Does Medicaid Cover Substance Abuse Treatment

Paying for drug rehab with Medicaid and Medicare.

Medicaid and Medicare can help pay for detox, addiction medications, and inpatient treatment centers.

What Are Medicaid and Medicare?

Medicaid and Medicare are state-funded health insurance plans. These insurance plans can provide free or low-cost drug and alcohol addiction treatment. Each plan has different stipulations for eligibility.

Medicare Medicaid could cover all of your addiction treatment costs.

Rules and eligibility are different for every state, and rules change annually. So, if you were turned down in the past, you may be eligible now.

Medicaid for Drug and Alcohol Rehab

Medicaid is a low- income public insurance program. The 2010 Affordable Care Act “Obamacare” stipulates that insurance providers must cover all basic aspects of addiction treatment. Although Medicaid covers addiction treatment, not all addiction treatment centers accept Medicaid as a form of payment. You can find a rehab that accepts Medicaid at http://www.samhsa.gov/.

Medicaid Eligibility by Income

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.
As of 2015, the table below explains the maximum income level allowed for Medicaid eligibility.

Medicaid Income Eligibility

Family Size Max. Annual Income
1 $15,654.10
2 $21,186.90
3 $27,121.50

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

What Does Medicaid Cover?

In most states, Medicaid recipients don’t have co-payments for addiction treatment. There are out-of-pocket maximums set for Medicaid recipients in states that due charge co-payments.

Medicaid covers all or part of the following services:

• Intervention
• Screenings
• Family counseling
• Detox
• Outpatient visits
• Other mental health services
• Maintenance and craving medications
• Inpatient rehab
• Long-term residential treatment