Do Drug and Alcohol Rehab Centers Take Medicaid Insurance?

What is Texas Known For?

Texas’ rich history boasts a diversity that spans centuries. Native American tribes, including the Apache, Comanche, and Caddo, initially inhabited the land. Spain claimed the area in the 16th century that later became part of Mexico in the 1820s. In 1836, Texas gained independence from Mexico and became the Republic of Texas.

Eventually, The Lone Star State joined the United States in 1845 as the 28th state.¹ Throughout its history, Texas played a significant role in the American Civil War and experienced periods of economic growth and challenges throughout the 19th and 20th centuries. One notable period in Texas' history was the late 19th century, when the state played a crucial role in the cattle industry. Cattle drives were a common sight as cowboys corralled large herds of cattle from Texas ranches to railheads in Kansas. From there, they were transported to markets in the eastern United States.

Famous trails such as the Chisholm Trail and the Goodnight-Loving Trail were used for these drives, lasting several months. This era of cattle drives significantly impacted Texas's economy and folklore, creating a lasting cowboy culture still celebrated today.²

Major Cities:

Houston: The largest city in Texas and the fourth-largest in the United States, Houston is known for its energy industry, diversity, and thriving arts scene. NASA’s Johnson Space Center for Science and Space Exploration is fun for the whole family!
San Antonio: Famous for its rich colonial heritage, San Antonio is home to iconic attractions like the vibrant River Walk and the Alamo. This symbol of Texas independence is a great place to learn about the state’s history.
Dallas: A central financial and cultural hub, Dallas is renowned for its modern architecture, upscale shopping, and professional sports teams.
Austin: The capital of Texas, Austin is known for its live music scene, technology industry, and exciting cultural events like South by Southwest (SXSW). After all, Texas is the birthplace of such prominent musicians as Beyoncé, Buddy Holly, and Willie Nelson!
Fort Worth: Often referred to as "Cowtown," Fort Worth embraces its cowboy heritage and is home to the renowned Fort Worth Stockyards, a popular tourist destination for rodeos.

If you're looking for stunning natural beauty, Big Bend National Park in West Texas is where it’s at. It’s close to the Mexican border and features desert landscapes, canyons, and the Rio Grande River, making it a unique and unforgettable destination. The 28^th state also boasts famous Mexican cuisine known as Tex-Mex, and you can’t forget the world-famous barbecue!

Texans are known for their intense passion for sports, and the state boasts several successful professional sports teams. However, football fans in Texas are divided in their support between the Dallas Cowboys (NFL) and the Houston Texans (NFL), both of which have a massive fan base. Basketball enthusiasts also have plenty to cheer about, with the Houston Rockets (NBA) and the San Antonio Spurs (NBA) achieving considerable success. Those who follow baseball can root for the Texas Rangers (MLB) and Houston Astros (MLB), while soccer fans can show their support for teams like FC Dallas (MLS) and Houston Dynamo (MLS).

Who is Medicaid?

Medicaid is a government-funded healthcare program that offers healthcare coverage to low-income families and individuals in the US. It was established in 1965 under the Social Security Act and is administered by the Centers for Medicare and Medicaid Services (CMS). It’s one of the most common means of funding for addiction treatment centers.³

The services offered by Medicaid differ depending on the state but typically include the following:

Doctor visits
Hospital stays
Prescription drug coverage
Long-term care
Laboratory and diagnostic testing
Medical equipment and supplies
Home health services
Behavioral health services

Medicaid eligibility requirements differ by state, and unfortunately, Texas is one of ten states who have yet to participate in Medicaid expansion,⁴ even though the state has the highest rate of uninsured people.⁵

To qualify for Texas Medicaid, you must be a Texas resident, a national or citizen of the United States, a permanent resident, or a legal immigrant needing health care or insurance help, and have a low or very low income. You also need to fit one of the following criteria:⁶

Pregnant, or
Responsible for a child 18 or younger
Blind, or
Have a disability yourself or a family member who is disabled
Age 65 or older

You must also meet specific income and asset criteria. Your household income must be at or below a particular percentage of the federal poverty level (FPL). The FPL is updated yearly and varies based on your household size and state of residence.⁷ Currently, the maximum annual income for an individual in Texas must not exceed $28,869 to qualify for Medicaid.

