Georgia Medicaid Substance Use Disorder Treatment (2026)

Georgia Medicaid covers the full range of substance use disorder treatment, from outpatient counseling and addiction medications to residential rehab and medically managed detox. If you or a family member has Georgia Medicaid, the treatment a doctor says is medically necessary is a covered benefit, and that includes older adults who develop a drinking problem late in life or who misuse prescription opioids or anti-anxiety medications. This guide explains what is covered, the medications for opioid and alcohol use disorder, how coverage works when someone has both Medicare and Medicaid, and the concrete steps to reach treatment in Georgia.

In This Guide

• What Georgia Medicaid Covers for Substance Use Disorder Treatment
• Coverage for Older Adults and Dual-Eligibles
• Medications for Opioid Use Disorder
• Medications for Alcohol Use Disorder
• Naloxone and Overdose Reversal
• The Federal Framework
• Georgia's Delivery System
• Pregnancy and Adolescent Treatment
• How to Access Substance Use Disorder Treatment
• Worked Examples
• Frequently Asked Questions
• Learn More

What Georgia Medicaid Covers for Substance Use Disorder Treatment

Georgia Medicaid covers substance use disorder treatment at every level of intensity. The clinical standard that decides which level a person needs is the American Society of Addiction Medicine (ASAM) Criteria, and it is what CMS requires residential providers to meet where federal money pays for treatment in a large facility. An assessment scores six dimensions, including withdrawal risk and the person's living environment, and matches the patient to the right setting. Residential care gets more complicated in facilities with more than 16 beds, because a federal rule restricts Medicaid payment there; the Section 1115 SUD demonstration is one of the routes states use to fund treatment there, and the federal framework below explains what that means for how long a Georgia stay is authorized.1

The continuum runs from brief screening to hospital-based detox.

Two delivery models sit alongside these levels for opioid use disorder. An Opioid Treatment Program (OTP) is the licensed clinic that can dispense methadone. Office-Based Opioid Treatment (OBOT) is buprenorphine prescribed in a regular clinical setting, such as a primary care office or a community health center.

Coverage for older adults and dual-eligibles

Substance use disorder does not stop at a certain age. Late-onset alcohol use disorder, misuse of leftover prescription opioids, and dependence on benzodiazepines prescribed for sleep or anxiety are common in older adults, and are often missed because the symptoms look like aging or another illness. Georgia Medicaid covers these conditions the same way it covers them at any age: the ASAM continuum, the medications, and the counseling, whenever a clinician documents medical necessity.

What changes for most older adults is how the bill is paid, because people over 65 generally have Medicare as well.2 A person with both programs is "dually eligible." Medicare is the primary payer and pays first; Georgia Medicaid is the secondary payer, which can cover Medicare premiums and cost-sharing and pay for medical costs Medicare does not cover or covers only partially, including nursing home care, personal care, and home- and community-based services. Extra Help, the Part D low-income subsidy, is granted automatically to three groups: people with full-benefit Medicaid, people whose state pays their Part B premium through a Medicare Savings Program, and SSI recipients. Most dual-eligibles fall into one of those groups, so drug costs are heavily reduced without a separate application.

Opioid treatment program services are a useful example of how this works for an older adult. Since January 1, 2020, Medicare Part B has covered OTP services, including methadone, buprenorphine, and naltrexone, as a bundled benefit. The beneficiary coinsurance is $0, though the annual Part B deductible ($283 in 2026) applies first. That zero copayment attaches to the program, not to the treatment: it applies to services furnished by an opioid treatment program that is enrolled in Medicare, certified by SAMHSA, and accredited. The same medications and the same counseling obtained from a doctor or other health care provider instead are paid under ordinary Part B rules and do carry cost-sharing.3 A person who has both Medicare and full Georgia Medicaid and receives the services through Medicaid pays nothing at all.

Dual Eligible Special Needs Plans (D-SNPs) are built for people who have both programs, and which ones exist varies by county, so check Medicare's Plan Finder for a given address. The Georgia Department of Community Health placed a moratorium on contracting with any new D-SNPs starting August 1, 2025, to comply with the federal D-SNP integration requirements at 42 CFR 422.514(h).4

For the adult child arranging care for a parent: you do not have to untangle which program pays before getting help. Ask the parent's plan's behavioral health line (listed under How to Access Substance Use Disorder Treatment) to coordinate an assessment and a referral, and have the parent sign a consent so you can speak with providers and plans on their behalf.

