Does Medicaid Cover Drug & Alcohol Detox? Yes- Here’s How to Use It at Sunrise

If you have Medicaid, you may be able to receive the medically supervised detox care you need at Sunrise Detox. Does Medicaid cover drug detox? Often, the answer is yes. Under the Affordable Care Act (ACA)’s mental health parity rules, substance use disorder treatment is considered a covered benefit. We work closely with Medicaid plans and are often an in-network provider, helping make treatment more accessible and easier to navigate. 

What Medicaid Typically Covers for Detox

Medicaid typically covers a range of services for individuals seeking substance use disorder treatment; however, the specific services and level of coverage vary depending on the individual’s plan and state benefits. 

Services that Medicaid typically covers include:

• Medically supervised inpatient detox
• 24/7 nursing care
• Withdrawal medication management
• Therapy while in detox
• Aftercare planning

In-Network vs. Out-of-Network: What It Means for Your Costs

For many people, understanding the ins and outs of their Medicaid coverage can be overwhelming. At Sunrise, our admissions team can make the process less complicated and is here to help you every step of the way. 

Does Medicaid pay for detox? It can, but coverage may vary. Depending on the type of Medicaid coverage you have, they may require that you meet your deductible, pay any required co-payments and obtain a prior authorization before starting your treatment at Sunrise.

A deductible refers to a set amount that you pay out-of-pocket before your insurance begins to cover your services. In most cases, this is required for hospitalizations, surgeries or procedures and not preventative care. For example, if you have a $1,500 annual deductible, you are required to pay the first $1,500 of the total bill before Medicaid pays the service provider.

Co-pays are a set fee that you pay out-of-pocket for covered services. These fees are paid directly to the provider at the time of service, and generally do not count toward your annual deductible. For example, if you have a doctor visit, you pay a set fee, such as $25.00, at the time of the appointment.

Prior authorization is an approval that Medicaid requires before you receive certain services, such as surgeries, procedures or inpatient hospitalization. To receive a prior authorization, Medicaid must deem your treatment to be appropriate and medically necessary before it will cover the cost of your services. 

In addition to a prior authorization, Medicaid may require that you obtain your care from an in-network provider. In-network refers to a contracted agreement between Medicaid and providers to deliver services at a pre-determined, discounted rate. In some cases, Medicaid may deny coverage if the provider is out-of-network. 

Our admissions team is here to help. We will obtain verification of your Medicaid eligibility and coverage and secure any prior authorizations they may require. We will also review any co-pays or deductibles with you so you have a clear understanding of what to expect before starting treatment. 

How to Verify Your Medicaid Benefits in 3 Steps

Obtaining a verification of benefits with Medicaid helps you to determine if the services you require, in this case medically supervised detox, are covered and to what extent. When you’re ready to see if your care at Sunrise Detox is Medicaid accepted, there are three steps you can take to begin the process.

Step 1: Call Sunrise. Our free insurance verification process helps make treatment less overwhelming by giving you a clear understanding of the cost of care. We can also answer any questions and help you understand what to expect throughout treatment at Sunrise. 

Step 2: Make sure to have your insurance card with you when you call. Our admissions team will record information such as your Medicaid ID and group number. 

Step 3: Get a same-day answer. Our admissions team understands how frustrating it can be to wait for an answer. We will provide you with the information about your insurance coverage and your financial responsibility on the same day you contact us.

What Detox at Sunrise Looks Like

Our team of highly qualified addiction specialists is here to provide around-the-clock care that meets your unique needs. From close medical supervision to withdrawal management at Sunrise, we partner with you to ensure your stay is as comfortable and supported as possible. 

One way we do this is by offering you a welcoming environment, with inviting private rooms and bathrooms so you have a place to stabilize and focus on your long-term recovery. al management to keep you comfortable and help you safely begin recovery. Our cozy, fully-furnished bedrooms and private bathrooms offer a home-like environment for rest and reflection. 

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