Rehabs That Accept Pennsylvania Medicaid (Medical Assistance)
Pennsylvania Medicaid provides healthcare coverage for 19 percent of the state’s residents, making it one of the largest insurance providers in Pennsylvania.
Individuals in Pennsylvania can use their Medicaid insurance plan to can seek care for addiction, as Medicaid provides coverage for behavioral health, or substance abuse and mental health treatment programs.
Before heading to treatment, it can be beneficial to know which rehab centers in Pennsylvania accept Medicaid insurance and which treatment services are covered by Medicaid.
Pennsylvania Medicaid Coverage For Addiction And Mental Health Treatment
Pennsylvania residents must first meet eligibility requirements to qualify for Medicaid. Then, they must enroll in one of the state’s managed care plans for Medicaid.
The following Medicaid managed care plans are available in the state of Pennsylvania:
- Aetna Better Health
- AmeriHealth Caritas Northeast
- AmeriHealth Caritas Pennsylvania
- Gateway Health Plan, Inc.
- Geisinger Health Plan
- Health Partners of Philadelphia, Inc.
- UnitedHealthCare Community Plan
- UPMC for You
The managed care plans available to each resident will depend largely on the region and county in which they reside.
Premiums And Copays
Pennsylvania Medicaid policyholders with an income greater than 100 percent of the Federal Poverty level will have to pay a minor monthly premium up to two percent of their household income.
Pennsylvania Medicaid plans also require a minor fee for most services, called a copay. The copay amount depends on the service type and cost, not to exceed $7.60.
Individuals who meet certain criteria will not have to pay copays or premiums.
These include individuals who are:
- pregnant
- under age 18
- in the foster care system and adoption assistance programs
Addiction Treatment Services Covered
Pennsylvania Medicaid plans pay for most addiction treatment services for eligible individuals. For many services, individuals may be required to undergo a clinical assessment to show medical need for treatment.
The following services are usually covered by Pennsylvania Medicaid insurance plans:
- cognitive behavioral therapy
- dialectical behavioral therapy
- counseling
- medically supervised detox
- medication management
- medication-assisted treatment (MAT)
- outpatient programs
- residential programs
Top 5 Rehab Centers That Accept Pennsylvania Medicaid
More than 250 rehab centers accept Medicaid plans in Pennsylvania, allowing residents a range of addiction treatment options.
The following top 5 rehab centers that accept Pennsylvania Medicaid were selected for:
- rehab facility accreditation
- rehab program excellence
- positive reviews
1. Gaudenzia, Philadelphia, Pennsylvania
Gaudenzia is a CARF-accredited drug and alcohol rehab center offering a range of treatment programs, including:
- adult residential programs
- adult outpatient treatment
- specialized programs for women/pregnant women with children
- teen outpatient programs
- court-ordered rehab programs
- transitional and sober living homes
Gaudenzia operates from a therapeutic community approach, believing the most important component of a successful recovery is a strong support system.
Rehab programs at Gaudenzia combine evidence-based and traditional as well as alternative therapies, counseling, and education.
Gaudenzia also helps individuals in its programs continue or explore their education options and secure employment.
Payments accepted at Gaudenzia include Medicaid managed care programs, certain private insurance plans, and private pay.
Location and contact information:
1306 Spring Garden St.
Philadelphia, Pennsylvania 19123
(215) 238-2150
2. Butler Health System, Butler, Pennsylvania
Butler Health System provides treatment services to residents in eight counties in Pennsylvania. Addiction treatment services are offered through the BHS Regional Recovery Center.
Butler Health System offers a range of treatments for a full spectrum of care that includes:
- individual counseling
- outpatient
- partial hospitalization
- intensive outpatient
- detox and inpatient
- relapse prevention
- family intervention
All services are licensed through the state of Pennsylvania. Alcohol and drug rehab programs at the BHS Regional Recovery Center are individualized.
Programs through BHS try to meet the varying levels of recovery. Individuals can enter programs that are four weeks in length (partial hospitalization), several months (partial hospitalization), or ongoing (outpatient).
The highest level of treatment, inpatient, provides ongoing medical and clinical care for as long as an individual needs, determined by an initial assessment.
Butler Health System accepts Medicaid, most private insurance plans, and private pay.
Location and contact information:
One Hospital Way
Butler, Pennsylvania 16001
(724) 284-4759
3. Roxbury, Carlisle, Pennsylvania
Roxbury provides inpatient, outpatient, and day treatment programs for addiction and mental health disorders.
Treatment is available for both adults and adolescents and involves a full continuum of care to ensure a lasting recovery.
Each program is designed to meet the individual’s treatment needs and may involve a number of treatment types.