Medications for opioid use disorder

Medication is the standard of care for opioid use disorder, and Georgia Medicaid covers all three FDA-approved options, because federal law requires every state Medicaid program to cover the FDA-approved drugs for opioid use disorder along with the counseling and behavioral therapy that go with them.5 Which of the three fits a given person is a clinical decision, and the Substance Abuse and Mental Health Services Administration (SAMHSA) is the federal authority a prescriber works from.

Buprenorphine

Buprenorphine is the most widely available opioid use disorder medication. The Mainstreaming Addiction Treatment (MAT) Act, enacted as Section 1262 of the Consolidated Appropriations Act, 2023, eliminated the old DATA-2000 "X-waiver" effective on enactment, December 29, 2022.6 Any practitioner who holds a current DEA registration that includes Schedule III prescribing authority may now prescribe buprenorphine for opioid use disorder, if state law permits, with no separate certification and no federal cap on the number of patients treated; a companion requirement had registrants check a box on the DEA registration form, on an initial application or a renewal beginning June 27, 2023, affirming completion of a one-time eight-hour training on treating and managing patients with opioid or other substance use disorders, and DEA says that one-time affirmation will not be part of future registration renewals. A primary care physician, an OB/GYN, a nurse practitioner, or a physician assistant can now offer treatment.

Federal law requires Georgia to cover the FDA-approved drugs for opioid use disorder as a class, and buprenorphine is one of the three FDA-approved drugs, alongside methadone and naltrexone.5,3 Which buprenorphine form is preferred on the Georgia Preferred Drug List (the sublingual film, Suboxone and generics; buprenorphine monotherapy, Subutex; or the monthly extended-release injection, Sublocade), and whether a given form needs prior authorization, is set by Georgia Medicaid and your care management organization and changes over time, so check the current drug list or call your plan before you fill a prescription rather than assuming either way.

Methadone

Methadone for opioid use disorder is generally dispensed only through a SAMHSA-certified, DEA-registered Opioid Treatment Program: under 42 CFR Part 8 it cannot ordinarily be prescribed at a pharmacy or by an office-based practitioner for that purpose, although methadone for pain can be. One carve-out matters for older adults. OTP certification is not required to start or continue methadone for a patient admitted to a hospital, long-term care facility, or DEA-registered correctional facility for some condition other than opioid use disorder who needs methadone during the stay (42 CFR 8.11(h)(3)), so a parent entering a nursing home does not have to stop treatment for want of an OTP on site. That carve-out is from OTP certification only; the facility still needs its own DEA registration. A certified OTP can also reach past its own building, establishing medication units, brick-and-mortar or mobile, from which its practitioners, its contractors, or community pharmacists dispense the medication.7 New patients dose daily on-site, then earn take-home supplies as they stabilize.

SAMHSA's 2024 final rule (amending 42 CFR Part 8), effective April 2, 2024 with a compliance date of October 2, 2024, made the COVID-era flexibilities permanent. Length of time in treatment is no longer the sole consideration, and the old requirement of rigid reliance on toxicology results showing sustained abstinence is gone, so a patient may be eligible for unsupervised take-home doses on the provider's clinical judgment as early as entry into treatment. A graduated ceiling still applies: beyond doses for days the clinic is closed, take-home supplies are limited to 7 days during the first 14 days of treatment, 14 days from day 15, and no more than 28 days from day 31, with the amount within each ceiling left to the OTP practitioner's discretion, exercised against six listed safety criteria and documented in the patient's record. That ladder governs methadone; the rule states the same dispensing restrictions do not apply to the buprenorphine products it lists. The rule also made telehealth available to start treatment within an OTP, using audio-only or audio-visual telehealth for buprenorphine and audio-visual telehealth for methadone (audio-only is acceptable for methadone only when audio-visual is not available and the patient is with a licensed practitioner registered to prescribe controlled medications), so an in-person physical examination is no longer required before the first dose. It is deferred, not waived: a full in-person physical examination is still required within 14 calendar days after admission to the OTP.8 Medicaid pays the OTP a bundled rate that covers the medication, counseling, and drug testing, so there is no separate pharmacy copay.

