Rehab Centers That Accept Medi-Cal Insurance

Drug and alcohol addiction is widespread in California, with an estimated 2.9 million residents struggling with a substance use disorder (SUD) in 2022. Despite this only-increasing epidemic, only around 10% of individuals received alcohol or drug abuse treatment. The cost of addiction treatment programs is often a primary factor that prevents people from seeking the help they need and deserve.

Medi-Cal, which is California’s Medicaid program, offers coverage for low-income residents seeking inpatient or outpatient treatment for an SUD. If you have Medi-Cal insurance, the type of coverage available to you will vary based on factors such as medical necessity and the type of treatment providers. When searching for a residential treatment program for addiction, it’s important to find one that accepts your Medi-Cal plan to ensure you receive maximum insurance coverage.

RehabNet is a trusted source for finding accredited and well-backed rehab centers. Our online rehab search tool is accessible 24/7 and can help you locate Medi-Cal-covered programs in your area for yourself or a loved one.

Yes, Medi-Cal insurance provides coverage for substance use disorder treatment as an essential health benefit as mandated by the Drug Medi-Cal Organized Delivery System (DMC-ODS).

The Drug Medi-Cal Organized Delivery System is a Medi-Cal-specific program that streamlines SUD treatment options for those covered. DMC-ODS is a county opt-in program that encourages local inpatient and outpatient services to accept Medi-Cal and utilize evidence-based treatment approaches for addiction recovery. Medi-Cal members must seek treatment through a Drug Medi-Cal-certified provider to receive coverage.

This program also emphasizes the continuum of care, providing Medi-Cal members with access to high-quality addiction services throughout every step of their recovery journey.

It’s important to note that coverage may vary by county or treatment provider. You can work with a Medi-Cal representative to learn more about your specific coverage options and the programs that are covered under your plan.

Medi-Cal offers coverage for several addiction and mental health treatment services, depending on your plan and recovery needs. Substance abuse treatment spans across several levels of care, so it’s important to understand the specific services you require for your best chance at lasting recovery.

Common substance use disorder treatments covered under Medi-Cal insurance policies include:

• Inpatient treatment centers, which require individuals to stay at a rehab facility for a set period of time and participate in various treatment modalities like case management and therapy.
• Partial hospitalization programs (PHP), which offer intensive addiction treatment on a more flexible basis compared to inpatient options.
• Intensive outpatient programs (IOP), which offer the most flexibility out of all intensive addiction treatment services and require participants to attend group and individual therapy several times a week.
• Withdrawal management, which allows people to stay at a medical facility while going through the drug or alcohol detoxification process and receive medical care to aid in symptom reduction.
• Medication-assisted treatment (MAT), which incorporates the use of FDA-approved medications to ease withdrawal and reduce cravings for addictions like opioid use disorder.
• Individual and group therapy, which may include cognitive behavioral therapy, dialectical behavioral therapy, and family therapy, centered around addiction recovery.
• Dual diagnosis treatment, which incorporates treatment plans that address both addiction and co-occurring mental health disorders like depression and anxiety.

Medi-Cal aims to provide coverage for addiction services that support long-term recovery from addiction. Your insurance representative can help you navigate recovery service options covered by your plan.

Medi-Cal is the Medicaid insurance provider servicing California residents. It provides care provider coverage for various low-income individuals, including families, pregnant women, and those with disabilities. Most wellness and health services covered are managed by the state of California’s fee-for-service (FFS) and managed care delivery systems.

While many policies are similar, certain factors influence a person’s eligibility and coverage limits for outpatient and inpatient rehab. These factors include:

There are two different types of plans under Medi-Cal. These include:

• Managed care plans: This type of plan uses managed care delivery systems, or services and providers that are within the plan’s specific network. This plan emphasizes preventative and primary care and aims to provide higher-quality care at lower costs.
• Fee-for-service plans: A FFS plan means that providers are reimbursed through the state for services provided to policyholders. The state pays the provider based on covered services and medical necessity. It offers a wider range of provider options to policyholders, making it easier to find care.

With a managed care plan, you may have a limited selection of behavioral health and addiction treatment providers. An FFS plan may offer more flexibility and greater access to short-term and long-term SUD services.

