If you’re wondering what addiction services are covered under Medicaid, you’re not alone. Medicaid is the largest payer for mental health and substance use disorder treatment in the United States, with more than 71 million enrollees as of November 2024 [1]. As a result of the Affordable Care Act and subsequent federal rules, Medicaid must cover a wide range of recovery services—from detox and inpatient rehab to counseling, medication-assisted treatment, and intensive outpatient programs. Understanding your benefits can help you access the support necessary for lasting recovery.
Coverage varies by state, but federal parity laws ensure mental health and substance use disorder benefits receive no more restrictive limits than medical and surgical care [2]. Additionally, 24 percent of Medicaid expansion enrollees have a diagnosed behavioral health condition, including substance use disorders, and nearly three-quarters of those individuals receive treatment or supportive services each year [3]. This guide will walk you through the core services Medicaid covers, how to use your benefits, and steps to overcome common barriers so you can begin your path toward recovery with confidence.
Medicaid coverage overview
Medicaid covers a spectrum of addiction recovery services under the 2010 Affordable Care Act and the Mental Health Parity and Addiction Equity Act of 2008. Your state plan, managed care waiver, or Section 1115 demonstration determines the specifics, but you can expect the following core components:
- Behavioral health services, including screening, assessment, and diagnosis [4]
- Detoxification, inpatient rehabilitation, and residential treatment
- Outpatient rehabilitation and intensive outpatient programs
- Medication-assisted treatment (MAT) for opioid use disorder
- Counseling, therapy, and peer support
- Case management and care coordination
As of 2020, 26 states plus the District of Columbia provided at least one service in each level of care specified by the American Society of Addiction Medicine (ASAM), while 13 states and DC offered all seven service types across ASAM levels. All Medicaid programs cover buprenorphine, nearly all cover injectable naltrexone, and most cover methadone in outpatient settings [5]. These requirements create a framework for individualized plans that address your unique challenges.
Covered rehab services
Rehabilitation programs help you stabilize, learn coping skills, and build a foundation for recovery. Medicaid typically covers:
Inpatient rehab
Inpatient or residential rehab involves round-the-clock care in a structured environment. You live at the facility for a set period—often 30 to 90 days—where you receive:
- Medical supervision during detox
- Individual and group therapy
- Holistic therapies like yoga or meditation
- Aftercare planning
Most states do not impose co-payments for addiction treatment, and out-of-pocket maximums apply if any cost sharing is required [6].
Outpatient rehab
Outpatient programs allow you to live at home and attend scheduled therapy sessions. Services may include:
- Weekly individual counseling
- Group therapy
- Medication management
- Life-skills workshops
Outpatient rehab coverage varies by state but is widely available under Medicaid. For details on your state’s outpatient benefits, see medicaid outpatient rehab coverage.
Intensive outpatient programs
Intensive outpatient programs (IOPs) offer more frequent sessions—often three to five days per week, several hours per day—while you maintain daily responsibilities. Medicaid covers IOPs in most states, providing a balance between structure and flexibility. Learn more at medicaid intensive outpatient program coverage.
Medication assisted treatment
MAT combines medications with counseling and behavioral therapies to treat opioid use disorders. Federal guidelines issued in 2020 mandate Medicaid coverage for specific drugs, counseling, and related therapy [1]. Coverage includes:
| Medication | Coverage level | Notes |
|---|---|---|
| Buprenorphine | All states | No copays in most states, prescribed by qualified providers |
| Methadone | 32 states + DC | Covered in licensed opioid treatment programs |
| Injectable naltrexone | Almost all states | Administered under medical supervision |
| Oral naltrexone | 34 states + DC | Coverage varies; check your state plan |
Buprenorphine and Suboxone
Buprenorphine, including branded Suboxone, is covered nationwide. You don’t usually pay co-pays, and coverage extends to both office-based treatment and pharmacy dispensing. To find a prescriber near you, visit suboxone doctors that take medicaid insurance or learn how to get Medicaid coverage for Suboxone. If you need details on Subutex, see is subutex covered by Medicaid.
Methadone clinics
Methadone treatment programs are covered by Medicaid in most states. Clinics provide daily dosing, counseling, and medical oversight. If you’re exploring this option, check can Medicaid pay for methadone treatment and medicaid coverage for methadone clinics.
Naltrexone coverage
Long-acting injectable naltrexone is covered in nearly every state. Oral naltrexone coverage is less consistent—34 states plus DC include it in their Medicaid plans. When available, it offers an alternative for those who can adhere to daily dosing.
Counseling and therapy
Psychosocial support is a critical complement to medical care. Medicaid covers multiple counseling modalities:
Individual counseling
One-on-one sessions with a licensed clinician help you explore underlying issues, set recovery goals, and develop relapse-prevention strategies. You generally won’t face co-payments for these sessions.
Group therapy
Group settings foster camaraderie and accountability. Sharing experiences with peers can bolster motivation and reduce isolation. Coverage is mandated under parity rules to be no more restrictive than group medical services [2].
Family counseling
Many plans include family or couples therapy, recognizing that addiction affects loved ones. These sessions support healing at home and reinforce a supportive environment.
For more on therapy benefits, see does Medicaid pay for counseling for addiction.
Access your benefits
Navigating Medicaid can feel complex, but understanding eligibility and provider networks empowers you to get care.
Eligibility and expansion
Income thresholds and expansion status differ by state. In expansion states, adults earning up to 138 percent of the federal poverty level typically qualify. In non-expansion states, eligibility can be much narrower [1]. Work requirements generally exempt individuals receiving SUD treatment under the “medically frail” category [7].
Finding a provider
- Contact your state Medicaid office or managed care plan for an up-to-date provider directory
- Use online search tools to locate Medicaid opioid treatment programs
- Ask local clinics about sliding-scale or no-cost options for uninsured gaps
- For outpatient services, see medicaid assistance for outpatient addiction programs
Work requirement exemptions
If you’re navigating work requirements, know that participation in an SUD treatment program designates you as “medically frail,” exempting you from work reporting and related penalties [7]. Behavioral health symptoms can make compliance challenging, so connect with your case manager for assistance.
Manage cost sharing
Most states eliminate co-payments for addiction treatment benefits and cap any out-of-pocket spending under broader Medicaid rules. When cost sharing applies, it is usually limited to:
- Buprenorphine in 16 states plus DC
- Oral naltrexone and individual outpatient services in 13 states plus DC [5]
Overall, average Medicaid spending for enrollees with a substance use disorder diagnosis was over \$1,200 per month in 2020, compared to less than \$550 for those without SUD [3]. This investment underscores Medicaid’s commitment to comprehensive care.
Plan your next steps
Understanding what addiction services are covered under Medicaid removes a critical barrier on your road to recovery. To move forward:
- Review your state’s Medicaid benefits handbook or website
- Verify coverage for your preferred services—detox, inpatient rehab, MAT, or counseling
- Contact a Medicaid-friendly facility or provider to confirm acceptance and schedule an assessment
- Explore peer support groups and aftercare resources to reinforce long-term recovery
By leveraging Medicaid’s extensive coverage, you can access the comprehensive, individualized treatment programs you need. Take the first step today by speaking with your Medicaid coordinator or healthcare provider—your recovery journey starts with a single call.
