Medicaid and Medicare Covered Drug and Alcohol Addiction Treatment in New Jersey

With expansions to Medicare and Medicaid under the Affordable Care Act, many people who struggle with substance misuse and addiction have new access to services for treatment and recovery support. Federally mandated insurance exchanges offer healthcare subsidies to low-income individuals, and the ACA itself requires insurance companies to cover addiction treatment. The ACA also expanded Medicare coverage and added Medicaid programs to cover more people.

This article will talk more about these programs in relation to addiction treatment, as well as highlight some rehabs in New Jersey that take Medicaid and Medicare.

The Role of Medicare and Medicaid

According to Medicare.gov, everyone covered under this government plan has the right to be treated with dignity and respect at all times, protected from discrimination, have personal health information kept private, and have the opportunity to make a decision about services needed. Medicaid’s role in healthcare and treatment is expanded across the country, and the government insurance program is creating new ways to monitor standards of treatment, ensuring everyone has access to high-quality care while recovering from addiction. Addiction treatment is a protected form of coverage per Medicare and Medicaid, although not all facilities who offer treatment programs accept this form of insurance. New Jersey has several great options that accept Medicaid, Medicare, or both.

It is also important to remember that those who do not have Medicaid or Medicare can still obtain high-quality treatment through a number of additional payment options. This can be done several different ways, such as by working directly with the treatment center to develop a payment plan or seeking a loan from a bank or a loved one.

Using Medicare and Medicaid for Addiction Treatment

Medicare and Medicaid may be able to pay for the majority of one’s drug or alcohol addiction treatment, however this is often based on a number of different factors. For example, each state has different rules for eligibility for both programs, therefore what may be covered fully by one of these programs in one state may only be partially covered in another. Other factors can include the level of addiction treatment being sought and the type of Medicare/Medicaid  plan a person has.

Does Medicare and Medicaid Cover Detox, Inpatient & Outpatient Rehab?

Medicaid, which is available for those over the age of 65 and under the age of 19, a parent, someone who is pregnant, or someone falling into a certain tax bracket, can cover some of all of the costs for medical detox, inpatient rehab, and outpatient rehab services. Medicare, which is only available for those 65 years of age and older or individuals with disabilities, may also be able to pay for the costs of inpatient, outpatient, and detox services, depending on one’s specific plan.

Will Medicare and Medicaid Pay For All Rehab Expenses?

While Medicare and Medicaid are both extremely helpful for millions of people, they are each complex systems of insurance provision. Both of them can offer a variety of different plans based on one’s financial abilities and other factors. Therefore, it is absolutely imperative to speak with an insurance representative to obtain specific plan information when considering enrolling in drug or alcohol rehab. By doing this, individuals can gain a stronger understanding of what exactly their plan covers partially and/or in full so that there are no surprises along the way.

This leg work is the responsibility of the patient and/or the individual who is overseeing their admissions into treatment, and gathering as much information as possible is beneficial to one’s mental health and their wallet.

New Jersey Rehabs That Accept Medicaid & Medicare

Some of the Medicare alcohol rehab and drug rehabs that take Medicaid offered in the state of New Jersey to residents and out-of-state individuals that accept this type of insurance are outlined in the following list:

• Bowling Green Brandywine: This treatment program offers detox and inpatient treatment services as well as help for pregnant women. A variety of programs are focused on treating specific addictions, such as addictions to alcohol, heroin, benzodiazepines, opioid painkillers, and more. The organization accepts both Medicare and Medicaid.
• Center for Family Services: This nonprofit group focuses on helping the entire family unit overcome addiction together. Their adult and child addiction recovery services are funded by charitable trusts as well as Medicaid and county-based resources. Once a person has been admitted to the recovery program, the care team at CFS assesses the individual, develops a plan to support them through recovery, helps them learn the value of sober activities, helps rebuild and develop healthy friendships and relationships, and works to prevent relapse.
• Evers Psychological Associates, PC: This multidisciplinary health practice offers counseling for addiction and substance misuse problems as well as other mental and behavioral health concerns. Children, adolescents, adults, and families are all welcome. The providers accept Medicaid.
• Family Intervention Services: Though many programs are offered by this nonprofit group, their addiction programs help the whole family heal together. Outpatient services involving children accept Medicaid insurance coverage.
• It Takes a Family: This is community-based treatment program for behavioral, mental health, and substance misuse difficulties. ITAF offers several therapies, including home therapy, medication monitoring, psychological and psychiatric assessments, individual and family therapy, and much more for addiction, eating disorders, behavioral and mental health, and relationships. The group accepts both Medicaid and Medicare insurance coverage.
• New Pathways Counseling: This charitable group offers detoxification and rehabilitation services for adolescents and adults. Rehabilitation programs include partial hospitalization, intensive outpatient, traditional outpatient, early intervention, medication-assisted therapy, individual therapy, and relapse prevention. Some programs offer transportation assistance too. Medicaid is one of the insurance payment options that New Pathways accepts.
• Sprout Health Group: This medical provider treats substance misuse issues in adolescents, adults, and families. The facility accepts one-time payment as well as Medicare insurance coverage. They provide medical detox, co-occurring disorder treatments, inpatient and outpatient addiction treatment services, and pain management.
• Clare’s Health: St. Clare’s Health provides emergency, hospital, and general medical services, including substance misuse and behavioral treatment. The group offers intensive and regular outpatient treatment options for those eligible for this type of addiction treatment. St. Clare’s also refers patients to other services if they require more intensive care than the hospital can provide. Medicaid is an accepted form of insurance, and patients can also apply for financial assistance.
• Summit Oaks Hospital: One of the longest-running addiction and mental health service programs in New Jersey, Summit Oaks Hospital was originally founded in 1902. Current programs include drug and alcohol detox, rehabilitation, inpatient and outpatient options, and co-occurring disorder treatment. In addition to major insurance options, Summit Oaks accepts Medicare and Medicaid.

Other New Jersey Treatment Resources

Drug and Alcohol Treatment in New Jersey

Regardless of age, finances, or health insurance type, everyone who struggles with substance use disorders in New Jersey should be treated with dignity and respect. They should have access to high-quality treatment based on their individual needs. Both Medicaid and Medicare help advocate for these resources. As government-based insurance programs, Medicare and Medicaid fight for the rights of those they cover, so programs can provide treatment to as many people as possible, without sacrificing effectiveness or quality. It is very possible to live a healthy, sober life, regardless of insurance or difficulty covering cost. Overcoming addiction means entering a rehabilitation program, and there are many options for treatment in New Jersey. Sunrise House Treatment Center is American Addiction Centers’ drug rehab in Lafayette, NJ and offers comprehensive addiction treatment services to those in need.

Sunrise House Treatment Center, our drug rehab in New Jersey, offers several levels of addiction treatment and customized programs to help get people started on their recovery journey. We do work with people with various financial situations. You can learn more about ways to pay for rehab and using insurance to pay for rehab at Sunrise House, as our rehab admissions navigators are prepared to yield all calls and answer your questions.

Get started on your recovery today by verifying your insurance with our , or call our number anytime at to discuss options and get admitted today.