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Medicaid Coverage For Methadone Treatment Could Mean More People Seeking Care

Department of Foreign Affairs

Indiana’s Medicaid will soon cover methadone treatment for people suffering from opioid addiction. That could mean more people seeking treatment, and savings for people already receiving it.

Methadone is one of a few FDA-approved medications for treating opioid addiction. There are now 14 methadone clinics in the state. But for poor people who need addiction treatment, costs were a barrier to getting methadone because Medicaid didn’t cover the treatment.

The Family and Social Services Administration, which administers Medicaid in Indiana, finalized details about the coverage on Friday. Indiana initially announced that coverage would begin August 1. Clinics will now be able to bill Medicaid for bundled treatment services starting September 1. The state also announced the addition of five new methadone clinics, bringing the total to 19 when they become operational next year. 

Dean Babcock, assistant vice president at Midtown Community Mental Health Center in downtown Indianapolis, says Medicaid coverage will be a positive change for the more than 600 patients that get methadone treatment at Midtown.

“One of the barriers to methadone treatment is that historically, it has been pay as you go [in Indiana],” he says.

Midtown’s clinic used to operate on a cash-only basis. Patients paid $75 a week – a lot of money, especially for people whose low income would make them eligible for Medicaid.

Currently, Babcock says about 30 percent of his clinic’s patients are enrolled in Medicaid. He says he expects that number to grow once Medicaid coverage starts: With the motivation of getting their medication covered, Babcock says more of the clinic’s uninsured patients will sign up for the insurance. He says there could be an influx of new patients seeking treatment, as well.

But he points out that treatment capacity is limited. There aren’t enough people in the state trained to treat addiction, and there are federal and state regulations that could affect the number of new people who could start treatment. And because of space and staffing limitations, Babcock says Midtown wouldn’t be able to take in many more people.  

Note: This post was updated at 2:05 to reflect new details from the Family and Social Services Administration. 

This story was produced bySide Effects Public Media, a reporting collaborative focused on public health.