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Defining Medicaid And Medicare

Medicaid and Medicare occurs on the federal and state level and is offered to those who have low income. Medicaid can exist for:

  • Children

  • Expecting mothers/guardians or caretakers of children

  • Individuals 65 and older

  • Disabled people

Each state offers different protocols for how they determine financial eligibility. For example, some states may decide what an acceptable bracket is for low income families, as individuals must meet the state delegated criteria to be considered. Recipients of Medicaid must be in the low-income category and meet the requirements listed above.

What Does Medicaid And Medicare Cover?

Medicaid and Medicare can be provided separately or combined, based on someone’s eligibility for meeting the requirements. The Affordable Care Act allowed for states to widen their coverage for Medicaid to those who are younger than 65 years old. In previous years, 12.2 million Americans were enrolled in both Medicaid and Medicare, with 49% having a mental health challenge, with 60% enduring chronic health conditions.

Both Medicaid and Medicare can help finance rehab and medications for alcohol treatment, along with mental healthcare and general healthcare. Medicare occurs in 4 parts that cover addiction-related services depending on certain factors. For example:

  • Part A: Includes coverage for inpatient care and hospitalizations. Patients are covered for 2 months and they pay a deductible.

  • Part B: Covers medical insurance and outpatient care. Fortunately, more than 75% of costs are covered, including medications, therapy, and some mental health disorders.

  • Part C: Private insurance that is approved by Medicare. Patients may consider Part C coverage who prefer more benefits.

  • Part D: Covers prescription medications that include alcohol withdrawal medications that reduce cravings.

According to Medicare Interactive, some drug medications are not covered by Parts B and D of Medicaid, however, some are covered by Part A. In 2021, Part A monthly premiums includes no payment if your spouse has worked 40 calendar quarters or more, $240 if, “your spouse has worked between 30 and 39 quarters,” and, “$437 if your spouse worked less than 30 quarters.”

The site also notes for Part A inpatient care costs, people pay $1,484 deductibles for each period; $371 daily coinsurance for 61 to 90 days; no coinsurance between 1 to 60 days, and lastly, “$742 coinsurance for 60 lifetime reserve days.” Part B 2021 costs include $148.50 if people make under $87,000, the annual deductible cost being $203, and outpatient care that cannot be any higher than, “the Part A hospital deductible.”

Who Qualifies For Medicaid?

For Medicaid, states will have different requirements for those who qualify for Medicaid. Generally, those who qualify are under 19 years of age, mothers, those who are 65 and up, and those who are disabled. In states like Ohio, older people aged 64 and up qualify for Medicaid, and have to have a household income in the following brackets:

  • 1 person: $16,612

  • 2 people: $22,491

  • 3 people: $28,369

  • 4 people: $34,248

  • 5 people: $40,127

  • 6 people: $46,005

Aside from financial considerations, being medically needy can be an eligibility factor. In this case, people who don’t financially qualify as they make too much money can still be eligible for Medicaid. Medicaid.gov notes the Medicaid program pays the cost of services that exceeds the expenses the individual had to incur to be eligible.” Contacting a qualified treatment provider or conducting research can help provide more information to determine qualifications based on income and health factors. Contacting 1-800-MEDICARE or connecting with local Medicaid offices can provide more answers to questions, and answer any general questions someone may have about treatment or recovery costs.

Medicaid And Medicare For Financing Rehab

Medicaid and Medicare are helpful ways to fund rehab for alcohol addiction. Medicaid covers the following including:

  • Medically-assisted detox

  • Inpatient and outpatient rehab

  • Mental health conditions

  • Screenings

  • Dual diagnosis-related conditions

  • Interventions

  • Addiction treatment medications

  • Alcohol testing

  • Hospital stays

Furthermore, Medicare covers some of the above-listed services and additional addiction-related services such as, but not limited to:

  • Psychotherapy/counseling

  • Hospital follow-ups

  • One-on-one therapy or group therapy

Medicaid and Medicare cover rehab both locally and out of state. Furthermore, these funding options can help the individual afford medications to help during their treatment. With the awareness of funding options for rehab and overall health, those who qualify can take comfort in knowing they can continue to get aid for alcohol addiction, addiction treatment, and addiction medications.

Learn More About Financing Options

Not having the funding for rehab can discourage someone from getting treatment. Examine how Medicaid and Medicare can help to get you one step closer to getting the treatment you need for recovery. Contact a treatment provider to explore more funding options including Medicaid and Medicare for alcohol rehab and treatment.

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