Does Rehab Take Medicaid or Medicare

Yes, most rehab facilities take Medicaid and Medicare but with some stipulations. Each state has different rules for accepting funding for behavioral health services, drugs and alcohol addiction treatment. Generally, state-funded and federally-funded programs are required to provide coverage for behavioral health services due to the following acts passing:

• 2010 ACA (Affordable Care Act, aka “Obamacare”)
• 2008 Mental Health Parity and Addiction Equity Act (MHPAEA)

One state might accept parts of Medicare or Medicaid, and then require the client to pay the remaining balance out of pocket or use a supplemental or secondary insurance plan. 

An insurance verification calculator will determine if the drug abuse treatment facility accepts certain plans.

Do out-of-state rehab facilities take Medicaid or Medicare? 

Generally, the answer is yes, but again, acceptance varies from state to state.

Which Addiction Treatment Services Does Insurance Cover?

Since Medicaid and Medicare can be used to cover costs for a variety of preliminary, current, and aftercare services regarding addiction recovery addiction treatment services, such as the following:

• Medically assisted detox
• Inpatient
• Intensive outpatient program
• Medications
• Mental health services
• Screening
• PHP (Partial hospitalization programs)
• Doctor visits
• Dual diagnosis
• Interventions
• Medication-Assisted Treatment (MAT)
• Counseling

Additionally, some things like meds will be at a lower cost or completely free. Additionally, aftercare services like therapy and followup meetings will be covered as well.

Payment plans, scholarships, and loans are available for people who Medicaid or Medicaid cover the services they need 100%.

Medicare and Medicaid Insurance Verification 

Most rehab facility websites will have an insurance verification form for potential clients to fill out to check if their coverage will be accepted. Medicaid services usually offer private insurance and recipients will get a specialized insurance policy number. That number can be used to check if the insurance is in-network or out-of-network for each facility. The process involves calling and speaking with the treatment center or visiting their website to check. The cost will depend on the program needed on an individual basis. Some people might need a co-pay option if Medicaid and Medicare does not cover the services 100%.

Qualifications for Medicaid and Medicare

Each state has different eligibility rules for Medicare and Medicaid.

General Medicare qualification requirements:

• Over 65
• Spouses paid taxes for ten years or more
• Young people with disabilities

Medicare comes in four parts and they all cover different aspects of addiction treatment

• Medicare A – Cover the main parts of treatment from hospital stays to inpatient services
• Medicare B – Covers outpatient services, medication, and therapy
• Medicare C – Covers out-of-pocket costs
• Medicare D – Covers prescription meds

General medicaid qualification requirements:

• Above 65 years old (exempted from MAGI)
• Low income (Income has to be under the federal poverty level, or less than approximately $16,000 a year for one person up to a cap of $57,000 for nine people. The Max Annual Income requirement changes every year.)
• Pregnant women
• Kids, adolescents (under 19)
• Disabled persons (applicable for some states)
• Residents of the state they are receiving the benefits
• SSI (Supplemental Income) – mandatory eligibility group

Medicaid qualifications for the above groups (unless stated otherwise) depend on Modified Adjusted Gross Income (MAGI).

Can Veterans Use Medicaid?

Yes, many who receive VA services are also eligible to sign up for Medicaid and can use both for coverage.

Find Out If An Rehab Center accepts Medicare and/or Medicaid

It’s best to contact the facility or hit up an addiction treatment hotline to find out which ones will accept Medicaid and Medicare just to be sure.

The great thing is if you find a substance abuse facility that accepts medicaid and medicare, the majority of the care and services you receive will be free.

Medicaid and Medicare Resources

• Sign up for Medicaid
• Sign up for Medicare