What NC Medicaid covers for addiction treatment
North Carolina's Medicaid program is called NC Medicaid. Since the 2010 Affordable Care Act, plans must cover substance use disorder treatment as an essential health benefit. SAMHSA and CMS identify Medicaid as the single largest payer for substance use and mental health treatment in the US.
For addiction treatment, NC Medicaid coverage can include these services. Before you start, ask the program and your plan to confirm what is approved for you.
- Detox.
- Residential rehab, where you live at a treatment program, usually for a few weeks to a few months.
- Outpatient care, where you live at home and attend scheduled treatment.
- Medications for opioid use disorder.
This chart shows how many of the North Carolina facilities in our directory list each service. Outpatient care is the most common at 340, followed by day treatment or partial hospitalization at 80, intensive outpatient at 36, residential rehab at 34 and medical detox at 15.
Of the same facilities, 175 list care for co-occurring mental health conditions, and 33 offer virtual or in-home treatment. Virtual or in-home options may be useful if you live far from a program. Confirm the details with each program.
Who qualifies for NC Medicaid and how to apply
Medicaid rehab in North Carolina starts with NC Medicaid coverage, which expanded on December 1, 2023 to adults earning up to 138% of the federal poverty level. Because the rules changed on that date, it can be worth checking again if you applied before then.
You can apply in any month of the year through the state's ePASS site or through HealthCare.gov, so there is no enrollment season to wait for. NC Medicaid says that if you apply by December 31, 2026, it will cover approved costs for up to 3 months before you applied. From 2027 that drops to 1 month for most adults aged 19 to 64, and to 2 months for children, people 65 and older and people with a disability.
You do not need to put treatment on hold while your application is pending. Call the program you want, tell them your application is in process, and ask what they can offer in the meantime, including state-funded treatment or a sliding-scale fee.
State-funded treatment if you don't have Medicaid
The NCDHHS Division of Mental Health, Developmental Disabilities and Substance Use Services oversees substance use services in the state. For uninsured residents, state-funded rehab is managed by regional LME/MCOs (local management entities). Each LME/MCO runs a 24-hour access line, and that call is how you reach state-funded beds and treatment slots. A call does not promise a bed or a slot. You can look up your LME/MCO through the Find your LME/MCO link in the official resources section of this page.
Many state-funded programs have waitlists for residential beds, while waits for outpatient care are usually shorter. Programs funded through federal SAMHSA block grants give priority admission to pregnant women and to people who inject drugs. If either applies to you, mention it on your first call.
What treatment costs without coverage
For people without coverage, free rehab in North Carolina often means state-funded treatment through an LME/MCO, or a fee set on a sliding scale that can be low depending on income. We do not list prices here, because each program sets its own rates. Programs that receive SAMHSA block grant funding are generally expected to serve people who cannot pay, often on a sliding scale.
A sliding scale works like this: you tell the program what you earn, and it quotes a fee based on your income. Ask for that quote before you start, and ask whether it would change if your care changes.
Facilities in our directory that accept Medicaid
As of this writing, our directory lists 617 treatment facilities across 140 North Carolina cities and towns. The facilities listed below are pulled from our database, and 297 of them accept Medicaid. Separately, 235 of our listed facilities accept Medicare.
Among Medicaid-accepting facilities, the largest numbers are in Charlotte (20), Raleigh (18), Fayetteville (13), Winston-Salem (12) and Wilmington (11). Smaller towns are also represented. For example, as of this writing our directory lists JFK Alcohol and Drug Abuse Treatment Center in Black Mountain and Hazelwood Healthcare in Franklin as accepting Medicaid. Counts and listings change as our directory is updated, so confirm coverage directly with each program.
This chart ranks the five cities with the most Medicaid-accepting facilities, from Charlotte with 20 to Wilmington with 11.
Treatment facilities in North Carolina are licensed by the NCDHHS Division of Health Service Regulation. Before you commit to a program, you can ask about its state license.
Involuntary commitment for substance use
North Carolina allows involuntary commitment for substance use under N.C. Gen. Stat. Chapter 122C. This is a legal process. If you are considering it for someone you love, discuss it first with your LME/MCO's access line or with an attorney.
Official North Carolina resources
- NC Medicaid (apply via ePASS), where you apply for NC Medicaid online.
- NCDHHS Division of Mental Health, DD and Substance Use Services, where you can learn about the state substance use agency and its services.
- Find your LME/MCO, where you look up the regional LME/MCO for your area.
- NC 211, where you can look up local help and services near you.
How to start today
If you have Medicaid, you can check your coverage on our insurance verification page.
If you have no coverage, call your LME/MCO's access line and ask about state-funded rehab near you. If you have not yet applied for Medicaid, you can start an application at the same time.
This diagram sets out a first step for each of three situations: you have Medicaid, you have no coverage, or you need help today.
SAMHSA's National Helpline can help you find treatment at any hour. It is free, confidential and available 24 hours a day in English and Spanish at 1-800-662-4357.
If you or someone with you is in crisis or thinking about suicide, call or text 988, the Suicide and Crisis Lifeline.
Our North Carolina rehab directory also lists facilities that don't accept Medicaid. Across all listed facilities, regardless of insurance, the most are in Charlotte (65), Raleigh (41), Asheville (31) and Wilmington (25). If you would like peer support alongside treatment, our North Carolina meetings listings include 1,576 AA meetings and 645 NA meetings.
