Using Medicaid in Arizona for Residential Treatment Support

Addiction treatment is never something to be taken lightly, but many people worry about the costs they will incur for services. Arizona’s Medicaid program may be able to help you cover the cost of treatment, whether you need substance abuse treatment or mental health services.

But when does Medicaid cover inpatient rehab in Arizona, and how can you ensure you are attending a proper facility?

Change Healing Center is committed to offering high-quality behavioral health services to as many people as we possibly can. We accept most insurance providers, including Medicaid recipients via the AHCCCS provider (the largest Medicaid provider in our state).

Keep reading to learn more, and remember that our dedicated admissions staff can help you start navigating your health insurance programs to seek treatment via phone at any time!

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Does Medicaid Cover Rehab and Addiction Treatment?

According to Medicaid, roughly 12 percent of adults who receive this insurance benefit struggle with a substance use disorder. With rates this high, it likely comes as no surprise that Medicaid recipients in general can benefit from covered substance abuse treatment.

On a national stage, the Affordable Care Act mandates that substance abuse treatment be covered and included in health insurance programs. Medicaid must also comply with this mandate from the federal government. However, you may see varying levels of care with your addiction treatment depending on the state.

Services covered by Medicaid can include health screenings, inpatient and outpatient treatment, hospital stays or medical detox, family therapy, and more. Medicaid is handled on a state-by-state basis with unique plans found in each of the state Medicaid programs. It is important to see what Arizona’s Medicaid program offers in terms of your addiction treatment coverage.

Eligibility Requirements for Medicaid Coverage

United States Citizen Resident

Not everyone who needs drug or alcohol rehab treatment will be eligible for Medicaid. This is not an age-based program but is instead based on income requirements, family status, and more. However, those who qualify for Medicaid will not pay a monthly insurance premium.

Some of the criteria for adults ages 19 to 64 who are Arizona residents include:

  • United States citizen or qualified immigrant
  • Social Security number or application for one
  • Does not qualify for Medicare
  • Must not be pregnant
  • Applies for supplemental security income, if applicable

Of course, there are also income eligibility requirements based on the size of your family. For a single-person household, your monthly income must be $1,616 or less. Each additional person permits an increase of $570 to the minimum income requirements, so you can easily see if your family qualifies for Medicaid coverage.

Knowing where you stand in terms of the federal poverty level is a great first step to finding eligibility for Medicaid.

What are the Types of Medicaid Plans in Arizona?

When it comes to selecting health insurance programs under the Medicaid umbrella, there are many options to choose from that fall under the AHCCCS umbrella. The plans you have to choose from are highly dependent on your zip code and where you live, but all feature mental health parity (meaning that such symptoms are treated as equally important as physical health concerns).

This ensures that you can find covered services in your area with in-network doctors and facilities. Depending on which AHCCCS plan you enroll in, Changes Healing Center may be able to help you facilitate drug and alcohol treatment in your local area.

Here are some of the AHCCCS plans that provide services to Maricopa County:

  • Arizona Complete Health – Complete Care Plan
  • Banner-University Family Care Plan
  • Molina Healthcare
  • Mercy Care
  • Health Choice Arizona
  • UnitedHealthcare Community Plan

If you receive benefits from any of the above plans or are eligible for Medicaid, you might want to take advantage of their services for addiction treatment.

Changes Healing Center can help you calculate the cost of your treatment with Medicaid during a quick and confidential same-day insurance verification.

Choosing Medicaid Benefits Based on County

Medicaid

For the most part, you will want to select your Medicaid plan based on the county in which you reside or intend to seek treatment. Before you enroll in a plan for the year, consider where you might want to receive substance use disorder treatment. You can select a plan within one of these neighboring counties if you are confident you will receive care here.

Otherwise, you might want to select a plan based on your geographic area to prevent the need to drive to a neighboring county for all of your healthcare needs.

While Changes Healing Center does not assist you in choosing a health insurance plan, we can run the benefits for you based on the healthcare coverage you have. Even if we are not an in-county provider for your plan, we can help you calculate what your final cost will be for our alcohol and drug rehab using Medicaid benefits.

AIHP Plans for Mental Health Services and Substance Abuse

The American Indian Health Program (AIHP) is also a major part of the AHCCCS program. If you are an American Indian or an Alaska Native, you can qualify for special Medicaid programs which may offset your costs for treatment of substance use disorder. What is special about the AIHP program and its relation to AHCCCS?

AIHP allows American Indians and Alaska Natives to seek health services specifically from Indian Health Facilities as well as those who are included under AHCCCS. Programs that are included in the AIHP include:

  • Indian Health Services
  • 638 health programs operated by tribes
  • Urban Indian health clinics

If you are eligible for AIHP plans, you may choose to go with the Care1st Health Plan or Health Choice Arizona as part of Arizona’s Medicaid program.

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Comparing Arizona Complete vs Long Term Care

When you are thinking of receiving addiction treatment for drug and alcohol use, it is important to have a solid understanding of the Medicaid benefits available to you. There are two major categories of health coverage allotted in Medicaid: Arizona Complete and Long-Term care.

