Addiction is a serious medical condition that requires professional treatment. So if you are struggling with substance abuse of any type, there is no shame in asking for help. You are not alone in this fight. At Harmony Ridge Recovery West Virginia, you will find a community of compassionate and caring specialists who will support you on your journey to recovery. Our evidence-based addiction program can be covered by insurance, both private and public. In fact, we are one of the only drug rehab centers in WV that accept Medicaid. This makes us a viable treatment option for anyone who’s struggling, no matter what their income is. If you are still unsure about what your insurance plan covers, feel free to contact us. Our insurance and admission specialists will be more than happy to help you work out a payment plan that fits your specific needs and capabilities.
All you need to know about Medicaid insurance
Medicaid is a public health insurance program that provides coverage for low-income families and individuals. According to the latest enrollment report from March 2022, more than 80 million Americans (or approximately 1 in 5 people) now rely on Medicaid to pay for visits to the doctor, hospitalization, prescription medication, screenings, lab work, and yes, treatment in rehabs in WV that accept Medicaid. In some states, including West Virginia, up to a third of the population is insured through Medicaid. This makes Medicaid the third most common type of insurance in the US overall, just behind employment-based insurance and Medicare.
The program was first introduced in 1965 as a part of the Social Security Amendments. Since then, it has been expanded multiple times (most notably by the Affordable Care Act in 2010) to make more Americans eligible for coverage. However, because Medicaid is a collaboration between the federal government and the states, the specifics of the program (such as who benefits from it and what it covers) differ from one state to another. Although federal guidelines establish the basic standards, individual states have a great deal of autonomy in implementation.
Who is eligible for Medicaid?
Under federal law, states must provide Medicaid coverage to certain demographic groups. This includes:
- low-income pregnancies
- children of low-income families and children in foster care
- low-income parents or caregivers
- seniors (65 and over) with low income
- people with disabilities
States may also expand eligibility to other vulnerable groups, such as low-income individuals without children. West Virginia has, indeed, expanded Medicaid coverage to adults whose income is 133% of the federal poverty level or less. In addition to financial eligibility, applicants must be able to offer legal proof that they are US citizens or legal immigrants residing in it.
Eligibility for Medicaid should not be confused with eligibility for Medicare. Both are federal health insurance programs however, they apply to different groups. While Medicaid primarily aims to help those with low income, Medicare focuses on individuals over 65 and those with disabilities. Therefore, it is possible to be eligible for both Medicaid and Medicare. Those who have coverage under both programs may qualify for financial assistance from both Medicaid and Medicare for the same treatment.
What does Medicaid cover?
As is the case with eligibility, Medicaid coverage varies by state. Certain benefits that the program provides are mandatory as per federal regulation. But additional benefits are up to the states. The Medicaid mandatory coverage plan includes:
- inpatient and outpatient hospital services
- early and periodic screening, diagnostic and treatment services
- nursing facility services
- home health services
- physician services
- rural health clinic services
- services provided by federally qualified health centers
- labs and x-rays
- family planning
- services of nurses & midwives
- pediatric and family nurse practitioner services
- services of licensed and recognized freestanding birth centers
- tobacco cessation counseling for pregnant women
- transportation to medical care facilities
Optional benefits may include prescription medication, physical therapy, optometry, dental care, and more. The coverage does also extend to mental health services provided by licensed psychiatrists, psychologists, therapists, and drug rehab centers in WV that accept Medicaid. However, Medicaid does not cover unnecessary services, treatment received abroad, or care provided by another government agency.
Medicaid and substance use disorder (SUD)
For a long time, the importance of mental health to overall well-being was misunderstood and underestimated. Consequently, most health insurance providers did not cover mental health treatment. That started in 1996 when the Mental Health Parity Act was signed into law; it banned excessive co-pays and deductibles for mental health services. In 2008, the Mental Health Parity and Addiction Equity Act replaced the Mental Health Parity Act to close some of the loopholes from previous legislature. Although the law does not require health insurance providers to offer mental health benefits, it does demand that when mental health benefits are provided, they have to be equal to or better than the benefits that pertain to physical and surgical care.
Medicaid coverage extends to both physical and mental health. In fact, Medicaid is the single largest payer for mental health services in the US. Treatment for substance use disorder is, therefore, included in the Medicaid insurance plan. Of course, not all rehabilitation centers accept Medicaid. But as long as you seek treatment at one of the rehabs in WV that accept Medicaid, your care will be partially or even fully covered.
How to apply for treatment at drug rehab centers in WV that accept Medicaid?
If you are a Medicaid beneficiary who struggles with substance use and you wish to seek help, then you should start taking steps toward applying for treatments that your insurance will cover. Before making any concrete choices, make sure to:
- Find out exactly what kind of coverage you have under Medicaid – The amount of coverage you receive, types of treatment you can seek, and potential co-pays may vary based on your state, income level, and insurance plan. If you are not sure what your Medicaid insurance covers, then take a look at the specifics of your state program on the Medicaid website or call the number on the back of your insurance card.
- Research drug rehab centers in WV that accept Medicaid – You can find lists of rehabs that accept Medicaid on state Medicaid websites, substance use resource websites, or even just Google.
- Take a closer look at the types of treatments that eligible facilities provide – It is possible for a Medicaid-approved facility to provide some types of treatment that the insurance doesn’t cover. Get a good grasp of your policy before you discuss treatment options with the facility.
- Narrow down your options for rehabs in WV that accept Medicaid – It is very important to choose the right rehab facility. So take your time to contact those that seem promising and even make the time to visit them in person, if possible.
