The Ultimate Guide to Medicaid Drug Rehab in Virginia

Breaking Down the Barriers to Addiction Treatment in Virginia

Medicaid drug rehab Virginia is a vital resource for thousands seeking recovery from substance use disorders but struggling with treatment costs. If you or a loved one faces addiction and worries about paying for help, Virginia Medicaid’s expanded coverage opens the door to comprehensive, evidence-based care—often at little to no cost.

Here’s what you need to know right now:

• Virginia Medicaid covers addiction treatment through the Addiction and Recovery Treatment Services (ARTS) benefit, launched in April 2017.
• Services covered include: medical detox, residential treatment (up to 30 days), outpatient counseling, medication-assisted treatment (MAT), and peer recovery support.
• Who qualifies: All enrolled Virginia Medicaid, FAMIS, and FAMIS MOMS members are eligible for ARTS benefits.
• How to access: Apply for Virginia Medicaid through CoverVA, find an in-network provider, and start treatment—often within days.
• No cost difference: The quality of care you receive is the same regardless of how you pay.

For immediate, confidential help: Call Addiction Helpline America at 844-561-0606 anytime, 24/7.

As one person shared, “It’s certainly not going to always be easy, but you’ll get the best support you need in getting healthy again.” That support is real, and it’s accessible. Too many people delay getting help because they’re worried about costs, but Virginia has worked hard to remove that barrier.

At Addiction Helpline America, we guide individuals and families through accessing Medicaid drug rehab Virginia services, connecting them with trusted treatment centers statewide. We understand how overwhelming this moment can be, and we’re here to walk you through every step—from checking your eligibility to finding the right facility for your needs.

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Understanding Virginia Medicaid and the ARTS Benefit

Virginia Medicaid is a crucial lifeline for many residents. It’s a joint federal and state program providing health insurance to individuals and families with low incomes. It’s the largest provider of health coverage for people with limited financial resources, ensuring that essential healthcare services, including substance abuse treatment, are accessible. While states administer their own Medicaid programs, they must adhere to federal guidelines.

In Virginia, the Department of Medical Assistance Services (DMAS) is the agency responsible for overseeing and administering the state’s Medicaid program. Recognizing the critical need for expanded substance use disorder (SUD) treatment, DMAS created the Addiction and Recovery Treatment Services (ARTS) benefit in April 2017. This marked a turning point for thousands of Virginians, letting them use their Virginia Medicaid benefits for a wide array of addiction treatment services.

This expanded benefit applies not only to Virginia Medicaid members but also to those enrolled in the Family Access to Medical Insurance Security (FAMIS) program and FAMIS MOMS. This means that a broad spectrum of Virginia residents now have access to a comprehensive continuum of addiction treatment services that were previously out of reach for many.

Not sure if you qualify? It can feel like navigating a maze, but we’re here to help. Call Addiction Helpline America at 844-561-0606 for a free eligibility screening and let us simplify the process for you.

What is the ARTS Program?

The Addiction and Recovery Treatment Services (ARTS) program is Virginia’s dedicated initiative to combat substance use disorders by providing comprehensive, evidence-based treatment. Its core purpose is to offer a full continuum of addiction treatment services for Medicaid, FAMIS, and FAMIS MOMS members across the state.

When ARTS was launched, it significantly expanded access to vital care, including:

• Expanded community-based addiction and recovery treatment services: Bringing care closer to where people live.
• Coverage of inpatient detoxification: Ensuring safe, medically supervised withdrawal.
• Residential substance use disorder treatment: Providing structured, live-in care environments.

The ARTS benefit is designed to align with the American Society of Addiction Medicine (ASAM) Criteria, which is a nationally recognized framework for assessing and placing individuals in appropriate levels of care. This ensures that treatment is individualized and clinically appropriate. The program is continuously evolving, with DMAS planning to submit an 1115 waiver renewal application in July 2024 for the “Building and Changing Coverage, Services, and Supports for a Healthier Virginia” initiative, further solidifying and enhancing these critical services. You can find more information about these plans on the Virginia Regulatory Town Hall.

Learn how ARTS can specifically help you or a loved one achieve recovery—speak with a specialist at 844-561-0606 today. Our experts are well-versed in the ARTS program and can provide personalized information.

