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Paying for Rehab With Medicaid

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Paying for rehab is one of the biggest sources of anxiety for people who want to get treatment for substance use disorder. Getting help is more accessible when you have the ability to pay for the proper services.

However, drug addiction quickly funnels all your money away from essentials. In many cases, it destroys your ability to work and provide for yourself. Even those who have a career can find it difficult to cover the cost of rehab. That’s why federal- and state-funded health insurance programs are the primary source of coverage for millions.

Medicaid and Medicare both offer free or extremely low-cost substance use disorder treatment. However, each program has different limits and eligibility requirements.

Does Medicaid Cover Rehab?

Medicaid is a public health insurance program available in all 50 states for individuals with zero to low incomes. The 2010 Affordable Care Act mandates that all insurance providers cover the basic, core elements of alcohol and drug rehab services. However, private facilities are not legally obligated to accept Medicaid. They set their own terms regarding coverage, which means you’ll have to inquire with each facility to determine whether they accept Medicaid.

The Substance Abuse and Mental Health Services Administration (SAMHSA) has an easy-to-use directory of rehabs across the nation that offer Medicaid coverage. Medicaid addiction services may also vary from state to state. Public rehabs often have long waiting lists and limited care due to the high volume of clients.

A private facility that accepts Medicaid is often better equipped to provide you with the personalized level of care that you need and deserve. The journey to recovery starts with education and learning about all your coverage options. When you feel secure in your ability to pay, you’ll be able to free your mind from financial anxiety and focus fully on your recovery.

Substance Use Disorder Treatment Services Covered by Medicaid

  • Diagnostic screenings for substance use disorders
  • Intervention services
  • Medical detox (Granite Recovery Centers provides medical detoxification for people who do not need immediate medical intervention, are not a danger to themselves, and are capable of self-evacuation in the event of an emergency.)
  • Recovery maintenance medications such as methadone
  • Inpatient rehab
  • Outpatient rehab
  • Mental health, substance abuse and family counseling services

The broad level of coverage under Medicaid enables people to receive treatment no matter what stage of recovery they are in. Even those who simply need ongoing support for co-occurring mental illnesses or medication to manage cravings may benefit from Medicaid coverage.

However, there are specific eligibility requirements that must be met in order to receive help. Furthermore, the level of services available may expand depending on the specific rehab facility. For example, a private rehab may consider relapse prevention and aftercare part of their inpatient treatment, so, while under Medicaid, you can continually receive care after you have completed your program.

Medicaid Income Limits

Because Medicaid is for low-income individuals, there are income limits to ensure only those with the greatest need receive coverage. Medicaid offices determine eligibility based on your Modified Adjusted Gross Income (MAGI). Your MAGI is your annual income after adding back certain tax-based interests and deductions.

Each state sets its own limits for Medicaid, but the general standard is that an individual cannot earn more than $2,349 per month to qualify in 2020.

To apply for Medicaid online, visit the official website.

Medicare and Addiction Rehab Coverage

Medicare is a program for Americans 65 and older and anyone younger with qualifying disabilities. Medicare is not free, but the cost of the monthly premiums varies based on income. There are four types of Medicare, and each individual plan covers different aspects of substance use disorder treatment.

Part A is the premium-based plan. The premium goes toward a deductible per benefit period. Part A covers inpatient services such as residential rehab treatments. It can cover up to 60 days in care without coinsurance. It’s important to note that Medicare will only pay for 190 days of inpatient care during a person’s entire lifetime.

Medicare Part B covers outpatient services. The average Part B premium can sometimes depend on your income. Part B coverages may include outpatient rehab, counseling services and treatment for co-occurring disorders like depression, anxiety or bipolar disorder.

Medicare Part C is a private form of Medicare that you may opt for if you want to expand the coverage limits of your policy. Part C is a form of optional coverage, which means you’re responsible for paying the deductible, co-pays and any out-of-pocket costs.

Finally, Medicare Part D is another form of private insurance that covers prescription medications. If you require any medications to manage your cravings or mental illness symptoms, then you will need this type of coverage. Most people opt for all four types of coverage as doing so ensures that they have access to every phase and care service they may require.

Types of Rehab Medicaid Covers

If you are approved for Medicaid coverage, you can begin to explore your treatment options. Every state has some form of public substance abuse treatment, but there are also numerous detox centers, inpatient and outpatient rehabs, and independent counselors you may rely on during recovery.

