Medicaid is an essential federal and state program, typically offered to individuals in need who are younger than 65. The program is intended to help individuals and families with limited income, special needs, and disabilities.
Each state determines Medicaid eligibility, and requirements differ among the states. In general, the following group of individuals may qualify for Medicaid:
- Pregnant women
- People with a disability
- Senior citizens
- People with limited income
Medicare is a joint federal and state program available to those who qualify. It is a valuable insurance option for many to access affordable health care. Due to the government management of Medicare, this program significantly lowers healthcare costs for people with limited resources and income.
Part A, Hospital Insurance: This helps cover inpatient care at hospitals and skilled nursing facilities. Part A also covers hospice and some options for home health care.
Part B, Doctor and Medical Insurance: Medicare Part B helps cover doctors’ services and outpatient care, as well as preventive care not covered by Part A. Part B usually involves payment of a monthly premium that is lowered for eligible people.
Part C, Medicare Advantage: Medicare Part C or Medicare Advantage coverage can be an alternative to Parts A and B. Private companies offer this option under contract with The Centers for Medicare and Medicaid Services. Part C plans provide the same benefits as Part A and B but typically offer additional coverage such as hearing, vision, dental, and wellness programs.
Part D, Prescription Drug Coverage: Since original Medicare does not cover prescription drugs, Part D helps lower the costs and protects against rising prices. Like Part C, Part D is only available from private insurers that contract with Medicare.
Medicare is designated for United States residents at least 65 years old. However, people under 65 may also qualify if they have specific disabilities or diagnoses.
According to the Center for Medicare Advocacy, Medicare will pay for treatment of a substance use disorder or alcohol addiction in both inpatient and outpatient capacities. With Medicare, Part A is typically used for inpatient substance abuse treatment, while Part B is typically utilized for outpatient care.
Under the Affordable Care Act, Medicaid must cover certain addiction treatment services. While eligibility and coverage options vary per state, Medicaid offers a wide range of coverage for rehab. Some addiction treatment services that Medicaid may cover are testing or screening, medically-assisted detox, counseling, dual diagnosis, and inpatient and outpatient rehab services.