Virginia Medicaid is a government-funded program available to multiple low-income demographics, including pregnant women, disabled people, and families.
In 2017, Medicaid launched new substance abuse treatment benefits under Addiction and Recovery Treatment Services (ARTS).
Medicaid Fee-For-Service Vs. Health Plans In Virginia
Virginia residents can get Medicaid coverage with a fee-for-service (FFS) plan or a health plan. FFS means Virginia Medicaid pays a health provider directly for their service.
With a health plan, the state pays a fee to the managed care plan for each enrollee.
In Virginia, most beneficiaries will first be enrolled in an FFS plan, then moved to a health plan.
Health plans that are offered through Virginia Medicaid are:
- Aetna Better Health of Virginia
- Anthem HealthKeepers Plus
- Magellan Complete Care of Virginia
- OptimaHealth Family Care
- UnitedHealthcare Community Plan
- Virginia Premier
Addiction Treatment Services Covered By Medicaid In Virginia
With the introduction of ARTS in 2017, more Virginia residents have access to affordable addiction treatment services.
Virginia Medicaid covers the following drug and alcohol addiction services:
- partial hospitalization program (PHP)
- day treatment
- residential treatment programs
- outpatient therapy
- intensive outpatient treatment
- inpatient treatment
- opioid treatment
- detoxification
- modalities such as cognitive behavioral therapy (CBT)
- dual diagnosis treatment
- psychiatric or psychological services
- prescription drugs, including buprenorphine (Suboxone, Zubsolv), methadone, naltrexone (Vivitrol)
Top 5 Drug Rehab Centers In Virginia That Accept Medicaid
There are many treatment centers in the state of Virginia that accept Medicaid for behavioral health services.
Five have been selected for their:
- accreditation
- Google ratings
- client testimonials
- other important selection criteria
1. Behavioral Health Group, Multiple Locations
Behavioral Health Group (BHG) is a multi-state drug addiction program with a few locations in Virginia.
This program has a primary focus on helping people dealing with opioid addiction.
Trusted features:
- Joint Commission accreditation
- Commission on Accreditation of Rehabilitation Facilities (CARF) accreditation
- LegitScript certification
- Substance Abuse and Mental Health Services Administration (SAMHSA) affiliation
Levels of care:
- outpatient program (OP)
- medication-assisted treatment (MAT)
Treatment services:
- individual therapy
- group therapy
- family therapy
Payment options:
- Medicaid
- Medicare
- commercial health insurance
- self-pay
Location and contact information:
5715 Princess Anne Rd.
Virginia Beach, VA 23462
(757) 962-0748
2. Centra Addiction Treatment Center, Lynchburg, Virginia
Centra Health is a nonprofit medical center that has two addiction treatment facilities in Lynchburg.
Comprehensive care is available through both inpatient and outpatient programs, including medication-assisted treatment.
Trusted features:
- Joint Commission accreditation
- positive client reviews
Levels of care:
- medical detox
- residential program
- intensive outpatient program (IOP)
- medication-assisted treatment (MAT)
Treatment services:
- evaluation
- individual therapy
- group therapy
Payment options:
- Medicaid
- Medicare
- commercial health insurance
- self-pay
Location and contact information:
3300 Rivermont Ave.
Lynchburg, VA 24503
(434) 200-4455
3. Crossroads, Multiple Locations
Crossroads is a methadone and Suboxone treatment center specializing in treating opioid addiction.
Trusted features:
- LegitScript certification
- evidence-based treatment methods
- 4.8-star Google rating
Levels of care:
- outpatient program (OP)
- medication-assisted treatment (MAT)
Treatment services:
- counseling
- addiction education
- relapse prevention
Payment options:
- Medicaid
- Medicare
- commercial health insurance
- self-pay
Location and contact information:
837 First Colonial Rd.
Virginia Beach, VA 23451
1 (800) 805-6989
4. Pinnacle Treatment Centers, Multiple Locations
Pinnacle Treatment Centers is an addiction program that has several locations throughout the United States, including 11 in Virginia.
Trusted features:
- Commission on Accreditation of Rehabilitation Facilities (CARF) accreditation
- LegitScript certification
- National Association of Addiction Treatment Providers (NAATP) membership
Levels of care:
- residential program
- intensive outpatient program (IOP)
- medication-assisted treatment (MAT)
Treatment services:
- individual therapy
- group therapy
- support groups
- educational groups
- relapse prevention
- holistic therapies
Payment options:
- Medicaid
- Medicare
- commercial health insurance
- self-pay
Location and contact information:
4906 Radford Ave.
Richmond, VA 23230
(804) 354-1996
5. SaVida Health, Multiple Locations
SaVida Health is a personalized, comprehensive addiction program that specializes in treating opioid abuse, though it also treats other types of addiction.
Clients can also find wrap-around support services here.