Services offered by Roxbury include:
- medical evaluation
- medication-assisted detox
- medication management
- addiction education
- 24-hour medical care
- therapy groups with activities
- family and individual therapy
- recreational therapy: art and music
- relapse prevention planning
- aftercare planning
Roxbury also provides families with education and a number of resources, as well as strongly encourages family involvement.
Roxbury accepts all Medicaid managed care plans, most private insurance, and self-pay options.
Location and contact information:
401 East Louther St., Suite 213
Carlisle, Pennsylvania 17013
(800) 648-4673
4. PA Treatment And Healing, East Stroudsburg, Pennsylvania
PA Treatment and Healing (PATH) provides mental health treatment, substance abuse treatment, and educational services in 11 different facilities throughout Pennsylvania.
PATH has been awarded multiple treatment excellence awards in Pennsylvania, including national model status with the U.S. Department of Justice for its court-ordered rehab services.
PATH places a large focus on helping troubled youth, with multiple programs in place for teens, including an intensive day program for adolescents, specialized foster care program, and alternative education for disruptive youth.
Intensive day treatment is available several hours daily and combines a number of methods, such as:
- group therapy
- individual therapy
- family counseling
- recreational therapy
- cognitive behavioral therapy
- a relationship-based model
- community-based treatment
Crisis intervention services are available 24/7 and transportation services are provided to and from the treatment center.
PATH accepts Medicaid insurance plans, private insurance, and private pay options.
Location and contact information:
80 North Burson St.
East Stroudsburg, Pennsylvania 18301
(570) 321-7892
5. Mazzoni Center, Philadelphia, Pennsylvania
The Mazzoni Center provides health and wellness services for the LGBTQ community, recently becoming the first treatment center in Philadelphia to offer a LGBTQ-specific addiction treatment program.
The intensive outpatient program is exclusively for members of the LGBTQ community and offers the following services:
- group, family, and individual therapy
- mental health care
- co-occurring disorder treatment
- mindfulness training
- yoga therapy
- art therapy
- medication-assisted treatment
- relapse prevention planning
- aftercare planning
In addition, the Mazzoni Center provides access to a number of support and recovery groups, including recreational and art, mindfulness-based stress reduction, and managing strong emotions groups.
Programs at the Mazzoni Center are person-centered and bring more than 20 years of outpatient treatment experience.
The Mazzoni Center accepts Pennsylvania Medicaid, Medicare, and most private insurance plans.
Location and contact information:
1348 Bainbridge St.
Philadelphia, Pennsylvania 19147
(215) 563-0652
Paying For Addiction Treatment With Pennsylvania Medicaid
Some of the most widely sought forms of addiction and mental health care are inpatient treatment programs, outpatient services, and medication-assisted treatment (MAT) programs.
All three forms of treatment are covered by Pennsylvania Medicaid.
Inpatient Treatment
Pennsylvania Medicaid plans typically cover short-term inpatient addiction treatment stays, up to 30 days in length.
Longer stays may be approved if the individual shows medical need for continued treatment. Inpatient stays may incur a daily copay fee.
Outpatient Treatment
Outpatient treatment services are covered so long as they are one of the approved services covered by Pennsylvania Medicaid plans and are provided by a state-licensed provider.
Each service will incur a session copay fee, determined by the type of service.
Medication-Assisted Treatment (MAT)
Medication-assisted treatment (MAT) programs are covered by Pennsylvania Medicaid plans for individuals who need help during withdrawal.
The following medications are covered for MAT programs through Pennsylvania Medicaid:
- buprenorphine (Suboxone): works to produce non-addictive opioid-like effects, allowing individuals to taper off use.
- methadone (Methadose): blocks effects of addictive drugs to allow individuals to quit use with time.
- naltrexone (Vivitrol): blocks effects of alcohol or opioids, which cause physical dependence, causing negative effects when an individual abuses these substances.
Individuals seeking medication-assisted treatment programs will have to get prior approval for treatment through a clinical assessment.
Locating A Rehab Center That Accepts Pennsylvania Medicaid
Medicaid is one of Pennsylvania’s largest payers of addiction treatment services. Residents of Pennsylvania can use their Medicaid plan to seek the care they need to enter and maintain recovery.
For more information on Pennsylvania Medicaid (Medical Assistance) plans and the rehab centers that accept them, contact one of our treatment specialists today.
Published on February 4, 2019
Addiction Resource aims to provide only the most current, accurate information in regards to addiction and addiction treatment, which means we only reference the most credible sources available.
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- Pennsylvania Department of Human Services — Health Care/Medical Assistance, Statewide Managed Care Map
http://www.dhs.pa.gov/citizens/healthcaremedicalassistance/index.htm
