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Rehab Insurance – Medicaid Coverage for Addiction Treatment​

Introduction

Addiction Helpline America is committed to helping individuals and families navigate the road to recovery, starting with understanding how to afford treatment. One of the most accessible ways to receive coverage for substance use disorder treatment is through Medicaid.

What is Medicaid?

Illustration representing Medicaid, a U.S. government program providing health coverage to eligible low-income individuals and families.
Call an Addiction Specialist now and they can help you by getting your insurance verified for free.

Medicaid is a joint federal and state program that provides health insurance to millions of Americans with limited income. It plays a vital role in ensuring access to behavioral health services, including addiction treatment. Since the passage of the Affordable Care Act (ACA), all Medicaid programs must offer mental health and substance use disorder services as essential health benefits.

Types of Rehab Facilities That Accept Medicaid

From state-funded centers to select private rehab programs, many treatment facilities across the country accept Medicaid. These programs offer quality, evidence-based care to help individuals recover, regardless of their ability to pay out of pocket.

Addiction Helpline America partners with Medicaid-accepting facilities across all 50 states. Our team can help you locate the right facility near you. Just call us at (844) 561-0606—we’re available 24/7.

Statistics on Medicaid in the U.S.

  • Over 85 million people were enrolled in Medicaid and CHIP as of early 2025.
  • Medicaid is the largest single payer of behavioral health services in the U.S.
  • Roughly 12% of Medicaid enrollees receive treatment for mental health or substance use disorders.
  • Since the ACA expansion, 39 states (plus D.C.) have extended Medicaid eligibility, helping millions access addiction care they couldn’t afford before.
  • Medicaid covers more than 1 in 3 people dealing with opioid addiction in the U.S.

These statistics highlight the critical role Medicaid plays in ensuring access to addiction treatment and other healthcare services for vulnerable populations.

Who is Eligible for Medicaid?

Medicaid eligibility is primarily based on income level, household size, and other factors such as disability, pregnancy, and age. While the exact criteria vary by state, individuals generally qualify if they fall into one or more of the following categories:

  • Low-income adults (including those under ACA expansion)
  • Children and teenagers
  • Pregnant women
  • Elderly individuals
  • People with disabilities
  • Former foster youth (up to age 26)

You can check your eligibility by visiting your state’s Medicaid website or calling our helpline for assistance

Medicaid Income Brackets

Each state sets its own income limits, but here are some general income guidelines based on the Federal Poverty Level (FPL) for 2024. These help determine Medicaid eligibility:

 

Persons in Household

100% FPL

138% FPL (ACA Medicaid Expansion)

1

$14,580

$20,120

2

$19,720

$27,214

3

$24,860

$34,307

4

$30,000

$41,400

5

$35,140

$48,493

6

$40,280

$55,586

Note: Income limits are higher in Alaska and Hawaii due to cost of living adjustments.

If your household income falls within these guidelines, you may qualify for Medicaid. Some states offer additional pathways for coverage even if your income is slightly higher, especially if you are pregnant, disabled, or caring for dependents.

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Persons in Family or Household Poverty Guideline

The Federal Poverty Guidelines are updated annually by the U.S. Department of Health and Human Services (HHS) and help determine eligibility for Medicaid and other benefits.

These guidelines consider gross annual income and number of people in the household. States use this information to determine if a person or family qualifies for Medicaid. Some states may also have optional coverage groups and higher income thresholds, especially for children or pregnant women.

How to Use Medicaid for Rehab

  1. Check your eligibility: Visit your state’s Medicaid website or call us for guidance.

  2. Verify your coverage: Make sure your plan covers substance use disorder services.

  3. Find a rehab center: We’ll connect you to facilities that accept Medicaid.

  4. Begin treatment: Start your journey toward recovery with support and structure.

Does Medicaid Cover Rehab?

Yes, Medicaid covers a wide range of rehab services for individuals struggling with substance use disorders. As one of the most widely accepted insurance programs in the U.S., Medicaid provides access to both short-term and long-term addiction treatment options, ensuring that financial challenges don’t stand in the way of recovery.

Provide the treatment center with your insurance information, and ask them to verify what specific services are covered under your plan.

What Types of Rehab Services Does Medicaid Cover?

Medicaid typically includes the following services:

  • Medical Detoxification (Detox): Safe and supervised withdrawal from drugs or alcohol with medical monitoring.

