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Medi-Cal refers to Medicaid for California residents. Medicaid insurance covers a range of healthcare services for low-income families and individuals, ensuring that those who may not otherwise be able to get essential health benefits can get the care they need.
If you have Medi-Cal, it is possible to find treatment services for substance use disorders that are covered in full by your insurance. This includes both inpatient and outpatient treatment. So, how can you find addiction treatment services that accept Medi-Cal?
In this article, we will talk about what Medicaid in California covers in terms of substance abuse treatment, the pros and cons, and how to choose a drug rehab that accepts Medi-Cal!
The Affordable Care Act (or ACA) ensures that individuals with Medicaid have access to a range of essential healthcare benefits. These benefits include mental health and substance use disorder treatment. As far as what kind of addiction treatment services in California Medicaid programs cover, there is a list.
Services one may be able to access via Medi-Cal include but aren’t limited to:
Primary care visits, laboratory services, and other healthcare needs are also covered under Medi-Cal. The kind of substance use or mental health treatment services a person will benefit from the most depends on a variety of different factors.
*Some individuals who pursue treatment for drug and alcohol use attend detox first and then proceed to treatment programs. Detox helps people go through the withdrawal process safely.
Inpatient treatment is exactly what it sounds like. When you are in inpatient treatment, you are admitted to a facility full-time. During your stay, you will sleep, eat, and get care at the facility. Inpatient treatment often involves a range of therapies (e.g., individual, group, and family therapy) and medication management, as well as other activities. Most of the time, inpatient treatment centers will help you build a relapse prevention plan before your stay ends. If you have a comorbid mental health condition, you may choose to look for a dual-diagnosis treatment provider.
Usually, but not always, people who start with inpatient treatment for drug or alcohol addiction move down to outpatient care in time. This is to ensure that you have care throughout the recovery process and don’t go from having a full treatment team to having no support and going back to old patterns. Outpatient care can include intensive outpatient programs, standalone therapy services, or another plan that is unique to the individual. The recovery process generally extends far beyond the date a person leaves treatment.
Some substance abuse treatment centers have alumni services for those who complete their treatment program. Alumni programs or services help individuals sustain recovery after rehab. Similarly, many individuals attend support groups to help them sustain recovery from substance abuse long after rehab. Most support groups are free and peer-led, which sets them apart from group therapy.
How long will you be in inpatient treatment? The length of treatment will vary from person to person. Similarly, the amount of time in treatment your insurance will cover can range. That said, most individuals can expect to stay in an inpatient or residential treatment for around one to three months. As an adult, you should be able to check yourself out in most cases, unless treatment is court-ordered.
Like other addiction treatment services, many eligible individuals are able to get alcohol rehab covered by Medi-Cal. Follow the steps below to find rehab centers for those who experience alcohol use disorder.
How do you find rehab centers that accept Medi-Cal? Whether you need to find inpatient or outpatient treatment services and rehab centers, the process is just about the same. There is a range of ways to go about your search for the right rehab center.
To find rehab centers that accept Medi-Cal, you can:
These options can be time-consuming and may be difficult to navigate. A preferred option is choosing the services of Rehabs Of Armerica to help you find a treatment center.
Our expert staff can verify your insurance coverage and help you find treatment centers that accept California Medicaid, completely confidentially and often within minutes!
You don’t need to attend rehab in your immediate city or town. With a Medi-Cal health care plan, you may be able to find treatment centers across the state, from Los Angeles to Stockton, that accept your insurance. Many people actually find it helpful for their recovery to leave their immediate area during treatment, so don’t hesitate to pursue this as an option.
Some people choose to look into and read online reviews for various treatment facilities to learn more and compare their options before they attend treatment. You can also contact the specific treatment center you are interested in if you have any questions.
Medicaid is available for individuals throughout the US. However, Medicaid requirements differ by state. If you think that you may qualify for Medicaid but don’t yet have insurance coverage, you may wonder if you are eligible. Most of the time, people are eligible for Medi-Cal health insurance versus self-pay for rehab based on their income, but there are other ways to qualify, too, such as a documented disability.
To get Medi-Cal based on income, you must have an income level under 138% of the federal poverty level. If you are in a single-person household, this would mean that you need to make $18,755 or less per year. The maximum household income a person can have to obtain and keep Medicaid benefits based on income level will differ based on household size.
Check to see if you may qualify for Medi-Cal. Once you determine eligibility, you can apply for Medi-Cal online or in person at an office near you.
While Medi-Cal can be a good option for those who need more affordable treatment for their addiction, this program does have its setbacks, including:
When seeking treatment through Medi-Cal, this program tends to have long wait lists. This means that you will have to wait a decent amount of time before you are actually able to begin receiving treatment. It can take weeks or even months for you to be accepted by Medi-Cal and for your coverage to go into effect.
Unfortunately, for those who need medical detox services for their withdrawal symptoms, this wait time may not be manageable. In many cases, people who are waiting to get accepted into Medi-Cal end up going back to using it by the time they finally receive this coverage. With this in mind, seeking out private health insurance treatment options may be better if you need immediate treatment.
The state-funded programs that are covered through Medi-Cal will usually be more cookie-cutter in their approach to treatment. While this might be okay for someone with a less severe addiction, non-specialized treatment can be ineffective for those with more intense substance use disorders.
