Is Using Public Health Coverage for Detox and Rehab Possible?

Accessing addiction treatment can feel overwhelming—especially when it comes to understanding how to pay for it. For many individuals and families, the question isn’t whether detox or rehab is necessary. It’s how to afford it. And if you rely on public health insurance, such as Medicaid or Medicare, you might wonder: is using public health coverage for detox and rehab even possible?

The good news is yes—public health coverage can and often does pay for medically necessary addiction treatment services, including detox and rehab. But there are important limitations, eligibility guidelines, and differences between programs that determine what type of care you can receive and where.

Let’s take a closer look at how public health insurance works when it comes to covering substance abuse treatment.

Here’s how PAGE Magazine steps in to help you with valuable resources.

Understanding Public Health Coverage in the U.S.

Before diving into treatment options, it’s essential to understand what “public health coverage” actually includes. In the United States, this generally refers to federally and state-funded programs that offer health insurance to eligible individuals. The two most common are Medicaid and Medicare.

Medicaid is a joint federal-state program that provides health coverage to low-income individuals and families. Each state administers its own Medicaid program, which means coverage can vary depending on where you live.

Medicare, on the other hand, is a federal program that provides health insurance to people over 65, as well as certain younger individuals with disabilities or end-stage renal disease.

Both programs include some level of behavioral health coverage, including services related to substance use disorder treatment.

Does Medicaid Cover Detox and Rehab?

Medicaid is one of the largest payers for behavioral health services in the U.S., including detox and rehab. States are required to offer coverage for mental health and substance use disorder services as part of the Essential Health Benefits outlined in the Affordable Care Act. That means most Medicaid plans cover: medically supervised detox services, outpatient therapy, inpatient rehab, medication-assisted treatment (MAT), and peer recovery support.

However, each state decides how these services are delivered and under what conditions. Some states may limit coverage to certain facilities, place caps on the number of treatment days, or require prior authorization.

For example, paying for treatment using MercyCare coverage and other leading plans, Arizona’s Medicaid program, AHCCCS, provides a range of substance abuse services to qualifying members, including residential treatment and outpatient services through Regional Behavioral Health Authorities (RBHAs).

But these services must typically be deemed medically necessary, and individuals must go through an assessment or intake process first.

In short, Medicaid can absolutely be used to cover detox and rehab, but you’ll need to find a treatment center that accepts it and follows your state’s specific coverage guidelines.

What About Medicare?

Medicare offers coverage for substance use disorder treatment as well, though it works a bit differently than Medicaid. Medicare Part A covers inpatient hospital stays, including detox and rehab when medically necessary.

This includes services at general hospitals and psychiatric facilities. Medicare Part B can cover outpatient services such as therapy, counseling, and medication management. Part D, which covers prescription drugs, may help pay for medications used in MAT programs, such as buprenorphine or naltrexone.

Like Medicaid, Medicare coverage requires that treatment be deemed medically necessary and delivered by approved providers. One limitation is that not all addiction treatment centers accept Medicare, especially private or luxury rehabs.

It’s important to verify in advance whether your desired facility is Medicare-approved and what services are eligible under your specific plan.

State and Local Options: Beyond Medicaid and Medicare

In addition to federal programs, many states fund or support local addiction treatment initiatives for uninsured or underinsured individuals. These may include grant-funded detox programs, sliding scale rehab facilities, or state-run treatment centers.

Some states partner with nonprofits to deliver care through community behavioral health centers. These programs are typically available to residents with no insurance or very limited means, and admission may be prioritized based on severity of need or availability of beds.

Eligibility criteria and availability of services vary widely. It’s worth contacting your state’s Department of Health or Substance Abuse Services Division to learn about publicly funded treatment options near you.

Even if you’re not currently enrolled in Medicaid, you may qualify based on your income and health status—and enrollment assistance is often available at the intake level of many treatment facilities.

