Does Medicaid Cover Addiction Treatment

medicaid for addiction treatment

Why Do People Fail to Get The Ongoing Treatment They need

Can Medicaid help? Financial insufficiency is one of the primary reasons people fail to receive the treatment they need for ongoing substance abuse. Thanks to financial assistance made available by the federal government, you can finally get the help you deserve. That’s because, as of 2010, the Affordable Care Act enabled medical assistance to all individuals under 65. These qualification factors include anybody with a substance abuse disorder and applies to all fifty states. 

Though the approval process is subject to specific criteria, be encouraged knowing you are likely to be at least partially covered. The following details highlight everything you need to know about Medicaid as it pertains to addiction treatment and all the other qualifications in between.

What is Medicaid

Medicaid is a financial assistance program that allows lower-income families to receive high-quality medical assistance they couldn’t otherwise afford. Medicaid not only enables approval for a variety of top-notch services. It is also subject to treatment duration qualifications. This means, not only does it help you get the treatment you need, but beyond that, ensures you get the treatment you need for the length of time your recovery requires. These approvals are solely based on financial factors, as well as the severity of your substance dependency and other variables.

What do Recent Statistics Tell Us About the Need for Medicaid

In 2020, behavioral health in conjunction with substance use disorders, accounted for roughly 30% of its approved funding. That’s a significant chunk of individuals who would have otherwise struggled without it. In addition, roughly 12% of adult Medicaid users struggle with a substance abuse disorder.

The over 70 percent of US substance abuse treatment facilities that support Medicaid further exemplify national recognition of Medicaid’s importance. Couple that with the nearly 7,000 people per day who seek emergency substance-abuse-related support and you get a glimpse of the dire need on a national scale.

What Factors Help You Qualify for Medicaid Services

Medicaid services, though reserved for families of a lower-income bracket, take into account numerous individual factors as well. That’s why, making it above the income bracket for usual approval does not necessarily exclude you from qualifying for financial aid. Please note, the following qualifications are not set in stone and are subject to individual state and personal approval criteria. Bearing that in mind, here are some individual factors that help you qualify for Medicaid funding.

High Expenses

Depending on your state region, you could still be approved for Medicaid even if your income is slightly above the qualification threshold. That’s because local state living costs and expenses have unique criteria for meeting Medicaid guidelines. A Medicaid service rep will guide you through the application phase and inform you on what to expect throughout the proceeds.


Of course, one of the primary credentials that factor into the approval process comes down to your income. If your gross income is around the vicinity considered to be low income per state criteria, you’re likely to get swift approval. This may even help you qualify for a more lengthy treatment period than others. Apply now to see if you meet the criteria for swift approval for Medicaid.

Condition Severity

The severity of your substance abuse disorder plays a heavy role in determining both Medicaid approval and treatment duration. Individuals who possess a mild form of substance abuse disorder are less likely to receive treatment regardless of income. However, those struggling with addiction on a more severe scale are more likely to be approved pending financial screening.

Established Medical History

Your doctor is one of your greatest assets in getting approved for Medicaid. Officially documented medical history tells a detailed story of your substance abuse struggle. Any information that comes straight from a medical physician automatically trumps individual testimonies. That’s because your medical record confirms your testimony firsthand. If this describes you, speak to your doctor about a potential referral for Medicaid financing.

Does Medicaid Cover Medication-Assisted Treatment

All Medicaid programs offered by the state are required by local state laws to cover medication treatment options. Therefore, you can have assurance knowing, if approved, you’ll have all the medications you need to take the next step in your recovery. This includes but is not limited to doctor-prescribed medications, refills, and referrals. These coverages and the extent of which are adhered to strict physician approval.

Is Out-of-State Treatment Supported by Medicaid

Though Medicaid is normally reserved for treatment within your state of residence, there are some exceptions. However, these exceptions are only approved with the appropriate physician’s approval and documentation. Consult your physician if you require any special temporary out-of-state treatment needs to see if you qualify.

Can Former Military Service Members Get Medicaid Treatment

Medicaid treatment programs are available to all military veterans through special ex-military service programs. This wide range of treatment options is made available through the Department of Veteran Affairs. If you are a veteran, reach out to a VA representative to learn more about the Medicaid options you may qualify for.

Are Alcohol and Substance Abuse Disorders Covered?

Whether you have an alcohol or substance use disorder, Medicaid covers a wide range of drinking and substance treatment. This includes treatment costs, duration, partial hospitalization, or intensive outpatient care. These coverages would also include any related medications as deemed necessary by a medical physician.

How Much is Mental Health Treatment Covered by Medicaid

Medicaid goes beyond covering just alcohol or substance abuse struggles. Financing services are equally extended to anybody suffering from mental health conditions and their symptoms. Like substance or alco

hol use disorders, your mental health conditions can be partially or fully covered depending on your factors. Again, contributing factors depend on condition severity, medical history, treatment needs, and treatment duration.

Verify Your Insurance Coverage

The only way to know if and how much Medicaid you are qualified for is to verify your insurance coverage. Representatives at Casco Bay exert all their efforts to get the most out of your insurance by coordinating closely with your insurance provider. This includes consulting closely with your physician regarding your needs and medical history. The entire process considers your coverage, income, and your testimony of your mental health or substance struggles.

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