Extended-release naltrexone

Vivitrol is a monthly intramuscular injection that blocks opioid receptors. Because it can trigger withdrawal if opioids are still in the system, it cannot be started until the person has been off opioids for an interval the prescriber judges long enough, commonly described as 7 to 10 days, which is the main barrier to beginning treatment. Naltrexone is one of the three FDA-approved drugs for opioid use disorder,3 so Georgia Medicaid's required coverage reaches it; ask your plan whether it is billed through the medical benefit or a specialty pharmacy and whether prior authorization applies.5

A note on telehealth beyond the OTP setting:9 the broader federal flexibility that lets DEA-registered prescribers start controlled medications, including office-based buprenorphine, entirely by telemedicine without any in-person evaluation is a temporary rule, not a permanent one. In its most recent action, published December 31, 2025, the DEA and HHS extended that flexibility through December 31, 2026. Two authorities do not lapse with it, so do not assume telemedicine prescribing simply stops at the end of 2026. Once a prescriber has conducted at least one in-person medical evaluation of a patient, DEA says that permits remote prescribing for that patient indefinitely, however long ago the visit was and whether or not it was for a different medical concern. And DEA and HHS published a separate permanent rule, "Expansion of Buprenorphine Treatment via Telemedicine Encounter," which took effect December 31, 2025, so buprenorphine has a standing telemedicine pathway of its own with its own conditions. Patients beginning buprenorphine by telehealth in a regular clinic (rather than through an OTP) should still confirm the current rule with their prescriber.

Medications for alcohol use disorder

Georgia Medicaid covers the FDA-approved medications for alcohol use disorder, which are underused relative to how well they work, especially in older adults for whom heavy drinking carries added risk.

Other medications are sometimes used off-label for alcohol use disorder. Whether your plan covers one, and whether it first wants a trial of an approved medication, is a question for the plan.

Naloxone and overdose reversal

Naloxone is the medication that reverses an opioid overdose, and it is broadly accessible. On March 29, 2023 the FDA approved Narcan, 4 mg naloxone hydrochloride nasal spray, for over-the-counter, nonprescription use, the first naloxone product approved for use without a prescription, and the CDC says naloxone is available over the counter in all 50 states with no prescription needed to buy it. That over-the-counter status reaches the nasal spray only: other formulations and dosages, including the injectable, remain available by prescription only.10 How your own Georgia Medicaid plan covers naloxone, and whether any cost-sharing applies, is a question for the plan, so ask before you fill it. The over-the-counter nasal spray is also stocked at retail pharmacies for anyone to buy. Georgia also has a statewide naloxone standing order through the Department of Public Health, which lets a pharmacist dispense it without an individual prescription, and it is available through community organizations and harm-reduction programs.

The federal framework

A handful of federal rules govern what Georgia Medicaid must and may cover for substance use disorder. They matter to a reader mainly because they explain why residential treatment is covered, why a primary care doctor can now prescribe buprenorphine, and why addiction benefits cannot be more restrictive than other medical benefits.

The IMD exclusion and residential treatment

The "IMD exclusion" is written into the Medicaid statute itself. Section 1905(a) of the Social Security Act excludes from medical assistance any payment for care or services for a person who has not turned 65 and who is a patient in an Institution for Mental Diseases: a hospital, nursing facility, or other institution of more than 16 beds primarily engaged in the diagnosis, treatment, or care of people with mental diseases, judged by the institution's overall character whether or not it is licensed as one.11 Federal substance use disorder policy treats addiction facilities as IMDs: both the state-plan option and the Section 1115 demonstration below exist precisely to pay for substance use disorder treatment inside one.12 Because most residential rehab facilities have more than 16 beds, this rule was for decades the single largest barrier to covering residential addiction treatment.

Section 5052 of the SUPPORT for Patients and Communities Act of 2018 created a state-plan option (Social Security Act Section 1915(l)) letting states pay for SUD treatment in these facilities for no more than 30 days, consecutive or not, in any 12-month period, for people who are at least 21, have not turned 65, and have at least one substance use disorder. As enacted, the window to elect that option would have closed September 30, 2023, but Section 204(a) of Public Law 118-42 (March 9, 2024) struck the end date, so the option is open-ended and a state may still elect it. Not every facility qualifies: an eligible IMD must follow reliable, evidence-based practices and offer at least two forms of medication-assisted treatment on site, including, for opioid use disorder, at least one antagonist and one partial agonist.12 Two other routes sit alongside it. A state running Medicaid through managed care may make the monthly capitation payment for an enrollee age 21 through 64 in an IMD for a short-term stay of no more than 15 days in that month, but only where the facility is a hospital providing mental health or substance use disorder inpatient care, or a sub-acute facility providing crisis residential services, and only where the stay meets Medicaid's in-lieu-of-services rules.11 The other is the Section 1115 SUD demonstration. Under the CMS guidance that set its parameters (State Medicaid Director letter SMD #17-003, November 1, 2017), a state drawing federal money for SUD treatment in these settings must report progress toward six standardized milestones, and the letter's own timetable proposes that within 12 to 24 months of approval its residential providers meet ASAM criteria or comparable evidence-based standards and offer patients access to medication-assisted treatment, with the operative dates set in the state's implementation plan and special terms and conditions. Meeting that national standard is not a precondition of payment, because CMS accepts interim provider qualifications during the initial implementation period, but federal payment is contingent on CMS approving the state's implementation plan, and the demonstration does not pay room and board in these facilities unless they qualify as inpatient facilities under Section 1905(a).1 The practical takeaway for a Georgia reader: every one of these routes caps how long a stay in a facility with more than 16 beds can be paid for, and which route Georgia uses decides the cap. Ask your care management organization how many days it will authorize before you commit to a program; a longer course may require a smaller (non-IMD) facility or a step down to intensive outpatient. A facility with 16 beds or fewer is not an IMD at all, so no such limit reaches it.

