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  • Writer's pictureMuhammad Sair Khan

Medicaid Eligibility Requirements for Substance Abuse Treatment




Beginning with the Affordable Care Act in 2010, Medicaid policies are required to pay for substance abuse treatment. Due to opioid crisis, the number of people seeking treatment is rising.



Not all treatment centers accept Medicaid as a form of payment. With the rising demand for treatment, however, those who can implement Medicaid into their current business plan could see an increase in their bottom line.



If you are considering accepting Medicaid patients, here are four things you should know:


Part A: Insurance for Hospital Stays.



Medicare Part A can help pay for inpatient rehabilitation. Part A covers up to 60 days in treatment without a co-insurance payment. People using Part A do have to pay a deductible. Medicare only covers 190 days of inpatient care for a person’s lifetime.

Part B: Medical Insurance.


Part B can cover outpatient care for addicted people. Medicare Part B covers up to 80 percent of these costs. Part B covers outpatient care, therapy, drugs administered via clinics and professional interventions. Part B also covers treatment for co-occurring disorders like depression.

Part C: Medicare-approved Private Insurance.


People who want more benefits under Medicare can opt for Part C. Out-of-pocket costs and coverage is different and may be more expensive.

Part D: Prescription Insurance.


Medicare Part D can help cover the costs of addiction medications. People in recovery often need medication to manage withdrawal symptoms and cravings. These medications increase the likelihood of staying sober.


For more information on how to be reimbursed by Medicaid or private payers, contact the Datapro Billing team.

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