The first stage of treatment for anyone who wants to achieve sobriety is detox. You should never attempt to detox alone due to the risk of overdose and potential side-effects from withdrawal. The more severe your substance dependence, the higher the risk of complications. In a detox center, you’ll receive care and support from licensed medical professionals. They can monitor your vital signs to ensure that your withdrawal is not causing any life-threatening conditions, and they can provide medication to improve your comfort. Detox is difficult, but supervision and medical intervention make it much easier to manage.

Rehabs that do not offer detox require clients to go through the process before they can begin any therapies. Medication maintenance and behavioral treatments are ineffective when a person still has an active chemical dependency. The length of inpatient and outpatient addiction treatments covered by Medicaid ranges from three weeks to a year. Your substance abuse severity and other conditions will impact the level of care and type of program professionals recommend.

Additional counseling can also be beneficial. Many people with a substance use disorder also suffer from a mental illness. Medicaid mental health services include inpatient psychiatric treatment, outpatient therapy, individual counseling and prescription medications like mood stabilizers and antidepressants. The level of Medicaid coverage for mental health is often more detailed and generous than those found with private health insurance providers.

How to Pay for Rehab

Once you apply for coverage, you’ll have to wait for approval through your local Medicaid or Medicare office. Once you’ve been approved, you’ll be mailed a card that you can provide to medical offices and rehabs. Some people have what is known as dual eligibility; they can receive both Medicare and Medicaid coverage for addiction treatment.

If you’re dual-eligible, then you can use benefits from either or both programs during your treatment. This may help offset the costs of care that you may not be able to otherwise afford.

What happens if you do not qualify for Medicaid? There are still some options to consider. First, there are state-funded public rehabs that offer low-cost or free detox and treatment services. However, these programs often have extremely long waitlists and may not be best for people with co-occurring disorders who need ongoing treatment. Rather than giving up, you should look for a private rehab that offers financing options.

Choosing the Right Rehab

Treatment for substance use disorder has to be personal. You need to feel like you’re in control and genuinely benefiting from the therapy you receive. Research is the most valuable asset at your disposal while you determine your wants and needs from a rehab. Many programs use a 12-step model that has helped millions, but you may not find this resonates with you.

Psychotherapies like cognitive-behavior therapy (CBT) and trauma therapy can help people who struggle with conditions like depression and PTSD. Many forms of therapy are also helpful for people without mental illness; they teach you how to communicate with yourself better, improve your thought processes, make better choices and cope with difficult emotions more productively.

Choosing a rehab that offers drug-specific treatment is also important. Granite Recovery Centers in New England offers a variety of treatments for alcohol use disorder, drug addiction, and emotional and mental health problems. They include anger management, trauma recovery, PTSD recovery and holistic programs.

All of our programs are rooted in our commitment to innovation, accountability and compassionate client-centered care. Unifying addiction treatment with mental health services allows us to create life-changing experiences.

The Granite Recovery Centers Approach

Using industry-standard addiction treatment with a personalized approach to care, we offer everyone who chooses our facility the opportunity to take control of their recovery. Rather than telling people how to live, we help them cultivate meaning and build skills that empower them to choose better for themselves.

In addition to a variety of detox and addiction programs, we offer long-term mental health care and sober living homes to help people prioritize their recovery and wellness. We connect our clients with local resources throughout New England to promote ongoing health and sobriety.

Our facilities are all in close proximity to one another among various states in the northeast. Our clients come to us from throughout New England and other parts of the country. We have 12 independent alcohol and drug rehabs throughout New Hampshire that make treatment accessible and dynamic for everyone who needs them. Our evidence-based therapies are coupled with compassion and support from experienced doctors and psychotherapists.

Furthermore, we’ve developed our own comprehensive 12-step treatment program that guides every client through the earliest, most challenging aspects of recovery. By combining our approach with individual counseling and healing activities, we offer a program that delivers transformative results and a lifetime of support.

Paying With Medicaid at Granite Recovery Centers

Our recovery centers began to accept Medicaid in 2019, and we’ve expanded our coverage since. You can contact our facilities at any time to ask about paying for coverage, the cost of treatment and how Medicaid goes toward your own program. If you’re inquiring for a loved one, we also provide 24/7 support to help you learn more about our services and staging an intervention.

Granite Recovery Centers wants to support the entire family through the recovery process. Guiding you through the technical aspects of rehab, such as paying for treatment, is only the beginning. Our continued care provides support and answers for all the questions that you have and will develop over the course of treatment. Reach out to us at any time to learn more and start healing.