Once you have chosen a rehab facility, it’s time to get your admission sorted. At Harmony Ridge, we have an admission team that will guide you through the process. Simply get in touch with us and we will be happy to answer any questions you might have. We are available 24/7 to help you with every step on your journey.
Insurance terms to consider
It can be mentally and emotionally draining to seek help for addiction even in the best drug rehab centers in WV that accept Medicaid. The last thing you need is to stress additionally over insurance. Unfortunately, many people have difficulties understanding how their insurance policies work and what they cover. This is in part due to the specific terms insurance providers use that most of us aren’t familiar with. Here are some that you will almost certainly come across, especially if your claim is denied:
- Medical necessity is a criterion that states that the service you seek must be medically necessary for the diagnosis, treatment, cure or relief of a condition, and not for the purposes of convenience or experimentation. It must also be generally accepted within the medical community.
- Utilization management refers to the assessment of the necessity and appropriateness of a given treatment that your insurance company will conduct (typically prior to authorizing your care).
- Prior authorization is the decision of your health insurance provider that the treatment you are seeking will be covered under your policy. As the name implies, you typically receive this decision before you receive any treatment.
- Step therapy refers to the policy that requires you to try less costly treatments first before seeking a similar treatment with a higher price tag.
What happens if the full cost of rehab in drug rehab centers in WV that accept Medicaid isn’t covered by your insurance?
Finding rehabs in WV that accept Medicaid is not a guarantee that your addiction treatment will be fully covered. Sometimes, insurance coverage only kicks in after you’ve spent a certain amount of money. There may also be a cap on how much insurance will cover for a given treatment. Finally, you may receive authorization for one part of your treatment but not another. When this happens, you can appeal the insurance provider’s decision. If that doesn’t work, Harmony Ridge allows you to combine different forms of payment such as insurance, loans, and self-pay. Our insurance experts will work with you to create a payment plan that you can follow.
Payment plans and insurances that can cover your recovery in Harmony Ridge
In addition to being one of the few rehabs in WV that accept Medicaid, Harmony Ridge takes various other forms of payment. So even if you do not have Medicaid coverage, consider the following alternatives:
- Self-financing – if you can pay for the treatment in full out of pocket, you don’t have to deal with any insurance claims.
- Personal loan – if you cannot afford the treatment yourself, you may be able to get a loan from your bank or use your credit card.
- Private insurance – Harmony Ridge accepts most major insurance plans including Humana, Blue Cross Blue Shield, Tricare, Peia, and others.
Which programs does Harmony Ridge offer?
You may worry that rehabs in WV that accept Medicaid offer limited services. Here, at Harmony Ridge Recovery Center, provide a variety of comprehensive treatment programs so that you can receive the type and intensity of care you need. Choose between our:
- Residential treatment center West Virginia. Recover from your addiction at our well-equipped facility surrounded by 50 acres of scenic landscape where you will receive support, structure, and 24/7 medical supervision.
- Intensive outpatient program West Virginia. Attend up to three 180-minute rehab sessions a week for intensive professional help with addiction while still retaining the ability to receive support from your family and friends.
- Partial hospitalization program West Virginia. Spend 4-6 hours a day 3-5 days a week in our program to get the benefits of an intensive rehab without needing to reside at one of our facilities.
- Sober living in West Virginia. Live in a supportive environment with others who are maintaining their sobriety until you are ready to go back to your day-to-day life.
Types of addiction that can be treated at drug rehab centers in WV that accept Medicaid
Harmony Ridge is counted among the best rehabs in WV that accept Medicaid. We offer treatment plans for a wide variety of addictions, including:
- Cocaine rehab
- Fentanyl rehab
- Heroin rehab
- Ambien addiction treatment
- Barbiturates rehab
- Benzodiazepine rehab
- Marijuana rehab
- Stimulants rehab
- Opiate rehab
- Meth rehab
No matter what substance you struggle with, you can find help at Harmony Ridge. Both inpatient and outpatient programs are available for all types of addiction and you can receive additional counseling for co-occurring mental disorders.
Reasons to opt for one of the best drug rehab centers in WV that accept Medicaid
The right facility can make all the difference on the path to sobriety. Recovering from addiction is never easy. It is paramount that you have the right kind of treatment and support along the way. Harmony Ridge Recovery Center can provide you with that support. Here is what makes our West Virginia rehab facility the best choice for people with Medicaid insurance plans:
- We offer a holistic approach to addiction treatment. You don’t need to visit multiple rehabs in WV that accept Medicaid – at Harmony Ridge, you can receive all the treatment you need. From detoxing to therapy and case management that ensures you do not relapse, our programs cover every step of the addiction recovery process. Furthermore, we understand that improving your overall mental health will aid you in staying sober. This is why we work on helping you manage any other ongoing conditions you may be struggling with.
- Our staff will treat you with dignity and respect. Most of our staff has had personal experience with addiction, whether they’ve struggled with it or because they know someone who has. Many of them have searched for drug rehab centers in WV that accept Medicaid when they needed help. So we understand what you’re going through and we are not here to pass any judgment.
- We focus on long-term success. The goal of our treatment is that you never again have to look for rehabs in WV that accept Medicaid. To give you the best chance at success, we create a treatment plan tailored for you, based on the severity of your case and the type of therapy you respond to.
Start your recovery journey at Harmony Ridge Recovery Center today!
If you have made the decision to seek help at one of the best drug rehab centers in WV that accept Medicaid, then the first step is to contact us. Our staff is at your disposal 24/7 to answer any questions you may have about your treatment at Harmony Ridge. You do not need to worry about the admission process at all – our team has you covered. The hardest part is admitting that you need help and you’ve already done that. From here on out, you will have all the support you need on your journey to sobriety.