Using Virginia Medicaid for Inpatient Rehab

It is a common misconception that those with Medicaid cannot get help for addiction using their coverage. It is crucial to know that there are rehab centers that accept Medicaid, and they can benefit anyone who is struggling with drugs and alcohol. Addiction treatment is a crucial component of recovery, and even those with Medicaid can receive this much-needed care from Medicaid network providers.

Understanding Virginia Medicaid Coverage for Rehab

Medicaid is a state-funded coverage for healthcare expenses. This can include drug and alcohol addiction rehab. Virginia Medicaid coverage can seem to be limited due to the state funding, however there are addiction places that accept Medicaid. Drug and alcohol rehab is a covered service under Virginia Medicaid, if services are provided through network providers. Medicaid does not allow for out-of-network care for addiction services, and centers must be approved by Medicaid to be covered under the policies.

Expand the eligibility and inpatient-coverage section

Who qualifies

Virginia Medicaid covers eligible residents who meet income and household rules, and the ARTS benefit is available to members who need substance use treatment. Eligibility is confirmed when you apply or when a provider verifies your benefits.

What inpatient coverage includes

Through ARTS, medically necessary inpatient and residential substance use treatment can be covered, based on an assessment of the level of care you need. Coverage and length of stay are tied to medical necessity and plan rules.

How to verify

Our admissions team can check your Medicaid benefits and explain your options. Please note that Virginia Recovery Centers provides outpatient care (PHP, IOP, and MAT). If inpatient care is the right level for you, we can help you understand your next steps.

Does Virginia Medicaid Cover Inpatient Rehab?

Yes, there are inpatient drug and alcohol rehab centers that accept Medicaid. These centers are Medicaid-approved and with proper authorization, services for addiction recovery can be covered both inpatient and outpatient.  The best way to understand a specific policy’s coverage and restrictions is to reach out and ask questions.

Eligibility Requirements for Medicaid in Virginia

Virginia Medicaid follows the Federal Poverty Level (FPL) guidelines. In order to qualify, the individual’s income must be below this threshold. The threshold can vary based on household size and the program applied for. For example, pregnant women, children, and parents can have higher income limitations. Another requirement is residency. Applicants must be a Virginia resident in order to receive benefits. Different Medicaid programs can also have different eligibility requirements. As an example, to qualify for the Elderly, Blind, and Disabled program, individuals would need to have one of the conditions listed, or be within the defined elderly age group.

Steps to Use Virginia Medicaid for Inpatient Rehab

To use Virginia Medicaid for rehab centers that accept Medicaid, there are steps one should take. The first step is confirming eligibility. Ensure that the individual meets all income, residency, and health status requirements for coverage. From there, the individual should enroll in coverage. Then, they can choose a Medicaid-approved facility for treatment. This is crucial as if the individual is not seen by approved facilities, it can leave a large out-of-pocket cost for the person as it won’t be covered by Medicaid. From there, the center should receive a referral or authorization for the services they will be providing. Inpatient levels of care like detox from heroin or alcohol will need to be authorized through Medicaid in order to be covered. Finally, the individual can access drug and alcohol addiction treatment.

Finding Inpatient Rehab Centers That Accept Virginia Medicaid

Finding rehab centers that accept Medicaid can be straightforward. However, selecting the right facility to support someone’s recovery journey is essential. Medicaid will cover part of the expenses, reducing out-of-pocket costs. It’s important to ensure the center is registered with Virginia Medicaid and listed on the official website to confirm coverage. Once a facility is chosen, the next step is to complete their intake process.

Benefits of Using Medicaid for Inpatient Rehab

The benefits of using rehab centers that accept Medicaid are immense. It provides the same kind of a care a private-insurance facility would, for a fraction of the out-of-pocket cost. Medicaid is for low income individuals who don’t have the means and opportunity to use private insurance for healthcare coverage. Medicaid providers are under a contract with the insurance to accept a certain rate for services they provide, meaning that anything above this contracted amount, usually, is not billed to the person receiving treatment. These centers must be approved by Medicaid, and are held to a certain standard that they must adhere to, so treatment from Medicaid-approved centers can be expected to be good. The providers and services being rendered can help the individual gain a start to their recovery journey, and this benefit is unmatched.

Applying for Virginia Medicaid for Rehab Services

Before applying, it is crucial to review the eligibility requirements. If the individual meets all of the listed requirements, applying for coverage on the Virginia Medicaid website, by phone, or in person would be the next step. Once the application is in, following up on the status and waiting for approval can be the most intensive part. Once approved, locating a Medicaid-approved rehab center and completing intake can get the individual started on the path to addiction recovery.

Other Financial Assistance Options for Inpatient Rehab

Outside of Medicaid, there are other financial assistance options that can be used for inpatient rehab. These can include scholarships and grants provided through the state. These scholarships and grants can help offset the cost of inpatient rehab when insurance is not an option. Researching the available options is the best way to see what is out there. Another option is personal loans. These can help pay the cost of treatment, with smaller payments. Either way, thinking of these options as an investment in the person’s future is important as without the help, the odds of them getting better and achieving long-term recovery can be smaller.

Change Your Life for the Better

Learning how to live without using drugs and alcohol is a vital part of addiction recovery. Inpatient rehab can be the starting point for learning and implementing vital tools and coping skills for recovery. If you or a loved one are struggling, there is help available, even with Virginia Medicaid. At Virginia Recovery Centers, we strive to provide safety and security for these individuals to begin a happier, healthier life. Call us today and begin your journey of recovery.