Required coverage of addiction medications

Section 1006(b) of the same 2018 law made coverage of medication-assisted treatment a mandatory Medicaid state-plan benefit nationwide, beginning October 1, 2020.5 As enacted that mandate was time-limited and would have expired September 30, 2025, but Section 201(a)(1) of the Consolidated Appropriations Act, 2024 (Public Law 118-42, enacted March 9, 2024) struck the end date, so the requirement is now permanent. Georgia Medicaid therefore covers the addiction medications as a matter of federal law, not state discretion: 42 U.S.C. 1396d(a)(29) and (ee) require every state Medicaid program to cover all drugs approved by the FDA and all licensed biologics to treat opioid use disorders (the statute names methadone specifically), together with the counseling services and behavioral therapy provided with them. Methadone, buprenorphine, and naltrexone are the three FDA-approved drugs for opioid use disorder.3 A state can escape the mandate only by certifying, at least every five years and to the Secretary's satisfaction, that it cannot implement statewide for want of qualified providers or facilities. Georgia did not take that route: CMS approved Georgia Medicaid State Plan Amendment TN 25-0014 on December 19, 2025, effective October 1, 2025, removing the scheduled end date from Georgia's required MAT program.5

Parity: addiction benefits cannot be more restrictive

The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) does not require any plan to cover mental health or substance use disorder benefits at all. What it governs is the terms when a plan does cover them: copays, visit limits, prior authorization, and other medical-management rules applied to addiction benefits cannot be more restrictive than the predominant limits that apply to substantially all medical and surgical benefits in the same classification (inpatient, outpatient, emergency, and prescription drug, in-network and out-of-network), rather than simply "no more restrictive than medical benefits."13 Medicaid is not a group health plan or a health insurance issuer, so MHPAEA does not reach it by its own terms. A Georgia Medicaid member's parity rights run instead through the 2016 federal final rule that applied those standards to Medicaid managed care organizations, Alternative Benefit Plans, and CHIP, which is why Georgia's care management organizations must meet parity. That route reaches people enrolled with an MCO: CMS says it cannot extend the rule to beneficiaries who do not enroll with one, and primary-care case-management arrangements are not required to comply.14 The Consolidated Appropriations Act, 2021 added a requirement that plans document a comparative analysis of their non-quantitative limits. A 2024 final rule sought to strengthen those requirements, but on May 15, 2025 the federal departments announced they will not enforce the portions of the 2024 rule that are new relative to the 2013 rule until a final decision in the pending litigation plus another 18 months, and they encouraged state regulators to take the same approach, so a complaint filed with a state insurance regulator may meet the same posture. The underlying 2008 statute, the 2021 comparative-analysis requirement, and the 2013 rule all remain in effect.13