In addition, several Medicaid waiver programs in Texas provide specialized services and support to eligible individuals. Medicaid waiver programs allow state Medicaid programs to modify or waive certain federal Medicaid requirements, providing access to healthcare services or support to specific populations, addressing health disparities.

Some notable Medicaid waiver programs in Texas include:⁸

Home and Community-Based Services (HCS) Waiver: This waiver provides long-term care services and support for individuals with intellectual and developmental disabilities to receive care in community settings instead of institutional settings.
Texas Home Living (TxHmL) Waiver: The TxHmL waiver offers home and community-based services for individuals with intellectual and developmental disabilities who require substantial assistance to live in community settings.
Community Living Assistance and Support Services (CLASS) Waiver: The CLASS waiver supports individuals with significant disabilities to live independently in the community by providing services such as personal assistance, case management, and adaptive aids.
Medically Dependent Children Program (MDCP) Waiver: The MDCP waiver offers support services to children with significant medical needs who would otherwise require care in a hospital or long-term care facility.

Check Your Health Insurance for Addiction Treatment in Texas

You can check your health insurance coverage levels for drug or alcohol addiction rehab by calling us on 866-461-3339 or by using the form below. Our admissions coordinators will interact directly with health on your behalf, removing from your shoulders the burden of figuring out if your insurance will pay for your addiction treatment.

What is Rehab Insurance Coverage?

Rehab insurance coverage refers to the amount that a health insurance policy covers for addiction treatment, therapy, or counseling services, all of which are critical to the recovery process. The extent of coverage may vary depending on the type of insurance policy, the specific rehabilitation treatments prescribed, and other factors.

Receiving rehabilitation services can be expensive, particularly if required for an extended period. With rehab insurance coverage, you can better manage these costs and gain access to the necessary medical care to recover from addiction, illness, or injury.

Does Medicaid Cover Drug and Alcohol Rehab in Texas?

Yes, Medicaid covers drug and alcohol rehab services in Texas, typically under behavioral health services.⁹ These services may have specific limitations, such as the number of days or sessions covered, and the level of coverage and services may vary based on individual circumstances, eligibility criteria, and the specific Medicaid plan, but they usually include the following:¹⁰

Detoxification services: Medicaid may cover medically supervised detoxification to help individuals safely withdraw from substances.
Inpatient rehabilitation: Residential or inpatient rehab in Texas with Medicaid may be possible. These treatment programs provide intensive care and support for substance abuse.
Outpatient treatment: Medicaid may cover outpatient services such as counseling, therapy, medication-assisted treatment (MAT), and support groups.
Medications: Medicaid may provide prescription drug coverage to treat substance use disorders, such as methadone or buprenorphine for opioid addiction.
Aftercare and follow-up services: Medicaid may cover transitional or continuing care services to support individuals after completing a rehab program.

Call 866-461-3339 to determine the details and limitations of your particular Medicaid policy.

Does Medicaid Cover Mental Health Rehab in Texas?

Yes, Medicaid does cover mental health rehab services in Texas. The specific coverage and services may vary based on individual circumstances, eligibility criteria, and the particular Medicaid plan. Medicaid coverage for mental health rehab services in Texas may include the following:

Inpatient psychiatric care: Medicaid can cover inpatient hospitalization for individuals who require intensive psychiatric treatment.
Outpatient mental health services: Medicaid may cover outpatient services such as individual therapy, group therapy, psychiatric evaluations, medication management, and counseling.
Intensive outpatient programs (IOP): Medicaid may cover structured programs that provide more intensive treatment than traditional outpatient care.
Partial hospitalization programs (PHP): Medicaid may cover PHPs that offer comprehensive day treatment for individuals with severe mental health conditions.
Case management: Medicaid may cover case management services to help individuals navigate the mental health system, access resources, and coordinate care.
Medications: Medicaid may cover medications prescribed for mental health conditions.

