How to Pay for Addiction Treatment in Maryland: Medicaid, CRISP, and Financial Assistance

Cost should not determine whether someone gets treatment for addiction. In Maryland, it does not have to. The state has one of the more comprehensive addiction treatment financing systems in the Mid-Atlantic region — combining Medicaid coverage, state-funded treatment slots, federal block grant dollars, and robust private insurance requirements to ensure that Marylanders across income levels can access care.

But navigating that system requires knowing where to look. This guide explains every major funding pathway available to Maryland residents, how to access each one, and what to do if you hit a wall.

Option 1: Maryland Medicaid (Medical Assistance)

Maryland Medicaid — called Medical Assistance in state documents — is a joint federal-state program that provides health coverage to low-income Marylanders. Unlike Florida, Maryland expanded Medicaid under the Affordable Care Act (ACA), covering adults up to 138 percent of the federal poverty level. This means hundreds of thousands of additional Marylanders qualify for Medicaid who would not have qualified under pre-ACA eligibility rules.

What Maryland Medicaid Covers for Substance Use Disorder

Federal law — specifically the ACA and the Mental Health Parity and Addiction Equity Act (MHPAEA) — requires Medicaid programs to cover substance use disorder treatment at parity with other medical conditions. Maryland Medicaid is required to cover:

Medical detoxification: Inpatient medically supervised withdrawal management
Inpatient/residential treatment: For patients meeting clinical criteria for residential care
Partial hospitalization programs (PHP)
Intensive outpatient programs (IOP)
Standard outpatient counseling: Individual and group therapy
Medication-assisted treatment (MAT): Buprenorphine prescriptions, methadone through licensed OTPs, naltrexone injections, and associated counseling
Psychiatric services: Evaluation and medication management for co-occurring mental health conditions
Peer recovery support services: Certified peer recovery specialists in some managed care plans

Maryland Medicaid Managed Care Plans for Behavioral Health

Maryland operates its Medicaid behavioral health benefits through a carve-out called the Public Behavioral Health System (PBHS), administered by Optum Maryland on behalf of the state. This means that behavioral health — including SUD treatment — is managed separately from physical health in Maryland Medicaid.

To access SUD treatment under Maryland Medicaid:

Verify your Medicaid eligibility and enrollment
Contact Optum Maryland at 1-800-888-1965 to find in-network SUD providers
Request a clinical assessment with a licensed provider to determine appropriate level of care

Medicaid Eligibility and Enrollment

Who qualifies:

Adults up to 138% of the federal poverty level (FPL) — approximately $20,783 per year for an individual (2024 levels)
Children and pregnant women at higher income levels
People receiving SSI (automatically eligible)
People who are blind or disabled meeting income requirements

How to apply:

Online: Maryland Health Connection at marylandhealthconnection.gov — also where you apply for marketplace insurance
By phone: 1-855-642-8572 (Maryland Health Connection) or 1-800-332-6347 (Maryland Department of Health)
In person: Local Department of Social Services offices throughout Maryland

If you are in active crisis and need treatment now, many providers will begin an assessment while your Medicaid application is processing.

Option 2: Maryland BHA-Funded Treatment (State and Federal Block Grants)

The Maryland Department of Health’s Behavioral Health Administration (BHA) administers state and federal funding that supports addiction treatment for Marylanders who do not qualify for Medicaid or who have Medicaid but need services not covered under managed care.

Funding sources include:

Substance Abuse Prevention and Treatment (SAPT) Block Grant: Federal dollars allocated to states annually for SUD prevention and treatment
State general revenue: Maryland budget appropriations for behavioral health services
Opioid State Response (OSR) grants: SAMHSA grants targeting opioid and stimulant use disorder treatment

How BHA-Funded Treatment Is Accessed

The BHA contracts with local behavioral health authorities (LBHAs) in each county. These LBHAs coordinate with local providers to deliver services for people without coverage or with coverage gaps.

Finding BHA-funded services:

Contact your county’s Local Behavioral Health Authority — listed at health.maryland.gov/bha
Call the Maryland Helpline: 1-800-422-0009
For Baltimore City, contact Behavioral Health System Baltimore (BHS Baltimore): 410-837-2647

Services funded through these programs are provided on a sliding-fee scale based on income. Many people qualify for no-cost or very low-cost treatment.