Parity compliance has lagged in practice: a 2024 HHS Office of Inspector General report found that none of the eight states it reviewed had built the required parity provisions into their Medicaid managed care contracts by the October 2, 2017 compliance date, and it recommended that CMS improve its oversight of states' compliance and require states to improve their monitoring of managed care organizations. CMS concurred.15 Georgia added its own layer in 2022. The Georgia Mental Health Parity Act, the insurance part of House Bill 1013, was signed April 4, 2022. Codified at O.C.G.A. 33-1-27, it requires every health insurer that provides mental health or substance use disorder coverage to provide it in accordance with the federal MHPAEA and its regulations, and to apply the statute's own definitions of "generally accepted standards of mental health or substance use disorder care," "medically necessary," and "mental health or substance use disorder" whenever it makes a medical-necessity, prior-authorization, or utilization-review decision. It also bars any prohibition on same-day reimbursement when a patient sees a mental health provider and a primary care provider on the same day, and it directs the Insurance Commissioner to conduct an annual data call of insurers by May 15 each year and to open a market conduct examination where that data suggests a violation. A parallel section added by the same Act inside the Medicaid Care Management Organizations Act, O.C.G.A. 33-21A-13, puts those same duties on Georgia's Medicaid plans rather than merely creating a complaint route, and it is the authority for the parity complaint portal the Department of Community Health runs for Medicaid (including Pathways to Coverage), PeachCare for Kids, and the State Health Benefit Plan; a complaint about any other coverage goes to the Office of Commissioner of Insurance and Safety Fire instead. The Commissioner's complaint process must also tell consumers about their rights under Georgia's Patient's Right to Independent Review Act, so a parity complaint is not the only route a denied member has.16

Confidentiality of treatment records

Substance use disorder treatment records carry heightened confidentiality protection under 42 CFR Part 2, which has historically been stricter than HIPAA and generally requires the patient's written consent before records are shared.17 A federal final rule published February 16, 2024 aligned Part 2 more closely with HIPAA: in place of the earlier separate consents, a single consent given once by the patient now permits a program to use and disclose the records for treatment, payment, and health care operations. That rule took effect April 16, 2024 and its requirements are now in the Code of Federal Regulations, so the change is in force while the core protection remains. Two things a family should know about that single consent. You can revoke it, in writing, at any time. And even where a provider re-discloses your records under the HIPAA rules, the regulation carves out uses and disclosures in civil, criminal, administrative, and legislative proceedings against you: without a court order or your consent, a Part 2 record cannot be entered into evidence against you, used for a law enforcement investigation, or used in an application for a warrant.

Georgia's delivery system

DBHDD and Community Service Boards

The Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD) is the state's single authority for behavioral health. It licenses opioid treatment programs, funds services for uninsured Georgians, runs the crisis system, and oversees the Georgia Community Service Boards (CSBs), the county-based agencies that are the most common entry point for low-income Georgians. Most CSBs offer outpatient counseling, intensive outpatient, buprenorphine prescribing, co-occurring mental health treatment, and peer support, and accept Medicaid.

Care management organizations

Behavioral health is "carved in" to Georgia's Medicaid managed care plans, meaning each plan handles prior authorization, its provider network, and claims for addiction treatment. As of September 2026, Georgia Families contracts with three care management organizations: Amerigroup Community Care, CareSource, and Peach State Health Plan. A 2024 reprocurement remains in the protest phase pending issuance of the Notice of Award, with no DCH-published go-live date and no member transition yet; pending that notice, DCH is extending the current three-plan contracts through June 30, 2027, an extension that can end sooner if the award issues.18 Because each plan runs its own authorization and network, ask yours which levels of care it authorizes and what documentation it wants before you choose a program. DBHDD-funded services can fill gaps beyond the Medicaid package, such as residential care past the time-limited benefit.

Pathways to Coverage

Georgia Pathways to Coverage is a limited Medicaid expansion under Section 1115 that launched July 1, 2023 and covers adults ages 19 through 64 whose household income is up to 95% of the Federal Poverty Level, which the state advertises as up to 100% because a 5% income disregard is applied, and who complete at least 80 hours a month of qualifying activities. CMS temporarily extended the demonstration through December 31, 2026.19 Effective October 1, 2025 Georgia eased the rules: members report hours only at application and annual renewal rather than monthly, and two qualifying activities were added, caring for a Medicaid-enrolled child under six and complying with the SNAP Works Program, alongside working, job training or education, and volunteering. Coverage begins on the first day of the month the application is received, with payment running back to that date once the applicant is determined eligible, which includes meeting the qualifying-hours requirement. Pathways members pay the same copayments as other Georgia Medicaid members, in amounts that vary by service and with none for members under 21 or people enrolled in HIPP, and DCH says that if you cannot pay a copayment you may still receive services.19 For a Georgian with a substance use disorder who would otherwise be uninsured, Pathways unlocks the full Medicaid benefit package, including SUD treatment.

