Does Medicaid Pay for Drug Rehab?

Substance abuse treatment centers throughout the country offer various treatment methods and services that can be paid for by Medicaid. The state you live in, and the Medicaid program you are enrolled in will determine the level of care available for your specific case. Some states have decided to add a co-payment for some addiction treatment programs. If there is a co-payment it will be a nominal amount. Medicaid does cover most forms of treatment including Inpatient drug and alcohol addiction treatment programs, Outpatient therapy, family counseling, interventions, and detox. Medicaid also covers medication therapy and maintenance/ craving medications. 

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Substance Use Disorders (SUD) impact the lives of millions of Americans in the general population, including individuals who are enrolled in the Medicaid program. Nearly 12 percent of Medicaid beneficiaries over 18 have an SUD, and CMCS is committed to helping States effectively serve individuals with SUDs. On average, 105 people die every day as a result of a drug overdose. Additionally, 6,748 individuals across the country seek treatment every day in the emergency department for misuse or abuse of drugs. In 2010, drug overdose was the leading cause of injury death and caused more deaths than motor vehicle accidents among individuals 25-64 years old. The monetary costs and associated collateral impact on society due to SUDs are very high. In 2009, health insurance payers spent $24 billion on treating SUDs. Of the $24 billion, Medicaid accounted for 21 percent of the spending. The evidence is strong that treatment in managing SUDs provides substantial cost savings.

For instance:

Persons with untreated alcohol use disorders use twice as much health care and cost twice as much as those with treated alcohol use disorders, and medications treating substance use disorder in pregnant women resulted in significantly shorter hospital stays than drug-addicted pregnant women not receiving MAT (10.0 days vs. 17.5 days). For inpatients with alcohol dependence, MAT was associated with fewer inpatient admissions. Total healthcare costs were 30 percent less for individuals receiving MAT than for individuals who not receive MAT. Medical costs decreased by 30 percent on average between the year prior to MAT and the third year following treatment, and these cost trends reflect a decline in expenditures in all types of healthcare settings including hospitals, emergency departments, and outpatient centers. Methadone treatment has been found to generate $4 to $5 in returns on healthcare expenditures for every $1 invested. Early intervention in the cycle of addiction for younger individuals with substance use disorders can bring costs down as they have lower pre-treatment costs than older adults with substance use disorders.