Established in January 2014, New Mexico Medicaid is a government-funded program that gives low-income people access to quality health care.
The program includes several mental health and behavioral health services so those struggling with mental illness, addiction, or another issue can get affordable care.
What Addiction Treatment Services Are Covered By Medicaid In New Mexico?
Covered services for addiction treatment programs may vary depending on the health plan.
Here are some of the general treatment options covered by Medicaid in New Mexico:
- inpatient treatment
- outpatient treatment (OP)
- intensive outpatient program (IOP)
- medication-assisted treatment (MAT) for opioid abuse
- partial hospitalization program (PHP)
- day treatment
- residential treatment
- screening, intervention, and referrals
- peer support services
- substance abuse counseling
- detoxification
- psychotherapy
Top 5 Rehab Centers In New Mexico That Accept Medicaid
Multiple behavioral health centers accept Medicaid for drug and alcohol addiction treatment.
We’ve chosen five for this list based on accreditations, Google ratings, client reviews, verifications, and other important criteria for selection.
1. ALT Recovery Group, Las Cruces, New Mexico
ALT Recovery Group is a methadone clinic with locations in New Mexico and California that accept Medicaid and Medicare.
A few of the trusted qualities of this treatment center include:
- a 4.1-star Google rating
- evidence-based treatment for opioid abuse
- accreditation from the Commission on Accreditation of Rehabilitation Facilities (CARF)
2. Santa Fe Recovery Center, Santa Fe, New Mexico
This rehab facility offers short-term and long-term treatment options for addictions.
The recovery center is backed by:
- CARF accreditation
- recognition from the U.S. Department of Health & Human Services
Options for substance abuse treatment include:
- detox
- MAT
- men’s residential treatment
- women and children’s residential treatment
- recovery housing
- OP and IOP
Location and contact information:
5312 Jaguar Dr.
Santa Fe, NM 87507
(505) 471-4985
3. Serenity Mesa, Albuquerque, New Mexico
This is an addiction treatment center for individuals and families struggling with substance abuse.
Substance misuse programs include therapy, relapse prevention, youth support services, and medication management, among others.
Serenity Mesa is supported by the following:
- a 4.2-star Google rating
- Psychology Today verification
Location and contact information:
3701 Condershire Dr. SW.
Albuquerque, NM 87121
(505) 877-3644
4. Solutions Treatment Center, Multiple Locations
Treatment facilities are located in Santa Fe and Albuquerque, New Mexico.
Trusted qualifications include:
- Psychology Today verification
- positive Google ratings and client reviews
Treatment options include IOP, OP, and support groups for working professionals.
Location and contact information:
2209 Miguel Chavez Rd.
Santa Fe, NM 87505
(505) 424-3170
5. Zia Recovery Center, Las Cruces, New Mexico
This drug rehab center accepts Medicaid and private health insurance.
Features of Zia Recovery Center include:
- verification from Psychology Today
- accreditation from CARF
Here, recovering individuals can choose from the following treatment approaches:
- withdrawal management
- PHP
- OP and IOP
- transitional housing
Location and contact information:
303 North Alameda Blvd.
Las Cruces, NM 88005
(575) 523-0111
Find a New Mexico detox and drug rehab center near you
Factors That Affect New Mexico Medicaid Coverage For Addiction Treatment
Coverage for a rehabilitation center may depend on a few variables, such as copays, referrals, and prior authorization.
Copayments For New Mexico Medicaid
Centennial Care requires several copayments, though these fees are generally under $10. Copays may look different for each health plan.
Factor in these general copays:
- brand-name drugs when generic could be used: $8 per prescription
- emergency room visits for non-emergencies: $8 per visit
There are maximums in place for copayments that vary based on each health plan. If you reach your maximum in the quarter, you will not have to pay any more copays until the next quarter.
Referrals And Prior Authorization For New Mexico Medicaid
Referrals are not needed for behavioral health services. However, you may need to get prior authorization (PA) for some services.
PA involves Medicaid verifying whether a treatment service is medically necessary. This may be necessary for drugs that are not on the preferred drugs list or out-of-network treatment services.
PA is required for the following treatments for substance use disorders:
- inpatient drug rehab
- PHP that exceeds 45 days
- residential rehab
Qualifying For New Mexico Medicaid
You must be a U.S. citizen and resident of the state of New Mexico.
You may qualify for Medicaid if you’re:
- pregnant
- responsible for a child 18 years of age or younger
- blind or disabled
- 65 years of age or older
New Mexico Medicaid Income Eligibility Requirements
Income requirements are set based on the federal poverty level (FPL) ranging from 100% to 150% of the FPL.
Here are the monthly income limits for those who are 130% of the FPL:
- one-person household: $1,383
- two-person household: $1,868
- three-person household: $2,353
- four-person household: $2,839
- five-person household: $3,324
- six-person household: $3,809
- seven-person household: $4,295
- eight-person household: $4,780
For each person after eight, add another $486.
Using A New Mexico Medicaid Plan For Drug Addiction Rehab
Centennial Care provides services with the use of health plans, or managed care organizations (MCOs).
These plans include:
- Blue Cross Blue Shield
- Presbyterian Health Plan
- Western Sky Community Care
These plans can be used to cover substance abuse treatment. First, choose a health plan that covers the rehab programs you need for recovery.
Then, wait to receive your health plan member ID card. Once you’ve been enrolled in a plan and have an ID card, bring it to the rehab center of your choice and start your drug abuse program.
New Mexico Medicaid Insurance Coverage For Drug And Alcohol Rehab FAQs
Here we’ve answered several questions about how to use Medicaid to cover drug and alcohol treatment in New Mexico.
What If I Need To Stay In Rehab Longer Than New Mexico Medicaid Covers?
Your health plan may only cover a limited number of days. However, it is possible to get that time extended if needed.
For example, Medicaid only covers 45 days of partial hospitalization, but it’s possible to get approved for further time spent in a PHP program.
If your request is denied, you can fund the rest of your rehab stay with sliding fee scales, scholarships, grant funding, and loans.
What Are The Benefits Of New Mexico Medicaid Drug Rehab?
The benefits of Medicaid rehab programs include the following:
- use of evidence-based treatment
- low or no cost for treatment
- access to comprehensive care
What Opioid Abuse Treatments Are Covered By New Mexico Medicaid?
Centennial Care covers methadone, naltrexone (Vivitrol), Suboxone, buprenorphine/naloxone tablets, and buprenorphine tablets.
Find Addiction Treatment Covered By New Mexico Medicaid
To find rehab facilities covered by Medicaid in New Mexico for yourself or a loved one, just reach out to our help center.
Our representatives are connected to a network of rehab centers, addiction treatment specialists, and more to help you to locate the right substance abuse program.
Article Sources- Blue Cross Community Centennial—2019 Member Handbook
https://www.bcbsnm.com/pdf/benefits/cc_member_handbook_nm_2019.pdf - New Mexico Human Services Department (NMHSD)—Centennial Care Managed Care Organizations
https://www.hsd.state.nm.us/lookingforinformation/centennial-care-managed-care-organizations/ - New Mexico Human Services Department (NMHSD)—Centennial Care Overview
https://www.hsd.state.nm.us/lookingforassistance/centennial-care-overview/ - New Mexico Human Services Department (NMHSD)—Income Eligibility (Federal Poverty Level Guidelines)
https://www.hsd.state.nm.us/lookingforinformation/income-eligibility-federal-poverty-level-guidelines/ - Substance Abuse and Mental Health Services Administration SAMHSA—Behavioral Health Treatment Services Locator
https://findtreatment.samhsa.gov/