The Role of Managed Care and Medicaid Expansion

Over the past decade, many states have adopted managed care models within Medicaid. This means that Medicaid members receive services through private managed care organizations (MCOs) that contract with the state.

These MCOs offer behavioral health networks and case management, which can help members navigate treatment options and access detox or rehab faster. In states that expanded Medicaid under the Affordable Care Act, more low-income adults qualify for coverage, increasing access to addiction treatment.

If you’re in a Medicaid expansion state, chances are higher that you can use your public coverage to access comprehensive care, including residential treatment, intensive outpatient programming (IOP), and MAT.

Barriers to Accessing Publicly Funded Treatment

While public insurance provides an important safety net, there are still barriers to accessing care through these systems. Common challenges include long waitlists for detox or residential beds, limited provider networks that accept public insurance, and restrictions on length of stay or levels of care.

In rural areas or smaller towns, availability may be even more limited, forcing individuals to travel far for services. Another issue is that some treatment centers may technically accept Medicaid or Medicare, but only for outpatient services—not residential or inpatient detox.

It’s also important to consider the need for prior authorization or medical necessity determinations, which can delay entry into care. Despite these hurdles, the landscape is improving.

Thanks to recent changes in federal law, such as the SUPPORT Act and increased funding for opioid treatment programs, more providers are beginning to offer care under public coverage programs.

Finding a Rehab That Accepts Public Insurance

The key to using public health coverage for detox and rehab is knowing where to look. Start by contacting your insurance provider directly. For Medicaid, that means reaching out to your state’s Medicaid office or your MCO case manager.

They can provide a list of in-network treatment facilities and help you understand what services are covered. If you’re on Medicare, check the Medicare.gov provider directory or call a local behavioral health center for guidance.

Many treatment centers now list accepted insurance plans on their websites. Look for language like “we accept Medicaid,” “AHCCCS approved,” or “Medicare certified.” You can also contact the SAMHSA Treatment Locator, which allows you to search for providers by payment type, including Medicaid or sliding scale options.

When evaluating a rehab facility, ask whether they offer medically supervised detox, whether residential treatment is included, and what levels of care are available under public coverage. Some centers may also help with insurance verification and admissions coordination, when paying for rehab with plans through UMR, among others.

Integrated and Holistic Care Under Public Plans

It’s a common misconception that using public health insurance means sacrificing quality or comprehensiveness of care. In reality, many facilities that accept Medicaid and Medicare are accredited, evidence-based, and staffed by licensed professionals.

Some offer integrated care models that address co-occurring disorders, physical health, trauma, and social needs—often with robust aftercare planning. In fact, public programs often emphasize continuity of care and wraparound services, including case management, housing support, vocational training, and peer mentorship.

The difference is not in the intent or effectiveness of the care, but rather in the funding structure and provider availability. You can still receive high-quality treatment through public insurance; it just may take a few more steps to find the right fit.

When to Consider Alternative or Supplemental Options

If public insurance doesn’t fully cover the type of care you need, there are still options. Some individuals combine Medicaid or Medicare with other benefits, such as veterans’ assistance, tribal health programs, or charity care.

Others turn to state block grants, nonprofit-funded beds, or short-term payment plans. Some treatment centers may offer scholarships or discounted rates for those with limited income, particularly if you're committed to long-term recovery.

Additionally, if you're working or recently unemployed, you may qualify for subsidized private insurance through the health exchange, which can offer expanded access to treatment providers.

Your Road to Recovery Is Within Reach

The road to recovery for detox and rehab shouldn’t be blocked by cost. And thanks to public health coverage, it doesn’t have to be. Whether you're covered by Medicaid, Medicare, or seeking state-supported services, help is available—and it’s more accessible than many realize.

The key is knowing your benefits, understanding what’s covered, and reaching out to the right providers. Detox and rehab are not just possible with public insurance—they are a vital and often life-saving part of the healthcare system.

Don’t let financial uncertainty stand between you and the care you need. There are people, programs, and support networks ready to guide you toward recovery—one step at a time.