Who is Covered by ARTS?

The beauty of the ARTS program lies in its broad reach. It provides treatment for members with substance use disorders across the state, ensuring that help is available to those who need it most. Specifically, the ARTS benefit covers:

• All enrolled members in Medicaid: This includes adults, children, and pregnant women who meet the income and other eligibility requirements for Virginia Medicaid.
• FAMIS members: Children whose families earn too much for Medicaid but cannot afford private insurance.
• FAMIS MOMS members: Pregnant women who meet specific income guidelines.

Eligibility for these programs is primarily based on income and household size, though other criteria may apply. The goal is to ensure that financial limitations do not prevent access to life-saving addiction treatment. If you’re currently enrolled in any of these programs, you’re eligible for the ARTS benefits. If you’re not, we can help you understand the eligibility criteria and application process.

Unsure about your coverage or if you qualify for Medicaid, FAMIS, or FAMIS MOMS? Don’t leave it to chance. Call Addiction Helpline America at 844-561-0606 for guidance and a free, confidential check of your eligibility.

What Addiction Treatment Services Are Covered?

Virginia Medicaid, through its ARTS benefit, provides comprehensive coverage for substance use disorder treatment. This means that if you qualify, you can access a wide array of services designed to support your journey to recovery. A crucial insight from our research is that the source of funding, whether it’s Medicaid or private insurance, does not impact the level or quality of care received at reputable facilities. Treatment decisions are always based on what will best prepare the patient for long-term recovery.

The ARTS benefit uses the ASAM Levels of Care, which means treatment is custom to an individual’s specific needs, ensuring they receive the most appropriate and effective care. This leads to individualized treatment plans that address not just the addiction, but also underlying issues and personal goals.

A Full Continuum of Care

The ARTS benefit covers a wide range of services, encompassing the full continuum of care for substance use disorders. This ensures that individuals can move through different levels of treatment as their needs change, from acute crisis to long-term recovery support. Here’s a breakdown of the services covered:

• Medical Detoxification: This is often the first step in treatment, providing medically supervised withdrawal management to safely rid the body of substances. It’s designed to manage uncomfortable and potentially dangerous withdrawal symptoms.
• Inpatient & Residential Treatment: For those requiring a highly structured environment, ARTS covers residential substance use disorder treatment. Under the ARTS program, short-term residential treatment is specifically defined as 30 days or less. This provides an intensive, live-in setting focused on healing and recovery.
• Partial Hospitalization Programs (PHP): PHPs offer a structured day treatment option. Individuals attend therapy and activities for several hours a day, multiple days a week, but return home or to a sober living environment in the evenings.
• Intensive Outpatient Programs (IOP): IOPs provide regular, intensive group and individual therapy sessions, often for a few hours a day, several days a week. This allows individuals to maintain some responsibilities while receiving significant support.
• Standard Outpatient Counseling: This includes individual and group therapy sessions that are less intensive than IOPs or PHPs, suitable for those with stable living situations and strong support systems, or as a step-down from more intensive care.
• Medication-Assisted Treatment (MAT): A cornerstone of evidence-based addiction treatment, MAT combines medications with counseling and behavioral therapies. Virginia Medicaid covers medications like buprenorphine (often found in Suboxone), naltrexone (Vivitrol), and methadone, especially for opioid use disorder. This approach has proven highly effective in reducing cravings and preventing relapse.
• Peer Recovery Support Services: These services involve support from individuals who have lived experience with addiction and recovery. Peer specialists offer guidance, encouragement, and practical assistance, acting as role models and advocates. This evidence-based model of care is a valuable component of the ARTS benefit.

Want to know which services you qualify for and which treatment path is best for your unique situation? Don’t guess. Call 844-561-0606 for a free, confidential assessment with one of our compassionate specialists. We’ll help you understand your options and connect you with the right support.

Coverage for Co-Occurring Disorders

It’s a common misconception that addiction exists in a vacuum. In reality, many individuals struggling with substance use disorders also experience co-occurring mental health disorders, such as anxiety, depression, bipolar disorder, or PTSD. These are often referred to as “dual diagnoses,” and they require integrated treatment for successful, long-term recovery.

