic aspects of drug and alcohol dependency recovery. While Medicaid covers substance abuse treatment, not all facilities accept Medicaid as a form of payment. To find a recovery provider that accepts Medicaid, get in touch with the Substance Abuse and Mental Health Services Administration (SAMHSA). Additionally, individuals can find a directory of rehabs and insurance providers here to aid in the search for local treatment centers and centers throughout the country.

Featured Centers Accepting Medicare and/or Medicaid

Medicaid Eligibility

To be eligible for Medicaid, applicants must be one of the following:

  • Over 65 years old
  • Under 19 years old
  • Pregnant
  • A parent
  • Within a specified income bracket

In some states, Medicaid covers all adults below a certain income level. Those who receive Supplemental Security Income are often automatically eligible for Medicaid.

The ACA requires people to earn less than 133 percent of the federal poverty level (FPL) to be eligible for Medicaid. A person living above the poverty level may still be eligible for government insurance if they fall in the right income bracket.

Even if someone meets income requirements, they may not be eligible for Medicaid. Each state has its own rules for Medicaid eligibility.

What Does Medicaid Cover?

Medicaid recipients don’t have co-payments for addiction treatment in most states. For states that charge co-payments, there is an out-of-pocket maximum set for Medicaid recipients. For more information on financial assistance options for treatment centers, click here to contact a treatment provider.

Medicaid covers all or part of the following services:

  • Screenings
  • Intervention
  • Maintenance and craving medications
  • Family counseling
  • Inpatient care
  • Long-term residential treatment
  • Detox
  • Outpatient visits
  • Other mental health services
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Medicare For Drug And Alcohol Rehab

Medicare is available to anyone over 65 years old and those with disabilities. Medicare is available for a monthly premium, which is based on the recipient’s income. People who earn less pay lower premiums.

Medicare can cover the costs of inpatient and outpatient drug rehabilitation. It consists of four parts that cover different parts of addiction recovery programs.

The Four Parts of Medicare
Part A Insurance for Hospital Stays. Medicare Part A can help pay for inpatient rehabilitation. Part A covers up to 60 days in treatment without a co-insurance payment. People using Part A do have to pay a deductible. Medicare only covers 190 days of inpatient care for a person’s lifetime.
Part B Medical Insurance. Part B can cover outpatient care for addicted people. Medicare Part B covers up to 80 percent of these costs. Part B covers outpatient care, therapy, drugs administered via clinics and professional interventions. Part B also covers treatment for co-occurring disorders like depression.
Part C Medicare-approved Private Insurance. People who want more benefits under Medicare can opt for Part C. Out-of-pocket costs and coverage is different and may be more expensive.
Part D Prescription Insurance. Medicare Part D can help cover the costs of addiction medications. People in recovery often need medication to manage withdrawal symptoms and cravings. These medications increase the likelihood of staying sober.

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Dual Eligibility

A person can be eligible for both Medicaid and Medicare. If someone is eligible for both, they can apply benefits from each program to their treatment. If you are over 65 or disabled, you may be eligible for both programs.

If you don’t have Medicaid or Medicare, contact a caseworker in your state. He or she can determine if you’re eligible for Medicaid or Medicare.

If you are eligible, the caseworker will walk you through the application process. Or, if you already have Medicaid or Medicare, you can find a drug or alcohol rehab facility on the SAMHSA website.

For more information about available recovery options, contact a treatment provider.

Published:

Author

Jeffrey Juergens

Photo of Jeffrey Juergens
  • Jeffrey Juergens earned his Bachelor’s and Juris Doctor from the University of Florida. Jeffrey’s desire to help others led him to focus on economic and social development and policy making. After graduation, he decided to pursue his passion of writing and editing. Jeffrey’s mission is to educate and inform the public on addiction issues and help those in need of treatment find the best option for them.

  • More from Jeffrey Juergens

Reviewed by Certified Addiction Professional:

David Hampton

Photo of David Hampton
  • David embarked on his journey into sobriety in June of 2005, which led him to his current career path as a Certified Professional Addiction Recovery Coach in private practice in Greater Nashville. David is also a public speaker and the author of two books. David is cohost of the weekly Positive Sobriety Podcast, as well as being a frequent contributor to various articles and recovery based materials. As a member of the National Association of Alcohol and Drug Abuse Counselors (NAADAC), David works closely with area treatment centers, recovery orientated nonprofit organizations, as well as being a keynote speaker for various recovery-focused events.

  • More from David Hampton

Sources

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Gifford Street Comprehensive Treatment Center

New Bedford , MA

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Serenity Mountain Recovery Center for Women

Waymart , PA

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Central Jersey Comprehensive Treatment Center

Cliffwood , NJ

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White Deer Run

Allenwood , PA

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Coatesville Comprehensive Treatment Center

Coatesville , PA

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Bowling Green Brandywine

Kennett Square , PA

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MeadowWood Behavioral Health

New Castle , DE

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Cove Forge Behavioral Health Center

Williamsburg , PA

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Harbor Oaks Hospital

New Balitmore , MI

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Lynchburg Comprehensive Treatment Center

Lynchburg , VA

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Ohio Hospital for Psychiatry

Columbus , OH

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New River Comprehensive Treatment Center

Galax , VA

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Life Center of Galax

Galax , VA

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Madison East Comprehensive Treatment Center

Madison , WI

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Beloit Comprehensive Treatment Center

Beloit , WI

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Rebound Behavioral Health Hospital

Lancaster , SC

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