Nearly five million Texas residents are enrolled in Medicaid. Of those enrollees, about nine percent received treatment for a substance use disorder (SUD) as of 2015.
Texas Medicaid provides health insurance for low-income children, families, seniors, and people with disabilities.
For those struggling with substance abuse, alcohol and drug addiction treatment is available in free and low-cost options under Texas Medicaid.
Find out more about using Medicaid to pay for addiction treatment
Addiction Treatment Services Covered By Texas Medicaid
If you or a loved one qualify for Texas Medicaid, you can receive addiction treatment for little or no cost.
There are many evidence-based, proven treatment measures covered by Medicaid in the state of Texas.
Some of the treatment programs and services covered include:
- detoxification
- intensive drug rehab
- supportive residential services (adult and youth)
- outpatient treatment (adult and youth)
- intensive outpatient programs (IOP)
- partial hospitalization programs (PHP)
- medication-assisted treatment (MAT)
- co-occurring psychiatric and substance use disorder services (adult and youth)
- specialized women’s services (adult and youth)
- outreach
- inpatient treatment
- screening and assessment
- referrals
- pregnant and parenting intervention, including treatment for neonatal abstinence syndrome
- community-based support
View our list of Texas drug detox and rehab center to find treatment near you
Types Of Medicaid In Texas
There are five different Medicaid programs offered in Texas.
The five plans are:
- STAR: available to anyone not enrolled in STAR, STAR+PLUS, STAR Kids, or STAR Health
- STAR+PLUS: available to people who have disabilities or those 65 or older
- STAR Kids: provides benefits to children and adults 20 and younger who have disabilities
- STAR Health: covers children and youth under 20 or 21 currently or previously in foster care
- Traditional Medicaid: available to anyone not enrolled in STAR, STAR+PLUS, STAR Kids, or STAR Health
Top 5 Rehab Centers In Texas That Accept Medicaid
Many treatment centers in Texas accept Medicaid, and five were chosen for this list.
Qualifying Medicaid rehab centers listed below have:
- accreditation
- high Google ratings
- evidence-based practices
- positive client testimonials
- awards and verifications
1. Austin Recovery, Austin, Texas
Private health insurance plans and most Medicaid plans cover outpatient treatment and individual counseling here.
Austin Recovery has a number of top qualities, such as:
- accreditation from the Commission on Accreditation of Rehabilitation Facilities (CARF)
- support from St. David’s Foundation
- a 4.7-star Google rating
Location and contact information:
4201 S Congress Ave.
Suite 202
Austin, TX 78745
(512) 697-8500
2. Cenikor Foundation, Multiple Locations
Behavioral health programs are available in multiple Texas rehab facilities, including Amarillo, Austin, and Houston, Texas.
Top features of this drug rehab center include:
- CARF accreditation
- accreditation from the Better Business Bureau (BBB)
- high Google ratings
Substance abuse treatment for drug and alcohol addiction here includes:
- drug and alcohol detox
- outpatient programs
- short-term residential treatment
- relapse prevention
- adolescent treatment services
Location and contact information:
1001 Wallace Blvd.
Amarillo, TX 79106
(888) 236-4567
3. MedMark Treatment Centers, Multiple Locations
This is an outpatient medication-assisted treatment rehab program for opioid drug abuse utilizing methadone and buprenorphine.
MedMark accepts Medicare and Medicaid for addiction recovery services.
MedMark is supported by:
- CARF accreditation
- high Google ratings
- positive client testimonials
Location and contact information:
7428 Military Dr. West
Suite D
San Antonio, TX 78227
(210) 673-8111
4. Phoenix House Texas, Multiple Locations
Outpatient drug rehab and residential treatment services are available in Austin, Dallas, Houston, Round Rock, and San Antonio, Texas.
The recovery center is set apart by:
- CARF accreditation
- high Google ratings
- recognition by Newsweek as one of the best addiction treatment centers in 2020
Location and contact information:
2345 Reagan St.
Dallas, TX 75219
(214) 999-1044
5. Unlimited Visions Aftercare, Multiple Locations
Here, Medicaid covers the following treatment options:
- residential treatment
- outpatient rehab
- relapse prevention
- recovery support
Marks of quality care include:
- CARF accreditation
- a 4-star Google rating
Treatment center locations are in Houston, Baytown, and Pasadena, Texas.
Location and contact information:
5519 Lawndale
Houston, TX 77023
(713) 923-1786
Factors That Affect Texas Medicaid Coverage For Addiction Treatment
Medicaid in Texas covers most of the cost of treatment services, but there may be some payment required. There may also be drawbacks in wait times for rehab or prior authorization.