There are several factors that go into a person’s addiction, including the type of substance they are abusing, how long and how often they have been abusing it, and whether or not they have any underlying physical or mental health conditions that may be contributing to this abuse. Without acknowledging and treating each of these factors, the individual will not be able to fully overcome their addiction and maintain long-term recovery.
If you need a more individualized treatment plan, rehab programs funded through Medi-Cal will not be a good fit for you. You can speak with a Rehabs Of Armerica recovery representative today to get a better understanding of your treatment needs and find out which rehab services will be best suited to your recovery.
With Medi-Cal coverage, your treatment options will be limited to public rehab programs funded by the state of California. In many cases, it will be recommended that you try to recover from your addiction in a rehab center that is far removed from the people, places, and things that can be associated with your substance abuse.
Staying at home for treatment can make it more difficult to successfully complete your program, as you will be constantly surrounded by things that remind you of your previous lifestyle. Traveling out of state for rehab, however, and recovering through private rehab programs can remove you from these triggers and stress factors and give you peace of mind throughout your recovery process.
One of the best indicators of a high-quality rehab program is having low patient-to-provider volumes. This allows for more individualized and one-on-one treatment and allows providers the flexibility to respond to tricky and emergency situations as they come up. When recovering through state-funded rehab programs, such as those covered by Medi-Cal, these will have much higher patient volumes.
In many cases, you may be sharing the same treatment team with dozens of other people. This can often make your care feel less personal, and more like you are just another number on their roster. Having the more personalized care that is offered through private rehab programs can provide a level of physical and emotional support that is often crucial to successful and long-term recovery.
Now that we have discussed the benefits of private rehab, it is important to address any concerns you may have over the costs of these programs. In many cases, people will turn to the state-funded programs covered through Medi-Cal to minimize their out-of-pocket expenses for treatment. However, as shown above, this can have its downfalls.
Fortunately, there are ways of offsetting the costs of private addiction treatment. For starters, you can try getting coverage through commercial insurance companies that offer addiction and mental health treatment benefits. Under the Affordable Care Act (ACA), most health insurance providers are required to give their clients some level of coverage for these services. You can learn more about using the Health Insurance Marketplace for covering addiction treatment here.
You can also ask your friends, family, and community members for financial support, as well as set up an online charity fund (i.e. GoFundMe) to help cover the costs of your treatment. In many cases, certain rehab programs will also allow you to set up a payment plan based on your personal income and financial capabilities, so that you can pay for your treatment over time, rather than all at once.
You can speak with a Rehabs Of Armerica representative today to learn more about what payment options will work best for you when expanding your rehab choices and getting the treatment you need to successfully achieve and maintain sobriety.
Whether you are a Medi-Cal recipient or are covered by another form of health insurance, we’re here to help. Looking for the right rehab center can be stressful, and Rehabs Of Armerica is here to take some of the weight off of your shoulders.
At Rehabs Of Armerica, we make it easier to find care. Whether you need to locate treatment services in your area, need help looking for treatment services covered by your insurance plan, or want to learn about recovery tools and resources, our hotline is available 24/7. Rehabs Of Armerica can also assist those who are in search of a treatment facility for a loved one, such as a family member.
We will help you find a treatment placement tailored to your needs and can verify your insurance coverage for you in complete confidence. Take the first step to lasting sobriety and call Rehabs Of Armerica now!
Yes. Medi-Cal covers methadone, naltrexone, and levo-α-acetylmethadol (LAAM). Medication-assisted treatment (MAT) through medications like these can help individuals achieve and maintain recovery. Medication-assisted treatment is known to help people stay out of legal trouble and maintain employment, a goal for many individuals working to recover from a substance use disorder. These medications can also aid the detox process by making withdrawal symptoms less intense.
The Drug Medi-Cal program is a treatment funding source that helps eligible members get substance use disorder services. For the Drug Medi-Cal program to cover your care, you must get treatment services at a Drug Medi-Cal-certified program.
IOP is shorthand for “intensive outpatient program(s).” Eligible Medi-Cal members can get intensive outpatient programs covered in full if they find an outpatient program or treatment facility that accepts their insurance and approves them for care.
If you intend to use your insurance for substance use disorder services, a treatment center will verify your coverage prior to your treatment.
According to the National Institute on Drug Abuse (NIDA), 40-60% of people with a substance use disorder recover. This statistic also means that 40-60% of people with a substance use disorder will face a relapse.
A relapse does not mean that an individual will never achieve recovery. Recovery from addiction often requires a focus on behavior change, implementation of coping skills, and other factors. Treatment can be advantageous in helping people in these areas, as well as in staying in recovery.
* Disclaimer: Rehabs Of Armerica is not affiliated with or endorsed by Medi-Cal Insurance. Details about Medi-Cal’s coverage are intended for informational purposes only. The specific details of your Medi-Cal plan may vary and the specific treatment services you require may or may not be covered. Please call our representatives today for more definitive details on your plan and to find options outside Medi-Cal if desired.
Charles F. has been an active part of the Florida recovery community for over 5 years. He began as a behavioral health technician at an addiction treatment facility in Ocala, Florida and has since begun training as a Licensed Addiction and Chemical Dependency counselor in Boca Raton. Charles’ passion involves the promotion of recovery and helping spread the hope of recovery to as many readers as possible!
