Screenings are used in order to determine if someone has a problem with drug or alcohol abuse. During this process, medical professionals use interviews or self-reports to determine if treatment will be needed.
Twelve percent of people on Medicaid aged 18 and over have a substance abuse disorder. (Source: Centers for Medicare and Medicaid Services)
Medication assisted treatment decreases the health care costs for Medicaid recipients by 33 percent over three years. (Source: Center for Medicaid and CHIP Services)
Fifteen percent of newly-eligible Medicaid recipients are struggling with an addiction.(Source: Centers for Medicare and Medicaid Services)
For every $1 Medicaid spends on methadone treatment, it generates around a $5 return on investment. (Source: Centers for Medicare and Medicaid Services)
In 2009, substance abuse disorders cost health insurance payers $24 billion dollars. Medicaid paid for 21 percent of that amount. (Source: Center for Medicaid and CHIP Services)
Among both Medicaid and non-Medicaid recipients aged 12 to 17, 10.1 percent use illicit drugs. (Source: Centers for Medicare and Medicaid Services)
Generally speaking, rehabs accept Medicaid for a variety of pharmacological and counseling-related substance abuse treatments. The following are some of the services the agency covers.
Screenings are used in order to determine if someone has a problem with drug or alcohol abuse. During this process, medical professionals use interviews or self-reports to determine if treatment will be needed.
Health care professionals perform assessments in order to obtain a detailed picture of the patient’s situation and create a treatment plan that is appropriate for them. This is done by conducting interviews with the person seeking treatment, as well as family members and significant others. When the process is complete, decisions are made about the level of care they should receive, and also what additional support will be needed after they’re discharged from rehab.
Residential treatment is for patients who will benefit from having their daily routine and patterns disrupted by receiving care in a safe, structured environment where help is available 24 hours a day. Patients who receive residential services get psychotherapy combined with medication-assisted treatments. In addition, peer support, crisis stabilization, case management, and relapse prevention services may be available.
Patients who get intensive outpatient treatment are required to receive services for around six to 19 hours each week—which could be during the day, evening, or weekends.
Partial hospitalization, or day treatment, refers to clinically intensive treatment that is provided at least twenty hours per week. This rehab is for people who don’t require services 24 hours a day, but will not get the best health outcomes with outpatient care. In these programs, patients receive daily monitoring to track their progress as they participate in medication management and group, individual, or family therapy.
Medication-assisted treatment is part of any holistic substance abuse treatment, as it allows patients to stabilize physically while they confront their addiction psychologically and emotionally. To that end, medications are chosen based on the substance patients abused, how long they used the substance, and what other health challenges they may be dealing with. Drugs that may be used for this treatment include methodone, naltrexone, disulfiram, buprenorphine, and acamprosate.
Every patient getting addiction treatment has individual objectives for success, and individual counseling is designed to address them. During this time, co-occurring mental illness is treated, problem-solving and coping skills are developed, and emotional and psychological trauma is tackled.
Group counseling provides patients with an opportunity to practice social interactions that don’t revolve around using drugs or alcohol while getting support from their peers. People in group therapy share their personal experiences and give each other feedback so they can each gain the skills they need to adapt to a sober lifestyle.
Family behavior counseling focuses on how a patient’s home environment can be improved to foster sobriety. This therapy may include parents, children, siblings, spouses, cohabitating partners, or extended family members like grandparents or cousins. During these sessions, each member of the family gains insight on how they can change their behavior to promote harmony and healthy relationships in the home, while helping their loved one remain clean and sober.
This type of therapy is designed to solidify a patient’s desire to change and give them the motivation to take steps needed for a clean and sober lifestyle. During these sessions, therapists help patients embrace a plan to change their behavior and teach them the skills they need to handle any temptation that arises.
The goal of cognitive behavioral therapy, or CBT, is to produce long-lasting change by tackling the maladaptive thoughts and behaviors that contributed to patients’ drug or alcohol abuse. Patients learn how to identify situations that put them at risk of substance use, recognize when they’re having cravings before they succumb to them, and utilize coping strategies when triggers arise.
Patients who need treatment for an addiction can qualify for Medicaid by meeting one of the following criteria:
Although it may seem daunting to find drug rehab centers that accept Medicaid, patients can get help locating facilities that will meet their needs. Some of the ways people can do this is by:
According to the Centers for Medicare and Medicaid Services, the opioid epidemic has had a disproportionate effect on those who receive these benefits because Medicaid patients are two times more likely to receive prescription painkillers than those who are not Medicaid recipients. As a result, the agency has created initiatives to solve the problem, which include increasing the use of naloxone, which is designed to prevent opioid overdoses; improving opioid prescribing practices; and expanding overdose prevention education.
Those who need treatment for alcohol and drug abuse can get help paying for their services through a variety of non-Medicaid sources. The following are some of these options, which include government programs that help with treatment, funding agreements that can be made directly with a specific rehab facility, and steps an individual can take on their own to obtain money for a rehabilitation program.
Just as Medicaid recipients can receive treatment for addiction to drugs or alcohol, people eligible for Medicare—those who are disabled or 65 years old and above—can get the help they need on an inpatient or outpatient basis. For those who need inpatient care, Medicare will pay for 190 days spent in a psychiatric hospital for substance abuse treatment. Medicare recipients who need outpatient treatment for addiction can receive a variety of services, including an assessment, a brief intervention, methadone therapy, and counseling.
Another option for those who may not be able to afford drug and alcohol treatment is to enter a state-sponsored program. In some cases, these rehabs are free of charge, while other facilities may require a nominal payment compared to what they would be charged in private rehabilitation centers. In order to qualify for treatment through a state-funded rehab program, patients may be required to provide proof of state residency, income, and legal status, as well as have a discussion with the facility about the nature of their addiction.
State-sponsored rehab programs can be found on the Substance Abuse and Mental Health Services Administration’s Directory of Single State Agencies (SSAs) for Substance Abuse Services.
Access to Recovery Voucher, or ATR, is a federally-funded program that was created in order to provide low-income individuals with access to the rehab of their choice—based on which facilities in their area are participating in the program—for 90 days. Through this program, patients can receive inpatient or intensive outpatient treatment, as well as counseling. In addition, Access to Recovery subsidizes services that facilitate patients’ ongoing sobriety, including continuing care, vocational training, transportation assistance, life coaching, legal services, employment coaching, childcare services, spiritual support, recovery checkups, and basic needs like food and clothing.
In order to qualify for an ATR voucher, patients must be a minimum of 18 years of age, make an annual income that is 200 percent below the federal poverty level, live in a county that provides ATR services, and have a history of substance abuse. ATR programs can be found through the Substance Abuse and Mental Health Services Administration.
Treatment for drug addiction can be expensive, but that doesn’t mean people who are low income cannot get the help they need. Those who qualify for Medicaid are able to receive many of the same addiction treatment services as those with private insurance. This page includes information on the services provided by Medicaid, as well as how to find rehabs that take Medicaid and utilize other payment methods to get this vital treatment.