We know rehab can be expensive. In this article, we lay out some ways to find affordable addiction treatment, including Medicaid rehab.
Does Medicaid Cover Rehab?
Under the Affordable Care Act (ACA), Medicaid must cover essential health benefits, including addiction treatment and mental health services. However, since Medicaid is a state-administered program, the exact extent of Medicaid rehab coverage will depend on where you live.
According to Medicaid policy guidelines, Medicaid addiction treatment must cover:
- Medication-Assisted Treatment: This is the use of special medications to treat SUD’s like opioid addiction. MAT drugs covered include methadone, buprenorphine, and naltrexone. Every state will cover buprenorphine and naltrexone; methadone is covered in 42 of 53 states and territories.
- Some form of counseling: There is flexibility here, but generally, all state Medicaid plans will cover some form of individual and group therapy.
Within the state of New Jersey, Medicaid rehab services include:
- MAT
- Inpatient Treatment (including for co-occurring mental health issues)
- Outpatient Treatment
- Withdrawal Management
Medicaid is often not accepted by private treatment providers for various reasons. The Medicaid program has made efforts to improve Medicaid acceptance.
What Does Medicaid Cover?
Medicaid rehab will generally include the following:
- Screenings
- Intervention
- Maintenance and craving medications
- Family counseling
- Inpatient care
- Long-term residential treatment
- Detox
- Outpatient visits
- Other mental health services
Medicaid rehab recipients generally 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. For more information on your Medicaid rehab coverage, call a treatment provider today.
Who Qualifies for Medicaid Rehab?
Medicaid addiction treatment eligibility varies by state but generally includes:
- Low-income individuals and families
- Pregnant women
- People with disabilities
- Children and young adults under the Children’s Health Insurance Program (CHIP; known in New Jersey as NJ FamilyCare)
- Some seniors who qualify for dual Medicare-Medicaid coverage
- Those under 19 years of age
- Single parents
Per the ACA, to be eligible for Medicaid addiction treatment, you must have an income 133 percent or more below the federal poverty line. A person living over the poverty line may still be eligible for government insurance if they fall into the appropriate income group.
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How to Find a Rehab That Accepts Medicaid
There are several resources available to help you find a New Jersey treatment center that provides Medicaid rehab.
These include:
- New Jersey Substance Use Treatment Directory: The New Jersey Division of Mental Health and Addiction Services (DMHAS) provides a comprehensive, searchable directory of licensed substance abuse treatment facilities. You can filter by location, type of service, and payment options, including Medicaid.
- NJ FamilyCare: Reach out directly to NJ FamilyCare to obtain a list of in-network rehab providers. They can assist in identifying facilities that accept Medicaid and guide you through the coverage details.
- Substance Abuse and Mental Health Services Administration (SAMHSA): The SAMHSA Treatment Locator shows facilities nationwide. You can filter results to show only those providing Medicaid rehab in New Jersey.
- NJ Department of Human Services (NH DHS): The NJ DHS’s Division of Mental Health and Addiction Services, in partnership with Rutgers, offers an Addiction Services Treatment Directory. You can search for Medicaid rehabs near your zip code and, at a glance, see which ones offer MAT drugs like buprenorphine or methadone.
By following these steps and utilizing the available resources, you can find a suitable treatment facility in New Jersey that provides Medicaid rehab and meets your needs.
What If Medicaid Doesn’t Cover the Rehab You Want?
If Medicaid does not cover the rehab facility or program you prefer, there are still several options to explore. While Medicaid provides coverage for many addiction treatment services, it may not include certain facilities, programs, or specialized treatments.
Here’s what you can do if your preferred rehab is not covered.
- Check for Sliding Scale Fees or Payment Plans: Many rehab centers offer sliding scale fees based on income or allow payment plans to make treatment more affordable. Contact the rehab facility and ask if they provide these options for uninsured or underinsured individuals.
- Look for State-Funded or Nonprofit Programs: Some state-funded rehab centers and nonprofit organizations provide free or low-cost addiction treatment to those who qualify, regardless of Medicaid coverage.
- Seek Assistance from Local Support Groups: Local Alcoholics Anonymous (AA), Narcotics Anonymous (NA), and other support groups may have resources or connections to affordable treatment options.
If Medicaid does not cover the rehab you want, there are still ways to access treatment. Many rehab centers offer sliding scale fees or payment plans to make care more affordable. Additionally, state-funded and nonprofit programs can provide free or low-cost treatment options. Local support groups like AA or NA may also have resources to help you find accessible care. While your first-choice facility may not be covered, exploring these alternatives can help you get the treatment you need. The most important thing is to seek help as soon as possible.
New Jersey Addiction Treatment
Footprints to Recovery in Hamilton, New Jersey, is committed to providing affordable addiction treatment. We accept a range of private insurance plans and offer flexible payment options, including sliding scale fees and payment plans, to accommodate diverse financial situations. Our admissions team is available 24/7 to assist you in exploring these options and to help verify your insurance benefits. We believe that financial constraints should not be a barrier to receiving quality care, and we are dedicated to working with you to find a solution that fits your needs. For more information on how to pay for alcohol and drug rehab in New Jersey, please visit our website.
- https://www.hhs.gov/answers/health-insurance-reform/does-the-aca-cover-individuals-with-mental-health-problems/index.html
- https://www.medicaid.gov/medicaid/benefits/behavioral-health-services/substance-use-disorders/index.html
- https://pmc.ncbi.nlm.nih.gov/articles/PMC7401763/
- https://aspe.hhs.gov/topics/poverty-economic-mobility/poverty-guidelines
- https://njsams.rutgers.edu/TreatmentDirectory/Home/Intro
- https://njfamilycare.dhs.state.nj.us/