Substance use disorder is one of the ten essential health benefits that insurers must offer under the Affordable Care Act (ACA). To comply with this requirement, Medicaid and other insurance companies must cover mental health care and treatment. This obligation covers both rehabilitation and mental health care services.¹¹

Reviewing your specific plan or speaking with the Texas Medicaid office for more detailed and up-to-date information regarding coverage for mental health rehab services is recommended. We at Virtue Recovery Center are happy to take care of this for you. Call 866-461-3339 or fill out our no-obligation online form to verify insurance for addiction treatment today.

Inpatient and Outpatient Rehab Centers in Texas That Take Medicaid Insurance

Virtue Recovery Center has been helping individuals overcome substance abuse and improve their mental health for years. They have multiple treatment centers in different states, including two accredited facilities in Texas that offer free assessments. These evidence-based treatment programs may or may not accept Medicaid.

Call 866-461-3339 to learn more about each of our Texas-based treatment centers below:

Houston, Texas: 9714 S Gessner Rd, Houston, TX 77071, United States
Killeen, Texas: 5200 S W S Young Dr, Killeen, TX 76542, United States

FREE ASSESSMENT

Get immediate treatment help now. 100% safe & confidential.

CALL (866)-461-3339

Contact us to schedule a free confidential assessment with a licensed clinician.

CALL US NOW

How Much Does Rehab Cost in Texas with Medicaid Insurance?

With Medicaid insurance, the cost of rehab in Texas is significantly reduced compared to paying out-of-pocket. In many cases, Medicaid will cover a substantial portion of rehab services, if not the entire cost. However, it's important to note that there may still be some out-of-pocket expenses, such as copayments or deductibles, depending on your specific Medicaid plan.

The cost of rehab in Texas with Medicaid insurance can vary depending on several factors, including the specific rehab facility, the level of care needed, and the duration of treatment. Medicaid is designed to provide coverage for necessary medical services, including substance abuse and mental health treatment.

The best way to determine the cost of rehab with Medicaid insurance in Texas is to contact us at 866-461-3339. One of our helpful admission coordinators can thoroughly review your Medicaid plan and explain your options for substance abuse treatment today.

How To Check Medicaid Coverage Levels for Rehab Treatment in Texas

Easily verify insurance coverage levels for Medicaid addiction treatment in Texas with our no-obligation, free online form. One of our compassionate staff members will contact you to review your policy and your options for treatment shortly. Our top priority is ensuring you receive the best possible care, and all submitted or exchanged information will remain completely confidential.

How To Get Medicaid Texas to Pay for Rehab Treatment

If you are interested in using Medicaid to pay for rehab treatment, the process may differ depending on your Medicaid plan and additional factors. However, you must satisfy specific steps and criteria to receive Medicaid addiction treatment coverage. Here are some general steps to follow:

Check your Medicaid coverage: Verify the details of your Medicaid coverage. Call 866-461-3339 – we can take care of this for you.
Get a diagnosis: It’s necessary to have a diagnosis of a substance use disorder or a mental health condition. A licensed healthcare provider can typically provide this diagnosis.
Find a rehab provider: You will need to find rehabs in Texas that accept Medicaid. You can search for providers on your state Medicaid agency's website or by calling 866-461-3339 for more information about our two treatment facilities in Texas.
Get a referral: You may require a referral from your primary care provider or a specialist. The requirements for this vary depending on your specific Medicaid plan and the type of treatment you need.
Get prior authorization: You may need approval from your Medicaid provider through a prior authorization process. You can typically seek assistance from your chosen healthcare provider for this step.
Attend treatment: Follow your healthcare provider's recommendations and attend your rehab treatment program once you have fulfilled all the requirements.

How Many Times Will Medicaid Texas Pay for Rehab?

Medicaid offers different rehab coverage periods, often placing annual limitations on the number of eligible services in specific treatment areas. Even though the needs of each patient determine most treatment time, inpatient treatment duration may be restricted to a specific number of days per calendar year, for instance.

