Having basic health coverage does certainly help increase the well-being of an individual, and for many Americans, Medicaid does help and provides the basic services needed. Medicaid is still the largest payer for mental health and addiction treatment services in the United States. The Mental Health Parity and Addiction Equity Act makes it easier for Americans to get the care they need for drug addiction, per the Medicaid website. This piece of legislation requires coverage to be no more restrictive than coverage for medical or surgical conditions. For example, this requirement applies to co-pays, out of pocket maximums, and coinsurance. It also applies to limitations on services or limits on the number of inpatient days or outpatient visits. The use of care management tools and criteria for medical necessity determinations also applies to this requirement.
Medicaid Insurance in the Different US States
Each state has category-defined statutes; for example, there are low-income seniors, parents enrolled in Medicaid of low-income children, pregnant women, and low-income children of a particular age. Persons with disabilities fall into certain categories as well, if they receive supplemental security income and have no work history they are enrolled in Medicaid to ensure they have health coverage. A person must prove they have a disability, such as blindness, deafness, mental illness, or a physical disability that prevents them from working.
Each state is not required to participate in Medicaid, although every state currently does and complies with federal Medicaid laws. Each state sets standards of eligibility, how much is paid into it, the types of services covered, and all of these changes from state to state as each state administers its own program. In the year 2002, there were close to 40 million Americans enrolled in the program, with the majority of them being children. By the year 2009, there were close to 63 million Americans enrolled in Medicaid and receiving different services and coverage.
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What is Medicaid?
Medicaid is a form of health insurance assistance each state provides qualifying residents. To qualify for Medicaid, the person must be a resident of the state in which they’re applying and demonstrate an inability to afford private health insurance. They’re then given free healthcare or access to particular subsidized policies they can afford on their current income.
How does Medicaid affect treatment costs?
Medicaid reduces or completely removes the cost of treatment for people with substance use disorder. But one of the drawbacks is that not all facilities accept Medicaid for payment, so those that do are usually in high demand. This can mean long waiting lists for those hoping to get into treatment as soon as possible.
Can I get coverage for Medicaid drug rehab?
If you qualify, anyone can apply for Medicaid and receive health coverage that can be used immediately upon receipt. Unlike private health insurers, Medicaid doesn’t restrict applicants to “open enrollment periods” or blackout periods for significant benefits. But it should be noted that enrolling in Medicaid can be slow and take several weeks.
Do all drug rehab Centers accept Medicaid for payment?
No. Only certain service providers accept Medicaid. These programs are generally state-funded and follow strict protocols due to the need to treat such a high volume of patients. So, service quality and speed can be lacking compared to privately funded programs.
What if I don't qualify for Medicaid and don't have private health insurance?
There are options if a person does not qualify for Medicaid but cannot afford private health insurance. Some facilities are subsidized by various grants and state or federal programs, allowing them to deliver free treatment. Other programs may work with patients by utilizing sliding-scale payment systems or discounted payment plans, allowing the person to start treatment even if they don’t currently have complete payment.
Want to know more?
The questions from Addicted.org’s “Learn from our Experts” are answered by Michael Leach, CCMA. If you need further clarification on any of the questions above or have any other questions you can contact him directly at mike@addicted.org.
Drug Use Statistics
Substance abuse does impact many Americans who are enrolled in the Medicaid program. Per the Medicaid website, roughly 12% of Medicaid beneficiaries over 18 years of age have a substance abuse problem. Their site also states that around 6700 people seek treatment every day in the emergency department of hospitals because of drug abuse. In 2010, Medicaid reported drug overdose as the leading cause of death for people between 25 and 64 years old. Medical also provides coverage to 27 million children under the age of 18 within the country.
Per the information provided by Medicaid, the drug use among youth ages 12 to 17 is 25% higher than those 18 years and older. Children who are exposed to trauma such as maltreatment are more likely to abuse drugs and alcohol. Many of the adolescent drug treatment programs in the United States will accept Medicaid. When you start to search for drug treatment centers, it is important to find the right one. According to the Center for Disease Control, 25.5% of Americans had public health insurance in 2018. These are Americans who are 65 years old and younger covered by programs like Medicaid.
This same report indicated that 41.8% of children under the age of 18 had public health insurance. Along with this, adults between 18 and 64 accounted for 19.4% of people who had public health insurance such as Medicaid. Public health insurance is used by millions of Americans and is accepted at many drug and alcohol treatment services.
Many people and families in the United States do not have the extra income to pay for health care. Medicaid is set up for low-income families with little to no resources available to them. Medicaid is available to people of all ages who fit the criteria and are eligible for coverage. The program is funded by the state and the federal government and currently, all of the states within the US participate in the program. Each state does not have to follow the eligibility criteria, specifically as to what is laid out. Each person applying must be a US citizen or a legal permanent resident, and this also applies to low-income adults, their children, and persons with disabilities. Having a low income is not the only requirement needed for eligibility and coverage.
