Does Medicaid Cover Tramadol Addiction Treatment

One of the factors which make individuals apprehensive about taking an addiction treatment is the high cost that comes with it. With the US government’s strong commitment to combat the opioid epidemic going on for years in the country, an expansion of Medicaid coverage has been implemented to serve the needs of the American people.

Research reveals that the cost of an untreated addiction, which is considered a chronic mental health illness, takes a greater toll on the economy compared to funding health insurance programs that can financially assist individuals with substance use disorder in getting addiction treatment.

Tramadol, a synthetic opioid painkiller, has caught almost two million people in the country in its addictive potency. Although it is classified as a Schedule IV controlled drug and is known to be less fatal than other opioids, tramadol can bring serious health risks including overdose and death once continuously abused over a long period.

This calls for treatment as an urgent necessary response and its cost should not hinder one from getting treatment. Luckily, Medicaid expansion now covers the expenses of all services included in a Medically Assisted Treatment (MAT) for individuals who are suffering from an opioid use disorder that includes tramadol use disorder.

Do I Qualify For A Medicaid Coverage For Tramadol Addiction Treatment

Medicaid, a federal and state-funded health insurance program, is beneficial to those who struggle in financing their treatment for tramadol addiction. Statistics show how it has aided a greater population compared to private health plans. Certain requirements must be met to be eligible to enjoy the benefits of the program.

Individuals who fall below the age of 19 or are above 65 years old are qualified to enroll in Medicaid. This advantage is also available to parents and pregnant women. The program also considers a person’s income and the size of their family during qualification since there is a certain income bracket requirement that the program follows.

Some states vary a bit about their policies with Medicaid. When a person finds themselves qualified for Medicaid benefits, it is important to reach their state’s Medicaid health provider online or visit their office to sign up. Citizenship and residency are also part of the qualifications of the program.

Medicaid offers coverage to US citizens while the non-citizens may still qualify as long as they have been residents of the state where their Medicaid program belongs. It is best to get to know the details of the Medicaid programs in the state where one resides to further understand their specific policies.

What is Included in the Medicaid Coverage For Tramadol Addiction Treatment

Medicaid coverage expansion requires states to provide increased coverage of the cost included in a Medically Assisted Treatment (MAT) for opioid use disorder. This brings a huge advantage in decreasing the country’s economic burden since hospitalizations caused by opioid overdose can now be limited.

Qualified members of Medicaid who suffers from tramadol addiction may now avail of free cost of the following:

Inpatient and outpatient treatment

Whether a person is enrolled in an inpatient or outpatient treatment plan, Medicaid can fund the cost of either type of care. It may be likely that full coverage of the cost may not be followed as the program may pose certain limitations during the treatment. Despite this, cutting the cost to about 20% is already a huge saving that one can enjoy.

Inpatient treatment is more expensive than outpatient treatment because of the added cost of food and accommodation on top of the cost of medications and therapies. But there is still a huge possibility for Medicaid to cover all of these. It ultimately depends on state policies. However, a limited span of 30 to 60 days of inpatient treatment per year is typically covered.

Counseling and therapy sessions included in outpatient treatment are typically limited to a maximum of 30 hours per week. Prescribed medications are still covered in full. It is important to note that falling off one’s treatment and giving in to relapse can cause a disadvantage to the Medicaid benefits one can enjoy.

Prescribed medications

Methadone and buprenorphine are the top medications prescribed to individuals who suffer from tramadol addiction. They are useful in detox as well as a maintenance medication. Covering the cost of these drugs is part of the improvement in the Medicaid program.

However, reimbursement of the cost of these prescriptions is very strict about the source of where these medications are dispensed. Methadone is only dispensed in qualified Methadone clinics. Methadone is a Schedule II controlled drug yet it can be safely administered with medical guidance.

Buprenorphine is more accessible since licensed physicians and medical staff are entitled to dispense these medications to patients. Buprenorphine is a partial opioid agonist which induces similar effects as methadone and with a less addictive factor. Most addiction centers, especially the ones in rural areas, prescribe this to their patients.

Naloxone, a highly known drug for reversing the effects of opioids, is used for the treatment of opioid overdose. This contains no addictive potential unlike methadone and buprenorphine, which both belong to the class of opioids. It is popularly useful during emergency admissions of patients suffering from an opioid overdose. This is included in Medicaid coverage.

Cost of behavioral interventions

This includes the cost of the services provided by therapists during counseling and individual therapy programs. Medicaid also ensures coverage of these costs. It has been noted how patients engaged in behavioral interventions on top of medications show more significant recovery compared to those who take medications alone.

This outcome also reduces the cost of the economic burden posed by opioid use disorder which is why Medicaid shares its strong support for patients who go through therapies by funding their treatment. Overall, Medicaid policies in every state vary in the limitations of the coverage and qualifications of members so make sure to make inquiries now.

Takeaways

Medicaid has helped many underprivileged people with their medical expenses. But one must met the criteria imposed for an individual to enjoy this benefit. This state-funded health insurance along with other private insurances you have, you can use them to finance your addiction treatment.

If you have any questions, feel free to reach out and we will answer you as soon as possible.