Crisis services

Georgia routes crisis care through a single system. The Georgia Crisis and Access Line (GCAL) is the home of the 988 Suicide and Crisis Lifeline in Georgia: Lifeline calls route to GCAL, which takes calls, text, and chat 24 hours a day, 365 days a year. DBHDD directs residents to call GCAL at 1-800-715-4225 for access to the state's behavioral health crisis system, and adds that you can also call or text 988 or chat at 988lifeline.org. GCAL is a nationally accredited crisis center operated by Carelon; its professionals provide crisis intervention by phone and can dispatch mobile crisis teams, available 24/7 for assessment, short-term intervention, and referral.20

The numbers below are the entry points a Georgia family uses most to reach an assessment or a crisis response.

Reentry coverage for people leaving incarceration

Under the Reentry Section 1115 Demonstration Opportunity CMS opened to states in 2023, a state may cover a limited set of pre-release services for Medicaid-eligible incarcerated people. CMS generally expects that coverage to begin 30 days before the expected release date, and will consider a window as long as 90 days. It does not expect to approve a proposal unless the package includes at least case management, medication-assisted treatment for all types of substance use disorder with accompanying counseling, and a 30-day supply of the person's medications at release. This addresses the weeks of highest overdose risk, when tolerance has dropped during incarceration. Two things hold regardless of any state's demonstration. Being incarcerated is not itself a reason to lose Medicaid: CMS says incarceration status is not a factor of eligibility, so the correct state practice is to suspend benefits rather than terminate them, and to lift that suspension when an incarcerated person becomes an inpatient in a hospital, nursing home, or other medical institution, because Medicaid can pay for inpatient care. And CMS says states should help someone not already enrolled apply no later than 45 days before their expected release date.22 Whether Georgia has approval under this pathway is not reflected in a verified state source we can cite, so confirm current pre-release coverage and timing with the Georgia Department of Community Health rather than counting on it.

Pregnancy and adolescent treatment

Pregnancy Medicaid covers comprehensive substance use disorder treatment. ACOG, SAMHSA, and the National Institute on Drug Abuse all recommend continuing or starting buprenorphine or methadone in pregnancy, because untreated opioid use disorder carries higher risk than treatment. DBHDD's Pregnant, Postpartum, and Specialty Care program provides intensive case management, and Plans of Safe Care are a support framework, not an automatic child-welfare referral.

For adolescents, buprenorphine's FDA labeling covers patients from age 16, and a younger adolescent's options are a question for the treating program rather than a closed door. DBHDD operates an adolescent treatment network with outpatient, intensive outpatient, and residential options. Whether a minor can consent to their own treatment turns on Georgia law and the service, so ask the treating program which consent it needs; the records are protected under 42 CFR Part 2 either way.

How to Access Substance Use Disorder Treatment

If you or a family member needs treatment, these steps move from first contact to ongoing care. They work whether the person is enrolling in Medicaid for the first time or already has coverage.

Worked examples

Margaret, 72, Savannah: late-onset alcohol use disorder as a dual-eligible

Margaret began drinking heavily after her husband died, and her daughter noticed falls and confusion the family first blamed on age. Margaret has Medicare and full Georgia Medicaid. Her primary care doctor screened her, diagnosed alcohol use disorder, and referred her for an assessment. She completed a short medically monitored detox, then intensive outpatient treatment, and started acamprosate. Medicare paid first and Georgia Medicaid covered the cost-sharing, so Margaret paid nothing.2 Her daughter, with a signed consent on file, joins care-coordination calls.

Robert, 68, Macon: prescription-opioid misuse and buprenorphine

Robert was prescribed opioids for chronic back pain and developed opioid use disorder. Because the X-waiver is gone, his primary care physician started him on buprenorphine/naloxone film in the same office, with no specialty clinic to find. As a dual-eligible, he pays nothing for the treatment delivered through his Medicaid plan.

Diane, 55, Athens: alcohol use disorder, residential treatment, and acamprosate

Diane has long-standing alcohol use disorder and early cirrhosis. Her ABD Medicaid covered medically managed detox at a hospital, then the high-intensity residential stay her plan authorized, then a step down to intensive outpatient. She takes acamprosate and her liver function is improving.

Putting it together

Substance use disorder treatment under Georgia Medicaid is broad. The FDA-approved medications for opioid use disorder are a required benefit, not a state option, and buprenorphine is available through any DEA-registered prescriber with Schedule III authority. Naloxone nasal spray is sold over the counter. A full dual-eligible generally pays nothing for opioid treatment program services received through Medicaid.3 And GCAL at 1-800-715-4225, or 988, is the 24-hour door to a crisis response or a referral.

Learn More

Find personalized help finding substance use disorder treatment in Georgia at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.