What Is Medicare and Medicaid?
Depending on the type of addiction treatment you recieve, many addition treatment centers that accept medicare or Medicaid will have offerings for those needing treatment. These are federal or state-funded health insurance programs that help individuals who don’t have health insurance get the coverage they need. Thes programs can help those who are unable to afford treatment get additional help from state and federal programs. Each treatment programs though often has different requirements for eligibility.
Medicaid & Medicare Rehab Coverage
Medicaid is public insurance provided provided by the government to help low income families afford treatment. Under the Affordable Care Act (ACA), known as “Obamacare,” insurance providers must provide coverage to those facing drug and alcohol addiction. While Medicaid offers coverage of addiction, not all facilities accept Medicaid as a form of payment.
Medicaid Drug Rehab
A drug rehab that is covered by medicaid will often utilize the most effective evidence based treatments when treating addiction. Most Programs will incorporate Holistic addiction treatment, evidence based care and SMART recovery philosophies to create an individualized treatment for clients. Often drugs and alcohol are not the core issue of addiction, there is usually a root cause that makes people use substances. Most drug rehab programs covered by medicaid will incorporate therapy and treatment to teat the core causes of addiciton.
Medicaid Outpatient Treatment Center
Often times those with medicaid are highly dependent on their jobs so they can support themselves and their family which mean they may not get the chance to go to a residential facility. Medicaid outpatient treatment centers allow those with busy schedules to seek treatment on a part-time basis so they can still manage their responsibilities like work, school, and family whilst also going through recovery. These outpatient treatment centers will often use a variety of evidence based practices like one on one therapy, dual diagnosis treatment, and motivational therapy to help empower those and help them find lasting recovery.
Often times detox centers will provide coverage options for medicaid so those who are facing physical dependency can rid their body of the dangerous chemicals of substance abuse. Detox centers that take medicaid are often extremely good at helping clients overcome physical addiction by helping them work through their withdrawal symptoms in a safe secure environment. By doing this, clients can be sure that detoxing from drug or alcohol won’t encounter dangerous complications when trying to quit alcohol. Another benefits of seeing a detox center is that they offer clinical and expert support for after the detox so you can be guided into the best treatment options for your specific needs.
Medicaid Eligibility by Income
To be eligible for Medicaid, applicants must be one of the following:
- > 65 years old
- < 19 years old
- 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|
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?
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. Medicaid covers all or part of the following services:
- Medication Management
- Family therapy
- Inpatient care
- Long-term residential treatment
- Outpatient therapy
- Other mental health services
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. While there are other options to pay for treatment (personal loans, credit cards, private health insurance, paying for treatment with Medicare or Medicaid is another option for those who are struggling to cover the costs.
|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.|