Does Texas Medicaid cover rehab?
It does for people who qualify. Most adults in Texas do not.
The short answer
Texas Medicaid covers substance use treatment for people who qualify, but adult eligibility is limited. Texas has not expanded Medicaid to most low-income adults. If you do not qualify, state-funded care may still be open to you.
You may qualify for Texas Medicaid if
- You are pregnant or recently gave birth
- You have a disability or are 65 or older
- You care for a child who has Medicaid and your income is very low
Children and teens have their own Medicaid and CHIP rules, with higher income limits. Former foster youth may also qualify.
Who can get Medicaid as an adult in Texas
Many states cover most low-income adults. Texas does not. Being low income is not enough here. An adult usually has to fit a group, such as being pregnant, having a disability, being 65 or older, or being the parent or caretaker of a child who has Medicaid.
An adult under 65 with no minor children, no disability and no pregnancy usually does not qualify, however low their income is. This is often called the coverage gap: too little income for help on the Marketplace, and no Medicaid group to fit.
The limit for parents and caretakers is very low. Texas publishes the current limits, so check them before you assume you do or do not qualify. Limits for pregnancy are much higher, and the state guide lists 198 percent of the federal poverty level as of March 2024. Coverage after pregnancy can run 12 months. Limits change, so check before you rule yourself out.
What Medicaid pays for
The state’s guide lists assessment, individual and group counseling, residential treatment, withdrawal management (detox) and medication-assisted treatment. Care generally has to come from a licensed treatment facility or an opioid treatment program. Medication-assisted treatment can also come from other qualified prescribers.
Dallas programs that take Medicaid
Most programs in our list do not say they take Medicaid. Three do: Cenikor Dallas Fort Worth, Homeward Bound and The Haven Texas. The Haven Texas says it admits through hospital emergency rooms. Call first and ask if they take your Medicaid plan, because plans differ. You can find their numbers in the Dallas programs list. Other programs may take Medicaid and not say so online, so it is fair to ask. If you are on Medicaid already, you can also call the member number on your card and ask which Dallas programs are in your plan’s network.
How to apply, and what to do if you do not qualify
You can apply through YourTexasBenefits.com or dial 2-1-1 for help. It costs nothing to apply. If you are not sure you qualify, apply anyway, so you have a clear answer.
If you are turned down, you still have options. State-funded treatment does not depend on having Medicaid, and some free and nonprofit programs take people with no coverage. OSAR for Dallas County can help you sort this out at 844-275-0600.
Questions to ask a program
- Do you take Texas Medicaid?
- Do you take my Medicaid plan?
- Is there a wait for Medicaid patients?
- What if my coverage ends?
Common questions
I am an adult with no children. Can I get Medicaid in Texas?
Usually not, unless you have a disability or are 65 or older. Texas has not expanded this group. See state-funded treatment and call OSAR at 844-275-0600.
Does addiction count as a disability for Medicaid?
It depends, and the rules are detailed. Ask a benefits worker at 2-1-1. If you have another health condition that keeps you from working, include it when you apply.
Does Medicaid pay for methadone or buprenorphine?
The state’s guide lists both as covered for people on Medicaid. Methadone for opioid use disorder comes only from an opioid treatment program. Read about medication-assisted treatment.
Will treatment cost me anything on Medicaid?
Ask the program and your Medicaid plan what you would owe. Confirm the program takes your plan before you start, so you are not surprised by a bill. See questions to ask.
