Does Medicaid Cover Rehab?

According to recent surveys, over 23 million people in the United States will struggle with addiction to drugs or alcohol this year alone. Of those individuals, only 1 in 10 will receive the substance abuse treatment they need to reclaim their lives and commit to sobriety.

Far too often, a person struggling with substance abuse feels they cannot get the help they need because of cost. While it can be overwhelming to navigate any medical treatment payment on your own, there is hope. In fact, with coverage from the right health insurance program, your preferred addiction treatment programs might be more affordable than you think.

If you have Medicaid insurance and don’t know if you can afford substance abuse treatment, you will be happy to know that rehab is definitely a budget-friendly possibility for you. At Skypoint Recovery Ohio, we accept Medicaid and most major insurance plans. This is part of our commitment to ensure that money never stands in the way of your recovery.
Read on to learn about whether Medicaid covers rehab – and how you can afford substance abuse treatment today.

What is Medicaid?

Medicaid is a government-funded public health insurance program for adults below a certain income level in the United States. 1 in 5 Americans actually benefits from Medicaid coverage, and it is a guaranteed opportunity for federal dollars to support local hospital treatment across the country. This is also intended to help individuals access healthcare who otherwise would have no access to health insurance.

While Medicaid was first implemented in 1965, the program has evolved over time. It was initially designed as cash support for required medical care to those who qualify for Medicaid, but now both the qualifications and the payout have shifted. Interestingly, Medicaid is also the largest payer for mental health services in the nation.

Since its inception, Medicaid dollar distribution has been translated to state-based stipulations. This means the eligibility requirements of both federal and state-based Medicaid programs must be met to receive Medicaid coverage. The federal Medicaid conditions are that you must either be younger than 19 or older than 65, or be a current or expecting parent. Then there are several other expectations, based on which state you live in.

Paying for Addiction Treatment

The passing of the Affordable Care Act (ACA) in 2014 was the greatest impetus for change in substance abuse treatment coverage. Thanks to this law, substance use disorders (SUD) are now recognized as pre-existing mental health disorders, which requires all health insurance providers to offer some form of financial coverage for addiction treatment facilities.

The exact type of treatment that is covered by each health insurance plan will vary based on whether you have private, employer-subsidized, or government-funded insurance. But you can guarantee the following will be covered under the requirements of the ACA:

• Your intake evaluation for care and any formal interventions that may place you in care
• Medication-assisted treatment for addiction, along with regular drug and alcohol testing
• Family counseling and other mental health services
• Clinical visits for your physical health throughout substance abuse rehab

For any treatment options that are not included in your insurance plan coverage, there are health parity and addiction equity laws. These are federal restrictions that prohibit insurance companies from overcharging a person in need of a substance abuse rehab center and other mental health services. As a result, you should only have a copay of as little as $1.00 per treatment in addiction recovery.

Does Medicaid Cover Rehab?

It’s important to know the additional requirements you must meet to be eligible for Medicaid in each state before you consider using Medicaid insurance to cover your substance abuse treatment. For example, in Ohio, where Skypoint Recovery is located:

• You must be a legal immigrant or U.S. citizen.
• You must be over 64 years of age.
• You must have a physical disability or care for a physically disabled dependent in your home.
• Your children must live at home and be under the age of 18.
• Your pre-tax household income must be under $23,000 (assuming there are two primary wage earners in your home).

Just as there are limitations to Medicaid coverage based on which state you are in, so also there are limits to Medicaid benefits for substance abuse. These mainly have to do with the amount of time you can spend in residential treatment before your copay increases.

Inpatient treatment programs covered by Medicaid should last between 30 and 60 days. You should only attend group therapy or individual therapy for up to 30 hours per week. But there are little to no rules for eligibility and treatment if you can attend outpatient treatment for your battle with addiction.

You also might be able to use Medicaid as secondary insurance on top of your primary plan. It’s also important to note that not all addiction treatment centers will accept Medicaid as a form of payment for substance abuse services. If you have questions or need help navigating a clear payment plan for your individualized treatment needs, don’t hesitate to call Skypoint Recovery Ohio today!

What to Expect in Addiction Treatment Programs

The hardest part of battling addiction to drugs or alcohol is admitting you need help. As soon as you are ready to admit you can’t end your cycle of substance abuse alone, our addiction specialists are ready to walk you through the rest.

Our individualized care at Skypoint Recovery Ohio begins with one phone call. We’ll ask you a few specific questions to better understand your personal struggle with substance abuse. Then we’ll connect you to the right combination of medical detox and mental health services to help you end your cycle of addiction for good.

Recovery from substance abuse is a lifelong commitment, which means Skypoint Recovery also understands the importance of offering you support and community even after you have finished inpatient or outpatient treatment services. That is why we also provide a sober living facility and access to job placement services at our location in Akron, Ohio. With the assistance and guidance of our team at Skypoint Recovery, we believe you can start and stay committed to your journey toward recovery.

The Skypoint Recovery Difference

As one of the largest cities in the state of Ohio, Akron is known for its diverse art scene and beautiful historic buildings. But when you choose the road to a sober life at Skypoint Recovery, you will get to enjoy the quiet and peaceful side of Akron culture.

At Skypoint Recovery, we will help you get away from the noise and chaos of your daily life so you can focus on your individual mental and physical needs. It starts with a phone call, and then we help you through every step of your addiction recovery process. We are even there for you after you transition back to your daily life outside of addiction treatment through services like our sober living community and job placement program. Through it all, our main goal of Skypoint Recovery substance abuse treatment is to help you take control of your life again!

Contact Skypoint Recovery today to learn how we can best help support you on your journey toward rehabilitation.