Examining Medicaid

Medicaid is a federal-funded and state-operated program that covers a lot of the same medical services a traditional health insurance plan would cover. There are also low or no co-pays with Medicaid. According to a November 2020 medical report, approximately 72.5 million Americans have been covered by Medicaid in 2017, receiving the support needed for various services. Presently, Medicaid accounts for 17% of health care coverage and enrollees are as follows:

  • 9% are 65 and older

  • 14% are disabled

  • 34% are adults under 65

  • 43% are children

Fortunately, Medicaid remains the most popular option for health insurance for those who have low income with 1 in 5 Americans receiving coverage. Lastly, individuals can combine both Medicaid and Medicare, which is called dual eligibility for more coverage and benefits.

Medicaid For Alcohol Inpatient And Outpatient Treatment

Medicaid can cover inpatient and outpatient rehab needs. Each facility would be different on their decision to accept Medicaid. For inpatient coverage, Centers for Medicare and Medicaid Services (CMS) notes those who do provide coverage for such services would also cover part of the inpatient visit; or separately to the professional billing for the provided services.

The provided services would have to “be recognized under part B and considered different from the inpatient stay.” Outpatient coverage would be based on a service-by-service basis if covered. Non-self-administered medications would be covered if they meet the requirements of Part B. Conducting research according to one’s personal Medicaid needs can be beneficial to get more information.

Medicaid remains the most popular option for health insurance for those who have low income with 1 in 5 Americans receiving coverage.

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Medicaid Eligibility And Financial Considerations

In order to be eligible for Medicaid, a person must be a resident of the state they are requesting coverage from, as well as be a US citizen, permanent resident, or legal alien who needs health coverage due to having a low income. In 2012, the Affordable HealthCare Act allowed Medicaid to be expanded to individuals under 65 years of age, opening the door for a variety of people to apply and receive coverage. Those who are eligible include those who are in the low-income tax bracket and individuals who receive Medicaid must be deemed medically needy. For a person to qualify they must also meet one of the following:

  • Low-income families or individuals

  • Qualified pregnant women

  • Those who receive Social Security income

  • Blind or disabled children or adults

  • Responsible for a child age 18 or younger

  • Those over 65

Beneficiaries have more access to healthcare coverage than those who are uninsured. Financial considerations vary from state to state each year.

Different states have different qualifications based on specific factors. For example, Ohio requires a 1 person household to be making $16,612 annually to qualify; 2 person households to be making $22,491 annually, 3 person households making $28,369 annually, 4 person households making $34,248, 5 person households making $40,127 and 6 person households making $46,005 annually. Those who are over 65 must be making less than $2,382 monthly to qualify and in some cases, assisted living facilities. Individuals seeking more information on Medicaid eligibility can access local offices for more information or log on to Medicaid.gov.

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What Medicaid Covers

Medicaid has several aspects of coverage like Medicare does. The insurance covers a vast number of health conditions and services depending on their provider. Many of these services include but are limited to:

  • X-rays

  • Rehab facility care

  • Inpatient hospital care

  • Medically-assisted detox

  • Alcohol testing

  • Intervention

  • Counseling

  • Outpatient hospital care

  • Clinical care

  • Ambulance services

  • Short-term home health care

  • Prescription medication

The insurance can cover premiums, nursing home care, and other services. Medicaid and Medicare can also cover substance abuse services ranging from prescription drug medications, alcohol treatment, and substance abuse inpatient and outpatient services. Additionally, prescription drugs that are not covered by Medicare are covered by Medicaid. Unfortunately, while Medicaid covers a vast number of services, some facilities may not accept the insurance. Those interested in Medicaid should ensure the facility they are interested in accepts the insurance.

Contact A Treatment Provider Today

Individuals needing treatment for substance abuse can learn more about coverage by conducting independent research or going on websites like SAMHSA to learn more. Furthermore, contacting a treatment provider to learn about which facilities accept Medicaid, or contacting the facilities can provide answers to rehab-related questions. If you or a loved one is suffering from alcoholism, and you qualify for Medicaid, you are one step closer to getting needed care. Don’t allow the lack of funds to deter you from getting the treatment needed for sobriety. Contact a treatment provider to learn more.

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