Despite the prevalence of addiction in the United States, few people who need rehabilitation treatment end up receiving it. There are many different reasons why people don’t go to rehab to treat their drug and alcohol addiction, but the top 2 reasons are:1
- The person has no healthcare and couldn’t afford treatment.
- They had healthcare coverage, but they still couldn’t afford it.
According to the 2019 National Survey of Drug Use and Health, only 17.8% of Americans over 12 years old needing treatment got the specialized help they needed.1 One of the common solutions to the problem of people being unable to pay for treatment is state-funded rehab, which provides treatment for free or reduced costs.2
What is State-Funded Drug and Alcohol Rehab?
Substance abuse not only claims lives, but it’s also economically straining on the country. According to the National Institute on Drug Abuse (NIDA), drug and alcohol abuse costs the nation an estimated $520.5 billion a year.3
The purpose of state-funded rehab is to combat substance abuse by providing free or affordable treatment for people who would otherwise be unable to afford it. State-funded rehab facilities pay for their operations through:2
- Federal grants.
- State funds.
- Government-assistance programs (Medicaid).
Many people suffering from addiction turn to state-funded treatment centers for a free or low-cost solution to their problem.
Can You Pay for Rehab with Medicare or Medicaid?
Medicare and Medicaid are both government programs, but they each target different populations and have slightly different sources for funding:4,5
- Medicare is an insurance program that is federally funded healthcare available to individuals who are 65 years old and older, or for people of any age that have certain disabilities.
- Medicaid is a government-assistance program funded by both state and federal governments. It provides health coverage to low-income individuals regardless of age, pregnant women, children, and people with disabilities.
Many state-funded alcohol or drug rehab centers allow patients to pay with Medicare and Medicaid. Some private institutions may also accept Medicaid and Medicare.
How Does the Affordable Care Act Help Cover Rehab?
The Affordable Care Act (ACA) made drug and alcohol rehabilitation available to more people in recent years. The ACA prohibits insurance companies from refusing coverage for pre-existing conditions, including mental health and substance use problems.6 The ACA also established the Healthcare.gov marketplace full of plans with the same minimum coverage requirements for substance use and other disorders.7
Healthcare plans through an employer or the ACA marketplace generally cover inpatient/residential treatment and outpatient care, which includes detoxification and therapy. That said, the level of coverage provided can vary greatly. The particular plan may:
- Have a limit on the amount of days or doctor visits covered.
- Have a high or low deductible that must be met before coverage begins.
- Restrict coverage on patients attempting treatment more than once within a year.
- Have high or low copayment costs for visits and prescription drugs (e.g., $40 for each visit to a physician).
Who Qualifies for State-Funded Rehab?
Each state has differing eligibility requirements for state-funded rehab. Because there are many applicants, these requirements tend to be very strict. Potential patients may need to provide proof of their annual income and state residency.
The Substance Abuse Prevention and Treatment Block Grant (SABG) provides funding to all the U.S. states, with a specific emphasis on:8
- Rehabilitation treatment for:
- Pregnant women.
- Single mothers.
- People who abuse needle drugs.
- Services for:
- Substance abuse prevention.
- Infectious diseases like HIV/AIDS and tuberculosis.
State-funded rehab may accept or deny patients based on their own criteria. This may mean they prioritize accepting people in dire situations due to income levels, co-occurring physical or mental problems, whether they have dependents, etc.
How Quickly Does Treatment Start?
It is often difficult to get into state-funded rehab due to high demand. State and local facilities may have varying procedures as to who is accepted and in what order. This means that some applicants may be put on a waiting list, which means a patient may have to wait between several weeks and several months to get accepted into a facility.9
Where Do I Look for a State-Funded Rehab Center?
The Substance Abuse and Mental Health Services Administration (SAMHSA) has a very useful tool for finding nearby rehabilitation treatment centers on their website called the Behavioral Health Treatment Services Locator. The tool allows the user to search for free addiction rehab treatment programs by typing in their address, city, or zip code. Clicking “more information” on a selected facility will reveal what services are offered, how the center is funded, and their payment options.
The SAMHSA also provides the Single State Agencies (SSAs) for Substance Use Services directory. This document lists contact information for the state government agencies that coordinate and provide addiction treatment services to those who are uninsured or low income. State agencies can provide info about government-funded treatment centers where individuals might qualify for treatment.
State-Funded vs Private Rehab
Both state-funded and private rehab have the same goal—to help someone get sober and to provide them with the necessary skills to remain in recovery. Many private and state-funded facilities treat addiction with medical detoxification, evidence-based therapy techniques, and medication-assisted treatment.
Because state-funded treatment is often free or provided at a dramatically reduced cost, it is usually more limited than private centers when it comes to amenities and extra comforts. Potential patients may be denied or have to go on a waiting list when attempting to receive treatment at a state-funded facility. These rehab centers are often limited to purely evidence-based techniques and may not offer supplemental therapy methods that may prove effective for some patients.2
In contrast, private rehab facilities often boast luxuries (like gourmet meals, private rooms, etc.), and alternative therapies in addition to evidence-based methods They are typically able to accept patients quicker than state-funded agencies as well. Many private facilities are able to afford extra amenities, provide supplemental therapy techniques, and accept new patients promptly because they are funded by private payments or through insurance coverage.
While the programs may differ, both state-funded and private rehab facilities provide effective treatment that helps patients address their substance use disorder (SUD) and start working toward recovery.
Any way that people suffering from SUDs can get effective, safe rehabilitation treatment is a valuable tool in combatting addiction in the United States. State-funded rehab is an excellent option for people who would otherwise be unable to get the help they need to get sober and remain in recovery.
For others, private rehabilitation facilities may prove to be a more viable route. American Addiction Centers (AAC) provides quality SUD treatment, and it is dedicated to helping all who are dealing with alcohol or drug addiction.
If you are unsure about the steps you or a loved one needs to take to pursue treatment, call one our admissions navigators today, at 1-888-287-0471 . They will be able to provide you with confidential, in-depth information to help start on your path toward recovery.
If you do have insurance, and you are wondering what it covers, click here.
- Substance Abuse and Mental Health Services Administration. (2020). 2019 National Survey on Drug Use and Health.
- Substance Abuse and Mental Health Services Administration. (2015). Funding and Characteristics of Single State Agencies for Substance Abuse Services and State Mental Health Agencies, 2015.
- National Institute on Drug Abuse. (2020). Costs of substance abuse.
- U.S. Centers for Medicare & Medicaid Services. (n.d.). What’s Medicare?
- U.S. Centers for Medicare & Medicaid Services. (2020). Medicaid.
- Fox, D.M., Grogan, C. M. (2017). The Affordable Care Act Transformation of Substance Use Disorder Treatment. American Journal of Public Health. (107): 1.
- HealthCare.gov. (n.d.). What Marketplace health insurance plans cover?
- Substance Abuse and Mental Health Administration. (2020). Substance abuse prevention and treatment block grant.