Program lengths for inpatient recovery can range from 15 to 90 days, depending on your needs. The duration of treatment is determined by the patient's needs, not by what the insurance will pay for. Generally, Medicaid will cover rehab treatment as often as medically necessary to treat your substance use disorder or mental health condition.¹²

Medicaid Rehab Treatment and Insurance Statistics

At $21.2 billion, Medicaid is the primary source of government funding, making up 76.6% of the total.¹³
Medicaid spending is predicted to be $71.8 billion in Texas state and federal funding for 2024 and 2025.¹⁴
As of October 2022, 5,429,009 are enrolled in Texas Medicaid.¹⁵
Hispanic women had the most significant percentage of Medicaid coverage at the time of birth in Texas from 2018 to 2020 (on average), followed by Black women (62.5%), American Indian/Alaska Native women (45.0%), White women (29.8%), and Asian/Pacific Islander women (20.0%).¹⁶
In Texas, 79% of Medicaid recipients who are not elderly are people of color.
Among Texas people on Medicaid, 54% are employed.
If Texas expanded Medicaid, the federal government would pay90% of the costs of the Medicaid expansion. Texas would also see a net gain of $1.9 billion over two years in fiscal incentive payments from the American Rescue Plan Act.
Medicaid covers 50% of births in Texas.
During the pandemic, Texas Medicaid enrollment increased by more than 1 million individuals.¹⁷
Pregnancy-related Medicaid coverage expires barely two months after giving birth, according to campaigners and experts, and this cutoff time is a factor in the state's high rates¹⁸ of maternal death and morbidity.¹⁹

Check Your Medicaid Insurance Coverage With Virtue Recovery Center

If you’re committed to recovery, submit a request to one of our professional admission coordinators today using the form below. Before discussing the next steps, a coordinator will address any inquiries regarding our programs, including interacting directly with Medicaid on your behalf to check your insurance coverage levels for drug or alcohol addiction rehab.

STEP 1

Using your Health Insurance Card, fill out all of the fields on the confidential form.

STEP 2

A member of our staff will contact your insurer to verify if your policy will cover your treatment

STEP 3

We will contact you promptly with the results of the verification and discuss the next steps

*Insurance Disclaimer: Virtue Recovery Center will attempt to verify your health insurance benefits and/or necessary authorizations on your behalf. Please note that this is only a quote of benefits and/or authorization. We cannot guarantee that payment or verification eligibility will be accurate and complete as conveyed by your health insurance provider. Payment of benefits is subject to all terms, conditions, limitations, and exclusions of the member’s contract at the time of service. Your health insurance company will only pay for services it determines to be “reasonable and necessary.” Virtue Recovery Center will make every effort to have all services preauthorized by your health insurance company. Suppose your health insurance company determines that a particular service is not reasonable and necessary or that a specific service is not covered under your plan. In that case, your insurer will deny payment for that service, and it will become your responsibility.

Your Name*

Phone Number

Email

Who is seeking treatment?*

Yourself

A Loved One

Name of Patient

Date of Birth of Patient*

Insurance Company's Name*

Insurance Company's Phone Number*

Member ID*

May we text you?

Yes

No

*Insurance Disclaimer: Virtue Recovery Center will attempt to verify your health insurance benefits and/or necessary authorizations on your behalf. Please note, this is only a quote of benefits and/or authorization. We cannot guarantee payment or verification eligibility as conveyed by your health insurance provider will be accurate and complete. Payment of benefits are subject to all terms, conditions, limitations, and exclusions of the member’s contract at time of service. Your health insurance company will only pay for services that it determines to be “reasonable and necessary.” Virtue Recovery Center will make every effort to have all services preauthorized by your health insurance company. If your health insurance company determines that a particular service is not reasonable and necessary, or that a particular service is not covered under your plan, your insurer will deny payment for that service and it will become your responsibility.