Trusted features:
- client testimonials
- 5-star Google rating
Levels of care:
- outpatient program (OP)
- medication-assisted treatment (MAT)
Treatment services:
- case management
- individual counseling
- group counseling
Payment options:
- Medicaid
- Medicare
- commercial health insurance
- self-pay
Location and contact information:
4001 Prince William Pkwy.
Ste. #300
Woodbridge, VA 22192
(703) 214-5825
Find more Virginia rehab centers near you.
Factors That Affect Virginia Medicaid Coverage For Addiction Treatment
The following factors will determine what is covered by your Virginia Medicaid insurance plan and what additional costs you’ll need to plan for.
Prior Authorization Might Be Needed
Some behavioral health and mental health services need prior authorization. This is a process used by Medicaid to determine if a service or prescription drug is medically necessary.
Expect Long Waitlists
Low-cost options such as Medicaid treatment centers are often in high demand.
There is a possibility that you may not be able to get into a Medicaid program due to long waitlists, or that you’ll have to wait a few months before getting in for treatment.
Copayments Are Required For Some Services
Medicaid covers almost the full cost of addiction treatment services in Virginia, but there are some minor copayments ranging from $1 to $3.
Inpatient stays can be more costly, with a copayment of $100.
People under 21 years of age, pregnant women, people receiving hospice care, and people in institutional care or receiving long-term care services are not responsible for any copayments.
Eligibility Requirements For Virginia Medicaid Drug Rehab
Virginia Medicaid is available for certain low-income individuals and families.
These groups qualify for Medicaid in Virginia:
- children under the age of 19
- pregnant women
- Supplemental Security Income (SSI) recipients
- adults who are aged 65 or older
- people who are blind or disabled
- those in need of long-term care in a facility
- those getting Medicare benefits
- those getting family planning services
- a person in the breast and cervical cancer early detection program
Virginia Medicaid Income Eligibility Requirements
Medicaid eligibility is determined by looking at a person’s wages compared to the federal poverty level (FPL).
Here are the income limits for adults ages 19 to 64 up to 133% of the FPL, as of 2024:
- one-person household: $20,121
- two-person household: $27,214
- three-person household: $34,307
- four-person household: $41,400
- five-person household: $48,494
- six-person household: $55,587
- seven-person household: $62,680
- eight-person household: $69,773
How To Use Your Virginia Medicaid Plan For Drug Rehab
When you first enroll in Medicaid, you’ll be automatically placed into an FFS plan.
If you choose to get treatment immediately after enrolling in Medicaid, you can use your FFS plan to cover treatment.
Bring your FFS identification card to the rehab facility to cover care costs.
After a certain period of time, you’ll need to select a health plan from one of the six available options.
Verify that the health plan you choose will cover the specific addiction treatment services you need.
If you’re entering a treatment program with a health plan, bring both your Medicaid identification card and your managed care card to get coverage.
Virginia Medicaid Insurance Coverage For Drug And Alcohol Rehab FAQs
Here you’ll find answers to common questions about drug rehab and Virginia Medicaid coverage.
Does Virginia Medicaid Cover All Addiction Treatment Services?
While Virginia Medicaid covers a wide range of clinically proven and evidence-based treatment services, not all services are covered.
What Are The Different Drug Rehabs Programs Available For Virginia Medicaid Patients?
Virginia Medicaid recipients can participate in outpatient programs, inpatient programs, medical detox, and more.
What If I Need To Stay In Rehab For Longer Than Virginia Medicaid Covers?
There is a limit to the number of days a person can stay in addiction treatment and get coverage from Medicaid.
Recovering individuals can usually remain in treatment for a short-term basis, generally up to 90 days.
If you need to stay in treatment longer, there are other financing options such as scholarships, grants, sliding-fee scales, and other programs specific to each treatment program.
Find Addiction Treatment Today
Addiction and drug dependency are complex conditions, but recovery centers are available to help.
If you or a loved one need behavioral healthcare for addiction, contact Detox Rehabs today to find substance use disorder services.
Article Sources- American Society of Addiction Medicine—Medicaid Coverage of Medications for the Treatment of Opioid Use Disorder
https://www.asam.org/docs/default-source/advocacy/state-medicaid-reports/state-medicaid-reports_va.pdf - Commonwealth of Virginia Department of Medical Assistance Services—MEDICAL ASSISTANCE HANDBOOK
https://www.coverva.org/sites/default/files/2021-03/Medical_Assistance_Handbook_2019_11.1.19_rev_FINAL%20English.pdf - Commonwealth of Virginia Department of Health—2021 Enrollment Information
https://www.vdh.virginia.gov/content/uploads/sites/10/2020/11/2021-Open-Enrollment-Letter-10152020.pdf - Virginia Department of Social Services—Frequently Asked Questions About Medical Assistance
https://www.dss.virginia.gov/files/division/bp/medical_assistance/intro_page/faq/about.pdf