Rehab Centers That Accept Medi-Cal Health Insurance – An In-depth Guide

• Content Reviewed By:
• Andrew McKenna - JD
• SUD's treatment executive, national news contributor & keynote speaker.

Navigation:

• Overview
• What Kind of Services Does My Medi-Cal Insurance Plan Cover?
  • Outpatient and IOP Treatment
  • Partial Hospitalization Programs (PHPs)
  • Inpatient Rehab
  • Detoxification and Withdrawal Management
  • Medication-Assisted Therapy (MAT) for Opioid Use Disorder
• How Do I Find Out What My Medi-Cal Plan Covers?
• Find Rehab Centers That Accept Medi-Cal Insurance Plans

Overview

Medi-Cal is the Medicaid plan offered by California-based health insurance provider Medi-Cal. It connects Californians struggling with substance use disorder and who have limited means, with medically necessary treatment services for their alcohol and drug addiction. While California continues to grapple with escalating rates of addiction, there’s also a widening income gap that leads to a serious treatment disparity for those who need it most. If you or someone you care about is covered by a Medi-Cal plan, you don’t have to let money get in the way of seeking treatment for substance use disorder and your path to recovery. 

What Kind of Services Does My Medi-Cal Insurance Plan Cover?

While the scope of coverage will vary according to a variety of factors, Medi-Cal plans commonly mirror those offered by other Medicaid plans, including individual and family therapy sessions, medication management and adherence guidance, applied behavioral health analysis (ABA) for children and adults, and more. These services are applied across a range of behavioral rehab models in order to meet members’ clinical and lifestyle needs.

While eligibility may vary, some of the more common types of treatment covered by Medi-Cal may include: 

• Outpatient and IOP Treatment: Outpatient treatment allows patients to attend daily sessions and return home each day at the conclusion of their daily care. It can offer the same elements of care as inpatient and more intensive “day” treatment programs, like partial-hospitalization programs (PHPs), but provide more flexibility to help patients stay present in their families and careers while they’re doing the work of recovery. Outpatient programs generally last between four and six weeks, with daily session duration differing based on program model and each patient’s ongoing care needs. Medicaid plans often cover outpatient treatment programs more readily than their inpatient and residential counterparts.
• Partial Hospitalization Programs (PHPs): Partial hospitalization programs follow the same format as outpatient programs, but offer a longer duration and a more intense level of care. They are often administered in a hospital-like or ambulatory setting, due to patients’ more severe medical needs. They often last six to eight weeks with daily treatment sessions lasting eight hours per day, and may include elements of sober housing and other post-treatment support resources to set patients up for success in long-term recovery. 
• Inpatient Rehab: Medi-Cal may, in some circumstances, cover Inpatient or residential rehab. This model of care allows patients to stay at their treatment center for a determined length of time (usually 28-30 days) and get the help they need in a safe, supportive, comfortable, and discreet atmosphere. It includes medical and behavioral care from experienced clinicians, as well as case management services, medication assistance, and medically supervised detoxification and withdrawal management.  Generally speaking, inpatient treatment consists of group therapy, individualized counseling, and supplemental therapies that address patients’ unique clinical needs. These therapies will vary, according to facility resources, but often include cognitive behavioral therapy (CBT), dialectical behavioral therapy (CBT), eye movement desensitization and reprocessing (EMDR), and more. Inpatient treatment is helpful for those who have not been able to avoid relapse after attempting outpatient therapy. 
• Detoxification and Withdrawal Management: Medical detoxification (detox) allows patients to get medical care for the worst of their physical and psychological withdrawal symptoms from trained doctors and nurses. It helps patients safely and comfortably eliminate the toxins in their system that have built up from a prolonged and untreated course of substance use. Clinical staff can help make the withdrawal period more tolerable and intervene in the event of a medical emergency. Detox programs usually last between three days and a week, depending on patients’ medical needs. While outpatient detox is possible, patients should undergo a thorough clinical evaluation to determine the health risks. 
• Medication-Assisted Therapy (MAT) for Opioid Use Disorder: As opioid use continues to rise and claim more lives in California, Medi-Cal is offering coverage for certain FDA-approved medications to help those seeking treatment reduce their cravings and withdrawal symptoms so they can safely taper off. Medication-assisted therapy (MAT) includes buprenorphine and naloxone (Suboxone), naltrexone (Vivitrol), methadone, Sublocade, and more. It can be offered either as part of an overall inpatient or outpatient treatment program or as an approved opioid treatment plan (OTP). 

How Do I Find Out What My Medi-Cal Plan Covers?

The fastest way to find out what your Medi-Cal plan covers is to contact the Behavioral Health department at Health Net and speak to a representative. They can provide you or your loved one with valuable insight and context on eligibility for plan benefits, what services require preauthorization, what services are covered when you use a provider in your health plan’s network, what services are covered when you use a provider who’s not in your health plan’s network (some plans only cover in-network services), your out-of-pocket costs, and benefit exclusions and limitations.

Find Rehab Centers That Accept Medi-Cal Insurance Plans

If you or a loved one have Medi-Cal insurance, you may be able to use your benefits to pay for alcohol and drug addiction treatment. Medi-Cal is California’s Medicaid program and provides free or low-cost health coverage for eligible individuals and families, including coverage for substance use disorder services through Drug Medi-Cal–certified treatment providers. Depending on your plan and medical needs, coverage may include detox and withdrawal management, residential treatment, outpatient and intensive outpatient programs, medication-assisted treatment, and ongoing recovery support services. Using our nationwide directory, you can quickly find rehab centers that accept Medi-Cal insurance plans, compare treatment options, and connect with programs that can help you begin your recovery journey.