Virginia Medicaid recognizes the critical importance of addressing co-occurring mental health disorders alongside substance use disorders. Our research confirms that coverage will often extend to dual diagnosis treatment services, meaning that Medicaid helps cover the cost of treating both conditions simultaneously. This integrated approach is vital because treating only one aspect (e.g., just the addiction) often leads to relapse if the underlying mental health issues are ignored.

Medicaid, by federal mandate, covers essential healthcare services, including behavioral health services. This commitment ensures that individuals receive comprehensive care that addresses all facets of their well-being. For more information on Medicaid’s role in behavioral health, you can refer to Medicaid.gov.

If you or a loved one is struggling with both addiction and mental health challenges, don’t lose hope. For help finding dual diagnosis treatment centers that accept Virginia Medicaid, call Addiction Helpline America at 844-561-0606. We specialize in connecting individuals with integrated care programs.

Your Step-by-Step Guide to Accessing Medicaid Drug Rehab Virginia

Navigating the healthcare system, especially when seeking addiction treatment, can feel daunting. But with Virginia Medicaid and the ARTS benefit, the path to recovery is clearer than ever. Here’s a step-by-step guide to help you access the Medicaid drug rehab Virginia services you need.

Call to Action: You don’t have to do this alone. Call our helpline at 844-561-0606 for free, confidential help at any step along the way. We’re here to guide you.

Step 1: Determine and Apply for Virginia Medicaid

The first crucial step is to ensure you are eligible for and enrolled in Virginia Medicaid. Eligibility is primarily based on your income, household size, and other specific criteria, which can vary.

Here’s how to proceed:

1. Determine Eligibility: You can check the current income limits and requirements on the CoverVA website.
2. Gather Documents: You’ll need documents to verify your identity, income, household size, and residency (e.g., birth certificate, driver’s license, pay stubs, tax returns, utility bills).
3. Submit Your Application: Virginia offers several convenient ways to apply:
   • Online: The quickest and easiest way is through the CoverVA website.
   • By Phone: You can call the Cover Virginia Call Center.
   • In Person: Visit your local Department of Social Services office.
   • By Mail: Download an application form from the CoverVA website and mail it in.
4. Provide Additional Information: Be prepared to submit any further information requested during the review process.
5. Receive Coverage: Once approved, you’ll receive your Medicaid ID card and information about your coverage.

The application and enrollment process for Virginia Medicaid typically takes about 30-45 days. While this might seem like a long time when you’re seeking urgent help, it’s a temporary wait for a life-changing benefit.

Feeling overwhelmed by the application process? Don’t let it stop you from getting help. Call Addiction Helpline America at 844-561-0606 for step-by-step assistance with your application. We can help clarify requirements and ensure you submit everything correctly.

Step 2: Understand Your Plan and MCO

Once you’re approved for Virginia Medicaid, it’s important to understand how your benefits are delivered. Virginia Medicaid primarily operates through Managed Care Organizations (MCOs). These are private health insurance companies that contract with the state to provide healthcare services, including addiction treatment, to Medicaid members.

Here’s what you need to know:

• Managed Care Organizations (MCOs): Most Virginia Medicaid members are enrolled in an MCO. You’ll typically choose an MCO from a list of options. Each MCO has its own network of providers, so understand which facilities are “in-network” with your specific plan.
• Role of MCOs: MCOs are responsible for coordinating your care, authorizing services (like detox or residential treatment), and processing claims. They play a significant role in accessing Medicaid-funded addiction treatment in Virginia.
• Fee-for-Service: A smaller number of Medicaid members might be under a “fee-for-service” model, where DMAS directly pays providers for services. However, most behavioral health services, especially SUD treatment, are managed through MCOs.

Understanding your specific plan and MCO is key to seamlessly accessing care. Your MCO will provide you with a member handbook and contact information for member services, who can help you steer your benefits.

Unsure which MCO plan is right for you, or how to steer your existing plan’s benefits for addiction treatment? Call 844-561-0606 for expert advice. Our team can help you understand your MCO and its role in your recovery journey.

Step 3: Finding a Medicaid Drug Rehab in Virginia

With your Medicaid coverage in hand, the next step is to find a treatment center that accepts your plan and meets your specific needs. This is where our expertise at Addiction Helpline America truly shines.

