Finding the correct rehab center for drug or alcohol treatment, especially for a person who needs Medicare or Medicaid, can be tough. Certain reputed organizations in the US are familiar with both Medicare and Medicaid coverage, thereby providing assistance in finding the ideal facility for a citizen in distress. Such organizations can assist individuals in locating the right treatment programs that will utilize their medical insurance and assist them in understanding the associated benefits.
What is Medicaid?
Medicaid was created as a health program to assist low-income individuals and families in receiving the medical care they require. Because the program varies by state and income, one person's coverage may differ from another's. Medicaid covers drug rehab and addiction treatment, health checkups, screening, as well as family counseling in many cases. It will also cover some of the costs of medical detox, inpatient treatment, and aftercare, although the extent of these benefits varies. Therefore, it becomes important for an addiction patient to look for an inpatient rehab that accepts Medicaid.
Eligibility Criteria
The following types of applicants would be eligible for Medicaid:
- Parent
- Over the Age of 65 Years
- Under the Age of 19 Years
- Pregnant
- Within a Certain Income Range
While individual plans and benefits differ by provider and state, Medicaid accounted for 21% of the $24 billion spent on substance use disorders (SUD) by health insurance payers in the year 2009 for a substance use issue affects nearly 12% of Medicaid participants over the age of 18 years. The Mental Health Parity and Addiction Equity Act was created to ensure that Americans with mental health and substance use disorders receive the treatment they require by outlawing discriminatory practices that could limit insurance coverage for behavioral health treatment.
Under new federal standards, Medicaid must adhere to parity requirements, which means that coverage for mental health and substance abuse disorders must be no less limited than coverage for other medical problems.
Medicaid supports all people under a particular income threshold in several states. Supplemental Security Income recipients are frequently immediately eligible for Medicaid.
All About Medicare
Medicare is a more detailed plan as compared to Medicaid. Although individuals who are 65 years or older are covered by both programs, Medicare also covers certain young people with disabilities and those diagnosed with End Stage Renal Disease (ESRD). The program comprises of hospital insurance, medical insurance, supplemental coverage, and prescription drug coverage.
When a person has Medicare and other types of insurance, Medicare coordinates who pays first with the other insurance. The primary payer is the insurance company that pays the person’s medical expenditures first, up to the limits of individual coverage, and then sends the balance to the secondary payer. In other words, it works in a manner similar to private insurance companies. The beneficiary is frequently asked to pay deductibles and co-insurance (half payment of initial and subsequent charges).
Eligibility Criteria
Individuals that are 65 years and older who are qualified for Social Security retirement insurance, as well as those who have received Social Security disability benefits for at least 24 months, are eligible for Medicare. Individuals who are eligible for Railroad Retirement or Railroad Retirement disability benefits, as well as those who have end-stage renal illness or ALS, are also eligible to enroll. If they worked and paid the Medicare Part A "hospital insurance" portion of their FICA taxes for a sufficient amount of time, certain federal, state, and local government employees who are not eligible for Social Security retirement or disability benefits may be eligible for Medicare benefits.
Initiating Drug Rehabilitation
Making the decision to seek treatment or persuading a loved one to seek treatment is a challenging journey fraught with anxiety and fear. This happens before getting started on the daunting chore of deciding on the optimal treatment strategy. Then, once various available facilities are explored or the decision is to be made between an inpatient or outpatient program, expenses become a major stumbling block.
However, there is now good news in the form of the Affordable Care Act (ACA). As per this Act, all health insurance plans must compulsorily cover substance abuse and mental health-based services. Along with this, the ACA has expanded Medicaid services to include many more Americans than before. This may mean sifting through a variety of websites to get knowledge about the programs. Many reputed organizations in the US are already sifting through them; people just have to find them.
Homelessness and Drug Rehabilitation
Substance misuse has been a major cause of single individuals becoming homeless in the US. However, not everyone has a substance addiction before they become homeless; many people turn to drugs and alcohol to cope with their homelessness, which typically leads to addiction and worsens the condition. Even mental illnesses affect a large number of homeless persons in America. It may be tough to break the cycle of homelessness and addiction without the proper addiction therapy.