     

  • Inpatient Residential Rehab: 24-hour care in a structured facility, with access to therapy, medical support, and group sessions.

     

  • Partial Hospitalization Programs (PHP): Intensive daytime treatment programs that allow patients to return home in the evening.

     

  • Outpatient Programs: Flexible treatment that includes scheduled therapy and medication management without full-time facility stays.

     

  • Counseling and Behavioral Therapy: Coverage includes individual, group, and family therapy to address the emotional and psychological aspects of addiction.

     

  • Medication-Assisted Treatment (MAT): Includes medications like Suboxone, Methadone, and Vivitrol, combined with therapy for opioid and alcohol addiction.

     

  • Dual Diagnosis Support: For those with both mental health disorders and substance use issues, Medicaid often covers integrated treatment.

     

Relapse Prevention and Aftercare: Continued support services like therapy, sober living housing, or outpatient programs to maintain sobriety after rehab.

Does Medicaid Cover Out-of-State Rehab?

Medicaid Coverage for Out-of-State Rehab Services
Explore options and resources available if your insurance plan does not include addiction treatment coverage.

In most cases, Medicaid does not cover out-of-state rehab unless it’s medically necessary and pre-approved. Since Medicaid is a state-administered program, coverage is typically limited to providers within your home state. However, in special cases—such as when a required level of care isn’t available locally—your state Medicaid agency may grant approval for out-of-state treatment.

To explore this option, our team at Addiction Helpline America can help you navigate the process and determine whether out-of-state coverage is possible based on your situation.

Length of Rehab Stay Covered by Medicaid

  • The length of stay Medicaid covers depends on your medical needs, progress, and your state’s guidelines. Typically, coverage may include:

    • Short-term detox: 3–10 days

    • Inpatient rehab: 15 to 90 days, sometimes longer with reauthorization

    • Outpatient programs: Several weeks to several months

    • MAT and aftercare: May be covered indefinitely with continued progress and physician oversight

    Medicaid often requires periodic evaluations to approve continued treatment. Our helpline can help you understand how long your treatment may be covered based on your case and state regulations.

Does Medicaid Cover Mental Health Treatment?

Yes, Medicaid covers a wide range of mental health services, which is especially important for those with co-occurring disorders (addiction + mental health). Covered services often include:

  • Psychiatric evaluations

  • Therapy (individual, group, and family)

  • Crisis intervention

  • Case management

  • Medication management

  • Inpatient psychiatric care (when necessary)

Mental health treatment is a crucial part of recovery, especially for individuals dealing with trauma, anxiety, depression, PTSD, or bipolar disorder alongside substance use. Medicaid helps ensure integrated care so that all aspects of your health are addressed.

Need Help Understanding Your Medicaid Coverage?

At Addiction Helpline America, our team is ready to answer your questions, verify your insurance, and connect you with a Medicaid-approved rehab center near you.

Call (844) 561-0606 today to start your recovery journey.

Why Choose Addiction Helpline America?

  • Free, 24/7 confidential helpline at (844) 561-0606

  • Personalized assistance with Medicaid rehab options

  • Network of trusted and licensed treatment centers

  • Support for individuals and families in crisis

Nationwide access—serving all 50 states

Frequently Asked Questions (FAQs)

Yes, Medicaid typically covers both inpatient (residential) and outpatient addiction treatment programs. Coverage includes detox, therapy sessions, medication-assisted treatment (MAT), and ongoing mental health support. However, coverage details may vary by state.

You can start by contacting your state’s Medicaid office or call our 24/7 helpline at (844) 561-0606. We help individuals locate approved rehab facilities that accept Medicaid and provide high-quality care for substance use disorders.

Medicaid eligibility is based on your household size and income. For example, in most states, an individual earning up to around $20,120 annually may qualify under Medicaid expansion. Check your state’s income guidelines or use the federal poverty level chart for reference.

Yes, many states offer Medicaid coverage for long-term treatment programs, especially if they are medically necessary. This may include extended residential care or ongoing outpatient services, depending on your treatment plan and state policies.

If you’re not eligible for Medicaid, there are still options. Some rehab centers offer sliding scale fees, payment plans, or state-funded programs. Call our team at (844) 561-0606 to explore affordable treatment options based on your financial situation.

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