Here’s how to find the right Medicaid drug rehab Virginia facility:

1. Use DMAS Resources: The Virginia Department of Medical Assistance Services (DMAS) provides an information and provider map on their website. This is a valuable tool for finding ARTS providers in different regions.
2. Contact Treatment Centers Directly: Many treatment centers, like the Life Center of Galax, proudly accept Virginia Medicaid. When you contact a facility, their admissions professionals can help you determine eligibility, confirm the parameters of the ARTS program, and answer any insurance-related questions.
3. Verify Insurance: Always verify that a treatment center is in-network with your specific Virginia Medicaid MCO before beginning treatment. Our team can assist with this crucial step.
4. Intake Assessment: Once you’ve found a potential facility, you’ll undergo an intake assessment. This thorough evaluation uses criteria like the ASAM (American Society of Addiction Medicine) Levels of Care to determine the most appropriate treatment plan for you.
5. Individual Service Plan (ISP): Based on your assessment, a personalized Individual Service Plan (ISP) will be developed, outlining your treatment goals and the services you’ll receive. This plan ensures your treatment is custom to your strengths, needs, and goals.

There are many facilities in Virginia that accept Medicaid. Our research indicates that there are over 270 centers in Virginia that accept Medicaid for addiction treatment, with some sources listing as many as 337. Look for facilities with accreditations like CARF (Commission on Accreditation of Rehabilitation Facilities) or The Joint Commission, as these indicate a commitment to quality and safety.

Don’t let the search for the right facility delay your recovery. Call Addiction Helpline America at 844-561-0606 to get help finding a Medicaid drug rehab Virginia center today. We have a vast network of trusted providers and can quickly connect you with options that accept your Virginia Medicaid plan.

The Advantages of Using Medicaid for Your Recovery

Opting to use Virginia Medicaid for addiction treatment offers numerous benefits that can significantly ease the path to recovery. Beyond the obvious financial relief, there are several compelling advantages that make Medicaid a powerful tool in addressing substance use disorders.

1. Financial Relief: This is arguably the most significant benefit. Addiction treatment can be incredibly expensive, often creating an impossible barrier for individuals and families. Virginia Medicaid dramatically reduces or eliminates out-of-pocket costs, making essential treatment accessible regardless of economic status. This means you can focus on healing, not on crippling bills.
2. Comprehensive Benefits: As detailed earlier, Virginia Medicaid, through the ARTS program, covers a wide spectrum of evidence-based services, from detox and residential care to outpatient counseling and medication-assisted treatment. This ensures that individuals receive holistic care custom to their needs.
3. Quality of Care: A common concern is whether Medicaid-funded treatment is of lower quality. Our research, including insights from facilities like Life Center of Galax, clearly indicates that the quality of care received is not dependent on the payment method. Treatment decisions are based solely on clinical necessity and what will best support long-term recovery. Reputable facilities provide the same high standard of care to all patients, regardless of how their treatment is funded.
4. Legal Mandates for Coverage: The availability of robust addiction treatment coverage through Medicaid isn’t accidental. It’s backed by federal law:
   • The Affordable Care Act (ACA): The ACA includes provisions requiring insurance plans, including Medicaid, to cover addiction treatment services as essential health benefits. This means SUD treatment is considered as vital as care for other chronic diseases. You can learn more about the ACA’s impact on addiction treatment on the Obama White House Archives.
   • The Mental Health Parity and Addiction Equity Act: This law mandates that coverage for mental health and substance use disorder services must be comparable to coverage for medical and surgical care. This helps prevent insurers from imposing stricter limits or higher costs on addiction treatment.
5. Integrated Care Model: Medicaid’s recognition of co-occurring mental health disorders means that it supports an integrated care model. This allows individuals to receive simultaneous treatment for both their addiction and any underlying mental health conditions, which is crucial for sustainable recovery.

By leveraging Virginia Medicaid, individuals can overcome financial problems, access high-quality, evidence-based care, and start on their recovery journey with confidence and support.

Don’t leave any stone unturned when it comes to your health. Find all your benefits and understand how Virginia Medicaid can empower your recovery. Call 844-561-0606 for a free consultation with our knowledgeable team.

