Medicare and Medicaid Drug Rehab

To use Medicare for an addiction recovery program at a rehabilitation center, the individual must meet certain eligibility requirements:

• Age 65 or older.
• Younger than 65 and have a disability.
• Younger than 65 and have end stage renal disease (permanent kidney failure that requires dialysis or a transplant).

If Medicare isn’t a possibility, some individuals qualify for Medicaid coverage. In the state of Utah, the requirements to qualify for Medicaid coverage are as follows:

• Age 19-64
• U.S. citizen or qualified alien
• Resident of the state of Utah
• Household income up to 5% federal poverty level
• Ineligible for any other Medicaid program (with the exception of
• Medically Needy or Refugee Medicaid)
• Meet one of three targeted categories:
  • Group 1: Chronically homeless.
  • Group 2: Involved in the justice system and needing substance use
  • or mental health treatment.
  • Group 3: Needing substance use or mental health treatment

It is also possible that a person can qualify for both Medicare and Medicaid, known as a dual-eligible beneficiary. This means that services not covered by one plan may be covered by the other. Between Medicare and Medicaid drug rehab funding, these insurance options can be used to make treatment affordable for those who qualify.

Medicaid and medicare coverage varies by state. In the state of Utah, these are the guidelines for what these programs will cover.

Medicaid and Medicare can cover part of or all of the following:

• Medical screenings
• Intervention
• Maintenance medications
• Family counseling
• Inpatient care
• Long-term residential treatment
• Detox
• Outpatient visits
• Other mental health services

Medication coverage will depend on the medication and eligibility. If you have additional questions, you can contact the Phoenix to speak to one of our staff members.

The best way to determine if your individual case will be covered by Medicare or Medicaid is to contact the representatives directly. It may also be beneficial to contact a caseworker to walk you through the process of using Medicaid or Medicare coverage for rehab. These individuals can help you find inpatient drug rehab centres that accept medicaid.