Deductibles And Copays
You may be required to cover a copayment for addiction treatment. This will be needed if you’re enrolled under a Health Insurance Premium Payment Program (HIPP).
A HIPP program is a Medicaid program that helps families with at least one person who uses Medicaid to pay for an employer-sponsored health insurance premium.
Getting Prior Authorization
Prior authorization (PA) requires an individual to get a certain service or medication authorized by Medicaid before starting treatment.
This might be necessary for some addiction treatment programs, including outpatient treatment over 135 units of group service and 26 hours of group service per year.
Waitlists
For treatment facilities that take Medicaid, expect waitlists to be longer.
Because Medicaid treatment centers are in higher demand, there will be more people seeking treatment at those locations.
What Are The Qualifications For Eligibility Of Texas Medicaid Drug Rehab?
To qualify for Texas Medicaid, a person must be within one of the following demographics:
- pregnant women
- a person responsible for a child 18 years of age or younger
- a person who is blind
- a person in foster care
- a person with a disability or a family member in their household with a disability
- those 65 years of age or older
Texas Medicaid Income Eligibility Requirements
Income limitations are based on a person’s income compared to the federal poverty level (FPL). For example, pregnant women are eligible for Medicaid if they make up to 198% of the FPL.
Here are the monthly income limits for pregnant women based on their household size:
- one-person household: $1,961
- two-person household: $2,644
- three-person household: $3,327
- four-person household: $4,010
- five-person household: $4,693
- six-person household: $5,376
- seven-person household: $6,061
- eight-person household: $6,747
For each additional person after eight, add another $687.
How To Use Your Texas Medicaid Plan For Drug Rehab
To use your Texas Medicaid plan to cover the cost of addiction treatment, follow these steps:
- Choose a health plan (STAR, STAR+PLUS, STAR Kids, Traditional Medicaid, or STAR Health)
- Apply for the insurance program
- If admitted, choose a health provider
Speak with a Medicaid rehab center about programs covered by Medicaid. You may need to verify your insurance to determine which services are covered with Texas Medicaid.
Follow through with treatment covered by Medicaid.
FAQs For Texas Medicaid Insurance Coverage Of Drug Rehab
As you narrow down your search for rehab centers that accept Medicaid, there are a few important factors to consider.
Here, we’ve answered top-asked questions about Medicaid insurance coverage for drug rehab in Texas.
Does Texas Medicaid Cover Behavioral Therapy?
Texas Medicaid covers behavioral therapies, including Cognitive Behavioral Therapy and Cognitive Processing Therapy.
How Much Does Drug Rehab Cost In Texas Without Medicaid?
Without Medicaid, drug rehab programs can cost anywhere between a few hundred dollars and $25,000.
Outpatient drug rehab costs between $5,000 and $10,000, and inpatient residential treatment can cost between $10,000 and $25,000.
What Is The Average Cost Of A Texas Medicaid Drug Rehab Program?
Many Medicaid-covered programs are completely free. There can be small copays, but most of the services are fully covered.
Find A Medicaid Rehab Center In Texas
For help determining the right treatment plan covered by Medicaid in Texas, call our helpline. We can connect you to support groups, rehab centers, and medical professionals who can help.
Reach out to one of our trained representatives today to get started on your road to recovery, or to find help for a loved one.
Article Sources- Center for Public Policy Priorities—How Medicaid and Federal Block GrantsHelp Treat Substance Use Disorders
https://everytexan.org/images/HW_2018_SubstanceUse_Medicaid.pdf#:~:text=Today%2C%20Texas%20Medicaid%20covers%20roughly,nine%20percent%2C%20received%20SUD%20treatment. - Texas Health and Human Services—Adult Substance Use
https://www.hhs.texas.gov/services/mental-health-substance-use/adult-substance-use - Texas Health and Human Services—Healthcare Statistics
https://www.hhs.texas.gov/about-hhs/records-statistics/data-statistics/healthcare-statistics - Texas Health and Human Services—Medicaid & CHIP
https://www.hhs.texas.gov/services/health/medicaid-chip - Texas Health and Human Services—Substance Use Disorder Service Providers
https://www.hhs.texas.gov/doing-business-hhs/provider-portals/behavioral-health-services-providers/substance-use-disorder-service-providers - Texas Health and Human Services—Chapter 3: Eligibility
https://www.hhs.texas.gov/sites/default/files/documents/laws-regulations/reports-presentations/2017/medicaid-chip-perspective-11th-edition/11th-edition-chapter3.pdf