Concerns about Addiction Treatment: Will TennCare Cover Drug Rehab?

What are among the largest barriers keeping people who require and are qualified for Medicaid from actually getting it? Stigma. Most Americans are people of pride who commonly see receiving aid, particularly from the federal government, as dishonorable.

Americans frequently equate means-tested help with sloth, lying, and moral degradation, even though this is not true for other types of federal support like tax rebates and social security. Requesting incentives may therefore put one's self-esteem at peril.

At the organizational level, this stigma also makes many potential aid recipients fearful of an unwelcoming response when they submit a benefit request.

1. Breaking the stigma of drug recovery with Tenncare

As per the National Institute on Drug Abuse (NIDA), stigma affects those with a drug or alcohol problem: People with addiction are blamed for their sickness. The general public, many in the medical community, and the criminal justice system continue to perceive addiction as the product of moral weakness and bad character. However, medicine long ago agreed that it is a complicated brain condition with behavioral components.

Why does this matter? The Commonwealth Fund, a nonprofit organization, states that although the psychological state is a widespread concern, low-income persons are frequently reluctant to seek help due to misunderstandings concerning care assistance. That is evident in studies of Medicaid recipients and focus groups they have conducted. To put it another way: Tennessee residents who are eligible for TennCare treatment yet want assistance for addiction treatment are frequently less inclined to get it. What is doable, then?

A Tenncare substance abuse treatment provider should ideally be equipped to handle a facility that can empower its clients by offering compassionate treatment. Alcoholics and addicts who are poor or from low socioeconomic backgrounds might feel heard and recognized; also, the treatment is safe from a medical standpoint. They are recognized as ill individuals. They are individuals afflicted by sickness, not "evil" people who are rejected or shunned due to their actions or lack of means.

Will such clinics provide drug rehab covered by TennCare? Yes, but it's crucial that individuals who would benefit from it choose the option that best suits their requirements and aids in eradicating those two stigmas.

2. Tenncare: Who is eligible?

This system primarily assists low-income pregnant women, parents or grandparents of young children, young kids, and senior or handicapped people, according to the Tenncare website. You must fulfill the income and resource requirements to qualify for Medicaid.

What are the restrictions on the number of categories, the revenue, and the resources? They are divided into various categories, most of which are intended to offer health care for young people, mothers, the elderly, and children.

According to the U.S. Department of Health and Human Services, substance treatment programs are available to people who get care via Tenncare. Each of the state's three Managed Healthcare Organizations Care, Amerigroup, or the UHC Community Plan, has access to most of them. Following the Mental Health Parity and Addiction Equity Act (MHPAEA, sometimes known as "parity," approved in 2008), Medicaid and CHIP programs (healthcare) must pay for mental illness and drug use disorder treatments in the same ways as they do for coverage of physical health care. It is the same as they do for the coverage of physical health services.

However, there are several restrictions, much like with other individual insurance policies. You must follow certain actions to activate those advantages as an alcohol and drug treatment center that has been granted Tenncare approval. To acquire the therapy you want at an approved institution, you must first obtain what is known as preceding consent. To do this, speak with the provider of your health insurance plan. Thankfully, most Tenncare-accepting facilities can guide you through the prior authorization procedure or handle it; all you need to do is get in touch with the facility's Admissions Department and provide them with your information.

But suppose you're not eligible for TennCare but require rehab? As per the State of Tennessee, resources are available if you satisfy the requirements listed below: "You don’t have economic means of getting services, you meet the 133 percent federal poverty guidelines established by the U.S. Department of Health and Human Services; you are not enlisted in Tennessee's Medicaid therapeutic program (Tenncare substance abuse treatment-program), there are no additional third-party health benefits available to you, you have used up all TennCare or other third-party coverage for alcohol and drug misuse treatment.

These are the people who get treated at institutions that get the federal government and state funding.

3. Will Tenncare cover drug rehab?

If you have an issue, you should take Tenncare's offer to pay for drug rehab. The cost of treating SUDs (substance use disorders) in 2009 was $24 billion, of which 21% came from Medicaid payers. There is a lot of proof that therapy is effective, and studies show that most of those who enter continue therapy and cease taking drugs.

The bottom line

The Tenncare substance abuse treatment providers will treat all patients, regardless of whether they are TennCare users. They will also provide them with a range of traditional and proven treatment options in an effort to help them improve. TennCare will cover more than just drug rehabilitation at these establishments.

Do you want to learn more about drug abuse treatment? Consider visiting the webpage of Cooperative Recovery.