Frequently Asked Questions

We know you likely have many questions about using Virginia Medicaid for drug rehab. Here are answers to some of the most common ones we hear:

Does Virginia Medicaid cover the entire cost of rehab?

Virginia Medicaid is designed to make addiction treatment highly affordable, covering most costs for approved services at in-network facilities. While the goal is to minimize financial burden, depending on your specific Medicaid plan and the type of service, there might be small copayments or deductibles. However, these are generally very low compared to the full cost of treatment. The ARTS benefit aims to expand access, so out-of-pocket expenses are typically minimal, ensuring that cost doesn’t prevent you from getting the help you need.

For precise details about your specific coverage and any potential out-of-pocket costs, don’t hesitate to call Addiction Helpline America at 844-561-0606. We can help you verify your benefits quickly and confidentially.

How do I find a rehab center that definitely accepts my Virginia Medicaid plan?

The best and most reliable way to find a Medicaid drug rehab Virginia center that accepts your specific plan is to:

1. Call the Facility Directly: Contact the admissions department of any treatment center you’re considering. They can verify your Medicaid benefits and confirm their acceptance of your specific MCO plan.
2. Use Official DMAS Resources: Check the DMAS website’s provider search tools or maps specifically for ARTS providers.
3. Call Our Helpline: The easiest and most efficient method is to call our confidential helpline at 844-561-0606. Our specialists have access to a vast network of treatment centers across Virginia and can help you verify benefits, find participating centers that match your needs, and even assist with the intake process. We take the guesswork out of it for you.

What is the difference between an OTP and an OBAT provider under the ARTS benefit?

Both Opioid Treatment Programs (OTPs) and Office-Based Addiction Treatment (OBAT) providers are crucial components of the ARTS benefit, but they serve slightly different roles, particularly concerning Medication-Assisted Treatment (MAT) for opioid use disorder:

• Opioid Treatment Programs (OTPs): These are highly regulated, specialized clinics certified by the Substance Abuse and Mental Health Services Administration (SAMHSA) and licensed by the state. OTPs are primarily known for dispensing medications like methadone, often on a daily basis, under strict supervision for individuals with Opioid Use Disorder (OUD). They also provide comprehensive counseling and medical services. Our research shows that OTPs typically treat members with a primary OUD diagnosis.
• Office-Based Addiction Treatment (OBAT) Providers: Often referred to as Preferred OBATs under ARTS, these are typically physicians or clinics that can prescribe medications like buprenorphine (often in combination with naloxone, such as Suboxone) in a more integrated, office-based setting. Unlike OTPs, OBATs can treat members with OUD as well as other primary Substance Use Disorders (SUDs). The OBAT model emphasizes the integration of medical and behavioral health services, often involving collaboration between a prescribing physician and a behavioral health clinician.

Essentially, OTPs are specialized clinics for methadone and other MAT, while OBATs integrate MAT (primarily buprenorphine) into a broader outpatient or office-based setting for various SUDs.

Understanding which type of provider is right for your specific needs can be complex. For help finding the right OTP or OBAT provider in Virginia that accepts your Medicaid plan, call 844-561-0606. We’ll help you make an informed decision.

Your Path to Recovery Starts Now

Taking the first step toward recovery is a brave and monumental decision. We understand that the journey can seem overwhelming, especially when you’re trying to steer the complexities of healthcare and insurance. But with Virginia Medicaid and the comprehensive Addiction and Recovery Treatment Services (ARTS) benefit, recovery is not just a dream—it’s an accessible reality.

Virginia has made significant strides in breaking down financial barriers to addiction treatment, ensuring that individuals across the state can access evidence-based care. From medically supervised detox to residential treatment, outpatient counseling, and crucial medication-assisted treatment, the support you need is available. And remember, the quality of your care remains paramount, regardless of how it’s funded.

At Addiction Helpline America, our mission is to simplify this process for you. We provide free, confidential, and personalized guidance, connecting you to the right recovery program from our vast network of trusted treatment centers. You don’t have to face this alone. We’re here to answer your questions, verify your benefits, and help you find a Medicaid drug rehab Virginia facility that aligns with your unique needs.

Your path to a healthier, more fulfilling life starts now. Don’t let uncertainty hold you back. Speak with a compassionate specialist and take the first, most important step toward recovery today. We’re ready to listen and ready to help.