Option 3: CRISP — Chesapeake Regional Information System for Our Patients

CRISP is Maryland’s statewide health information exchange (HIE). It is not itself a funding source, but it plays an important role in coordinating care for people navigating the treatment system.

For treatment providers, CRISP allows:

Access to patient medication history (including prescription data and MAT prescriptions)
Coordination with emergency departments and hospitals
Continuity of care records across providers

For patients seeking treatment, understanding CRISP matters because it means your treatment provider can see your full medication and care history — which allows for better, safer treatment. You can opt out of CRISP, but doing so may limit care coordination.

Option 4: Private Health Insurance

Most private health insurance plans — employer-sponsored, individual marketplace, and most large group plans — are required by federal law to cover SUD treatment at parity with other medical conditions.

The Mental Health Parity and Addiction Equity Act (MHPAEA)

MHPAEA prohibits insurance plans from:

Imposing more restrictive day or visit limits on SUD treatment than on medical/surgical treatment
Requiring higher cost-sharing (copays, coinsurance, deductibles) for SUD treatment than for equivalent medical treatment
Applying stricter prior authorization requirements to SUD treatment

Maryland has its own parity law as well, with enforcement through the Maryland Insurance Administration (MIA). If you believe your insurance company has improperly denied SUD treatment coverage, you can file a complaint with the MIA at insurance.maryland.gov.

Working With Your Insurance

Before entering treatment:

Call the behavioral health number on your insurance card (not the general member services line)
Ask specifically about SUD treatment benefits — inpatient, residential, PHP, IOP, outpatient, and MAT coverage
Ask about in-network providers and what documentation you need for prior authorization
Get the name and ID of the representative you speak with, and the reference number for the call

If treatment is denied, request a written explanation and file an appeal. Many parity-based denials are successfully overturned on appeal.

Option 5: Veterans’ Benefits

Maryland has a large veteran population with access to VA addiction treatment services:

VA Maryland Health Care System: Major campuses in Baltimore (Perry Point), Perry Point, and Fort Howard, with community-based outpatient clinics throughout the state
VA SUD treatment: Comprehensive services including MAT, residential treatment, outpatient, and peer support
MISSION Act: Veterans who cannot access timely VA care may qualify for community care covered by the VA

Veterans can call the VA health benefits line at 1-877-222-8387.

Option 6: Medicare

For adults 65 and older or adults with qualifying disabilities:

Medicare Part A: Covers inpatient hospital detox
Medicare Part B: Covers outpatient SUD counseling and partial hospitalization
Medicare Part D: Covers many MAT medications
Medicare Advantage: Often has enhanced behavioral health benefits

Dual-eligible Marylanders (Medicare and Medicaid) receive coordinated coverage with enhanced benefits.

Option 7: SAMHSA’s Grant-Funded Programs

SAMHSA administers multiple grant programs that fund treatment and services for specific populations in Maryland:

State Opioid Response (SOR) grants: Maryland has received SOR funding that has expanded MAT access and treatment capacity throughout the state
Opioid Response Network: Provides training and technical assistance for SUD treatment
Grants for Criminal Justice Diversion: Support treatment for people in the justice system

These dollars flow through BHA and local providers — they fund treatment slots you access through the LBHA or BHA-contracted provider network.

Option 8: Sliding-Scale and Charity Care

Many Maryland treatment facilities — particularly nonprofit and community health center-affiliated programs — offer sliding-scale fees based on income, or have charity care funds for patients who cannot pay.

Questions to ask any facility:

Do you offer a sliding-scale fee?
Do you have a charity care or financial assistance program?
What is the self-pay rate, and can it be paid in installments?
Are there any grants or scholarship funds available?

When You Need Help Navigating

The funding landscape is complex, and navigating it while in crisis — or while trying to help a family member in crisis — is genuinely difficult. This is one of the most important reasons to call a hotline rather than try to figure it out alone.

Get Help Today

Our Maryland Addiction Hotline specialists are trained to help you identify funding pathways, verify insurance benefits, and connect with programs that have availability. Cost does not have to be a barrier — but you may need help finding the right door.

Call our Maryland Addiction Hotline today. Free, confidential, and available around the clock. Let us help you take the next step.