DMC-ODS is a voluntary system for California counties. Counties that participate are required to offer a complete range of drug and alcohol addiction treatment options, including inpatient and outpatient rehab, to residents. Counties are reimbursed for services through a cost-reimbursement model.

Examples of counties currently participating in DMC-ODS include Orange County, Los Angeles, and Sacramento. As of 2025, 40 counties are enrolled in the program, and an estimated 95% of the state’s population is eligible for SUD treatment coverage due to county participation.

Even though a treatment may be covered, the state must deem it medically necessary for a policyholder for providers to be reimbursed for services. Some plans may require individuals to get prior authorization through a current provider for a specific treatment, such as a detox program, to receive coverage. Working with your Medi-Cal representative or RehabNet can help ensure you know what services you’re eligible to receive coverage for.

Factors like your age, income level, disability status, any current pregnancies, and any co-occurring disorders can affect your Medi-Cal rehab eligibility. For example, to receive Medi-Cal coverage, each age group has different criteria and potential benefits. There are also specific income requirements for different groups, such as families, pregnant women, and those who fall under the non-Modified Adjusted Gross Income (MAGI) category.

Most Medi-Cal plans require treatment from in-network or contracted providers. Out-of-network care may be approved in certain circumstances, such as:

• Emergency healthcare situations
• Lack of or limited access to addiction services that are in-network
• Transportation limitations or location barriers that prevent individuals from seeking treatment from an in-network provider
• Medi-Cal beneficiaries with FFS plans that provide service reimbursement for out-of-network providers

Requesting authorization for out-of-network inpatient or outpatient addiction services requires your provider to deem the service medically necessary and to submit an authorization request on your behalf. You may also have to follow a process outlined by the Department of Healthcare Services, depending on your unique needs and situation.

To learn more about Medi-Cal treatment approval for out-of-network rehabs, use the number on the back of your insurance ID card to reach a representative and discuss your options. You can also call the Medi-Cal Managed Care Ombudsman Office at 1-888-452-8609.

Addictions covered by Medi-Cal typically include:

• Alcohol use disorder
• Opioid use disorder, such as heroin or prescription opioid addiction
• Stimulant use disorder, such as addiction to methamphetamine or cocaine
• Cannabis use disorder
• Prescription medication misuse
• Tobacco or vaping addiction
• Benzodiazepine addiction
• Phencyclidine (PCP) Use Disorder
• Sedative, Hypnotic, and Anxiolytic Use Disorder
• Co-occurring mental health and substance use disorders

Some insurance plans may cover behavioral addictions like gambling and porn addiction based on medical nessecity.

There are several methods available to find Medi-Cal substance abuse providers in your area. Here are a few:

• Reach out to your county’s mental health or substance use disorder department for rehab referrals near you. You can then verify the rehab is in-network with your plan.
• Use California Health and Human Services directories to search for in-network drug and alcohol rehabs that accept Medi-Cal.
• Utilize RehabNet’s treatment center locator tool on our website to search for nearby rehab centers that accept Medi-Cal by location and addiction type.

It’s essential to verify that any treatment center near you is covered by Medi-Cal before seeking their services. You can verify coverage by:

• Using the California Department of Public Health’s online Cal Health Find Database. Once you locate the facility, look for the provider’s details, which will include if they accept Medicaid.
• Searching the Substance Use Disorder County Access Line for eligible rehab centers by county on the DHCS website.
• Reaching out to a RehabNet expert for free and confidential verification of eligibility and coverage services.

The following are common questions about Medi-Cal addiction rehab coverage:

If you or a loved one needs addiction treatment and you’re unsure of your financial abilities to cover it, help is available. If you have Medi-Cal, you can rest easy knowing that its DMC-ODS system requires coverage for qualified beneficiaries. However, each plan varies, as do eligibility and authorization requirements for SUD services.

You can use a trusted source like RehabNet to locate addiction-specific treatment facilities in your area that accept Medi-Cal. Our free online directory allows you to search rehabs by insurance, location, and addiction type. Our experts can also provide free and confidential assistance that includes verifying your insurance coverage for a specific facility and checking on placement availability.

All of our services are available 24/7 to meet your needs and require no commitment or charge on your behalf. Reach out to RehabNet today to start your path to recovery with Medi-Cal coverage.