Related Rehab and Insurance Resources

Sources and Citations

^[1] National Geographic Society. “Dec 29, 1845 CE: Texas Becomes a State.” National Geographic,2022, education.nationalgeographic.org/resource/texas-becomes-state
^[2] “Texas Cattle Drives — Texas Parks and Wildlife Department.” Texas.gov, tpwd.texas.gov/education/resources/keep-texas-wild/vaqueros-and-cowboys/texas-cattle-drives. Accessed 16 May 2023.
^[3] Treatment, Center for Substance Abuse. “Chapter 6 --Funding and Policy Issues.” Integrating Substance Abuse Treatment and Vocational Services - NCBI Bookshelf, 2000, www.ncbi.nlm.nih.gov/books/NBK64279
^[4] Neukam, Stephen. “The Hill.” The Hill, 23 Mar. 2023, thehill.com/homenews/state-watch/3914916-these-10-states-have-not-expanded-medicaid
^[5] World Population Review. “Uninsured People by State 2023.” World Population Review, worldpopulationreview.com/state-rankings/uninsured-people-by-state.
^[6] United States government. “Texas Medicaid.” Benefits.gov, www.benefits.gov/benefit/1640. Accessed 16 May 2023.
^[7] “Federal Poverty Level (FPL) - Glossary.” HealthCare.gov, www.healthcare.gov/glossary/federal-poverty-level-fpl.
^[8] “Waivers.” Texas Health and Human Services, www.hhs.texas.gov/regulations/policies-rules/waivers. Accessed 16 May 2023.
^[9] Centers for Medicare & Medicaid Services. “Behavioral Health Services.” Medicaid, www.medicaid.gov/medicaid/benefits/behavioral-health-services/index.html. Accessed 18 Apr. 2023.
^[10] “Adult Substance Use Services.” Texas Health and Human Services, www.hhs.texas.gov/services/mental-health-substance-use/adult-substance-use-services. Accessed 16 May 2023.
^[11] “Substance Abuse and the Affordable Care Act.” The White House, obamawhitehouse.archives.gov/ondcp/healthcare. Accessed 16 May 2023.
^[12] “Overview of Substance Use Disorder (SUD) Care Clinical Guidelines: A Resource for States Developing SUD Delivery System Reforms.” Medicaid.gov, Apr. 2017, www.medicaid.gov/state-resource-center/innovation-accelerator-program/iap-downloads/reducing-substance-use-disorders/asam-resource-guide.pdf.
^[13] “HHS System Annual Federal Funds Report for State Fiscal Year 2020.” Texas Health and Human Services, Dec. 2020, www.hhs.texas.gov/sites/default/files/documents/laws-regulations/reports-presentations/2020/annual-federal-funds-report-fy2020.pdf.
^[14] Kolkhorst et al. “Bill Analysis.” Texas Health & Human Services, 16 Mar. 2023,capitol.texas.gov/tlodocs/88R/analysis/html/SB00745S.htm.
^[15] “MEDICAID IN TEXAS.” Kaiser Family Foundation, Oct. 2022, files.kff.org/attachment/fact-sheet- medicaid-state-TX.
^[16] “Medicaid Coverage by Race/Ethnicity: Texas, 2018-2020 Average.” March of Dimes | PeriStats, www.marchofdimes.org/peristats/data?reg=99&top=11&stop=653&lev=1&slev=4&obj=1&sreg=48.
^[17] Ernst, Sara Willa. “Texas Medicaid Rolls Grew by More Than 1 Million People During the Pandemic.” Houston Public Media, 24 Jan. 2022, www.houstonpublicmedia.org/articles/news/in-depth/2022/01/24/417375/417375.
^[18] National Center for Health Statistics (NCHS) and National Vital Statistics System. “Maternal Deaths and Mortality Rates: Each State, the District of Columbia, United States, 2018‐2020.” Centers for Disease Control and Prevention (CDC), www.cdc.gov/nchs/maternal-mortality/mmr-2018-2020-state-data.pdf. Accessed 16 May 2023.
^[19] Rivera, Elena. “In Texas, Medicaid Ends Soon After Childbirth. Will Lawmakers Allow More Time?”NPR, 5 Mar. 2023, www.npr.org/sections/health-shots/2023/03/05/1158813214/texas-medicaid-limits-after-childbirth.