The Government programs also include Medicaid and Medicare insurance cover that helps provide an option for some substance abuse treatments as part of the Affordable Care Act. Some of the most common methods to pay for drug and alcohol rehab, Medicaid, and Medicare come under federal and state-funded health insurance programs. These government-funded programs help provide free or low-cost drug and alcohol addiction treatment. Each of these programs follows a different requirement for eligibility.
This government programs designed to provide care for the elderly and disabled persons, as well as low-income individuals in need. These programs offer the two most common methods for paying drug or alcohol detox treatments. Medicaid helps pay a fourth of all Buprenorphine prescriptions (an addiction treatment program). In some states, government health insurance has expanded, and addicts for treatment are higher, and Medicaid pays for almost half of the treatment prescriptions.
Every state follows different laws and regulation for the eligibility and treatment criteria. These rules for eligibility also change annually. If you were not eligible for Medicaid or Medicare in the past, it’s not that you will not qualify for it now.
Drug and Alcohol Rehab Under Medicaid
Medicaid program is a government program also considered as a public insurance program for low-income families. Under the 2010 ACA, also known as Obamacare, insurance providers, including Medicaid, must provide or cover all essential aspects of drug and alcohol dependency recovery. While Medicaid covers mostly substance abuse treatment, not all the facilities accept Medicaid as a form of payment. To get better assistance regarding recovery provider, it is good to be in touch with the Substance Abuse and Mental Health Services Administration (SAMHSA).
Eligibility by Income for Medicaid Program
For the ability of Medicaid, an applicant must meet one of the following:
• More than 65 years old
• Must be under 19 years old
• Pregnant women
• A parent
• Within a specified income domain
In some of the states, Medicaid covers adults below a specific income domain. The individual with supplemental security income is automatically eligible for Medicaid. The person with federal poverty line percent less than 133 is available for Medicaid according to the ACA requirement. A person who has a percentage above the poverty level is still eligible for government insurance if the right income domain is followed.
According to the 2015 reports, the maximum income level allowed for Medicaid eligibility for different family size is like this: A person with family size should have maximum annual income up to $15,654.10, for the family size of 2 the maximum yearly salary is recommended $21,186.90, and for the family size of 3 the recommended limit is $27,121.50. Even if these income requirements are met, the person may not be eligible for Medicaid because each state follows its own rules for Medicaid eligibility.
What is the Coverage of Medicaid?
The co-payments for addiction treatment under Medicaid are not provided in most of the States. If there is any charge for co-payments means out of the pocket, charges are taken for Medicaid.
Medicaid covers part of the service or all of the following services:
• Maintenance and craving medication
• Family counseling
• Inpatient care
• Long-term residential treatment
• Outpatient visits
• Mental health services
Medicare for Drug and Alcohol Rehab Treatment
The eligibility for Medicare is recommended for the person more than 65 years of age and those with disabilities. A monthly premium is available for Medicare, which is dependent on the recipient’s income. People with less income pay least premiums. The four parts of Medicare areas:
• Part-A- It provides insurance for Hospital Stays. Part-A Medicare can help pay for Inpatient rehab. It covers up to 60 days in treatment without a co-insurance payment. Medicare covers 190 days of inpatient care for a person’s lifetime.
• Part-B- It provides Medical Insurance. It can cover outpatient care for addicted people. Part-B covers up to 80 percent of these costs. It provides coverage for outpatient care, therapy, drugs administration via clinics, and professional intervention.
• Part-C- It is Medicare-approved Private Insurance. A person who wants more treatment benefits under Medicare can opt for Part-C. Out of pocket costs and coverage is different under different conditions.
• Part-D- It provides Prescription Insurance. People who need coverage from medication to manage withdrawal symptoms can go for this option. This helps increase the likelihood of staying sober.
A person is eligible for both Medicaid and Medicare treatment. The person can avail the benefits of both the treatment programs. If a person with disabilities, more than 65 years may be eligible for both programs.
It is advisable to contact the caseworker in your State facility to get Medicaid and Medicare services. The specialist can help you determine Medicaid and Medicare. An eligible person will be assisted with the application process by the caseworker. If already a person comes under Medicaid or Medicare, contact the SAMHSA to find the right drug and alcohol recovery facility.