Arizona Complete

Arizona Complete is an integrated healthcare program for most Arizona residents. Complete Care as part of AHCCCS is still going to give you a choice in which facilities you want to receive treatment from and provide excellent behavioral health services for their members.

They have Regional Behavioral Health Authorities (RBHAs) will serve people who have a serious mental illness (SMI) and people who are also serviced by the Department of Economic Services/DDD. If you require crisis-level services for your substance abuse, Arizona Complete has a plan that can assist you.

Arizona Long-Term Care

While AHCCCS is the more well-known option for Medicaid recipients, some individuals will qualify for Arizona Long-Term Care (ALTCS). This program differs from Complete because it is designed for those over age 65, those who have a disability, and anyone who requires nursing-level care to function.

If you qualify for ALTCS, you may want to consider if it will also include a drug and alcohol rehab. It does cover behavioral health services as needed, so be sure to check with our insurance verification department and admissions staff to discuss your Medicaid coverage.

Serious Mental Illness (SMI) Designation and Behavioral Health Services

Mental Illness Services

Some people who struggle with mental health in addition to drug and alcohol use may fall under the purview of a serious mental illness designation. To receive this qualification, you must be able to prove that your mental health does not allow you to participate in daily activities or reside within community structures.

It should be severe and persistent, as well as greatly impeding your ability to engage in daily activities like taking care of yourself, managing interpersonal relationships, and holding down a job.

If you fall under the designation of an SMI, you will get an individual service plan that allows you to receive mental health counseling and any services you may need to reenter the community to the best of your ability. This may include drug and alcohol rehab if your mental health is negatively influenced by substance use disorder.

How Much Will Treatment Cost with Medicaid Coverage?

The most pressing question for many people who are considering rehabilitation services while in a Medicaid insurance plan is how much the treatment programs will cost. For the most part, Medicaid beneficiaries are low-income families who may not have thousands of dollars to spare for substance use treatment.

What can you expect to pay for your treatment?

The good news is that Medicaid often covers the cost of alcohol rehab and drug rehab treatment in its entirety. Keep in mind that this is based on your annual income and the size of your family though. Sometimes, you may not be eligible for full coverage but the cost will be substantially lower than the sticker price of rehabilitation services.

Before you enroll in our treatment centers, let us verify your Medicaid benefits and see what you will pay for your treatment. Even if you have been to treatment before, Medicaid and other insurance will often pay for rehab multiple times if medically necessary.

Can You Access Treatment Without Health Coverage?

Because many people could benefit from addiction treatment, AHCCCS has an order of priority for those who qualify for substance abuse treatment and mental health services. These priorities are defined by the Substance Abuse and Mental Health Services Administration (SAMHSA).

Grants that cover rehabilitation services for Arizona residents are given to the following groups of people in this order:

  • Pregnant women and teens who are injecting drugs
  • Pregnant women and teens who are using any kind of substances
  • Anyone else using drugs by injection
  • Women and teens with dependent family members or those trying to regain custody

Everyone else is covered after these populations have been accounted for, as long as funds remain.

Another thing to keep in mind is that AHCCCS may be able to help you find treatment services even if you have another private health insurance. If your other insurance does not cover substance abuse treatment, then you may look to this program to help cover the cost. It can help with mental health services, addiction treatment, and more.

Seeking Care from Qualified Facilities

Treatment from Qualified Facilities

Unfortunately, not all facilities that are covered by Medicaid are of the highest quality. Changes Healing Center prides itself on offering evidence-based drug and alcohol rehab services that can make a huge difference in your life and relationships.

We offer both individual and group therapy and are proud to hold a Joint Commission accreditation. This means that our facility is safe and provides evidence-based treatment opportunities to those we help. If you want to maintain your sobriety long-term, consider seeking a Medicaid-covered facility with this accreditation.

For more than 70 years, the Joint Commission has made it a priority to endorse quality healthcare in a safe setting. Don’t sacrifice this standard of care just because you need a Medicaid-covered drug abuse or alcohol rehab.

Reach Out For Help At Changes Today!

Get Help from Changes Using Medicaid in Arizona

When you are ready to embrace the help of treatment centers and receive addiction treatment services, you need to ensure that your health insurance coverage will kick in. We do accept Medicaid coverage, and we can verify your insurance benefits in a quick and easy, confidential phone call.

Our alcohol and drug rehab program is evidence-based and robust to offer you the help you need. Plus, we offer the Joint Commission accreditation that proves how safe and high-quality our facilities are.

Don’t delay your drug and alcohol addiction treatment just because you are unsure what your insurance will cover. Reach out to our warm and welcoming staff at our approved treatment facility to get the help you need today. We will make it easy to see if Arizona Medicaid will cover the cost of your treatment!

References

  1. Ahcccs Complete Care (ACC) health plans. (n.d.).
  2. American Indian Health Program (AIHP) (health plan ID #999998). AHCCCS. (n.d.-a).
  3. Health Insurance for adults, beginning January 1, 2014. AHCCCS. (n.d.-b).
  4. Substance use disorders. Medicaid. (n.d.).
  5. Substance use prevention, treatment and recovery block grant (SUBG – formerly known as SABG). AHCCCS. (n.d.-c).