Free and state-funded rehab in Texas: how to get it

If you need help now: call 911 in an emergency. In a mental health or substance use crisis, call or text 988. SAMHSA's National Helpline, 1-800-662-4357, is free, confidential and open 24/7, including for people without insurance. Stopping alcohol or some drugs suddenly can be dangerous; see alcohol detox in Texas.

Every way to get free or low-cost rehab

Route	Who it's for	How to start
State-funded treatment	Texans whose income qualifies, with no other way to pay	Call 2-1-1 and ask for your regional OSAR
Texas Medicaid or CHIP	Children, pregnant women, parents with very low income, and people with disabilities	Apply at YourTexasBenefits.com; treatment is covered with no copays
Sliding-scale fees	Anyone; the fee is set by income	Ask programs directly, or use the sliding-fee counts below
VA health care	Enrolled veterans	Your VA medical center
Community health centers	Anyone, insured or not	findahealthcenter.hrsa.gov; fees are discounted by income

Step by step: getting state-funded treatment

1. Find your OSAR. Call 2-1-1 (or 877-541-7905) and ask for the Outreach, Screening, Assessment and Referral program for your county, or look it up on HHSC's OSAR page, which lists every OSAR by region. For a teenager, ask whether the OSAR sees teens.
2. Get screened. The OSAR asks about your alcohol or drug use, health, income and situation, often by phone first. Have your ID, proof of income and proof of where you live ready if you have them.
3. Get referred. The OSAR matches you to an HHSC-funded program at the level of care you need, such as detox, residential, outpatient or medication, and screens whether you're in a group that's admitted first.
4. Ask about the wait. State-funded beds can fill up. If you're placed on a waitlist, ask what services you can get while you wait, and check back.
5. Ask about cost. State help depends on your income, expenses and other resources, and sometimes you pay part of the cost.

Already have insurance? State funds are for people who can't pay another way, so start with your plan: see does insurance cover rehab?

Who qualifies

• Texas residents with low income. HHSC's adult treatment contracts describe the people they serve as Texas residents below 200% of the federal poverty level who meet HHSC's client eligibility rules.
• Who need treatment. Programs assess you against the DSM diagnostic criteria and the ASAM criteria to decide the level of care.
• Teens have their own programs and rules: see teen drug and alcohol treatment in Texas.

The exact income limits and paperwork are set by HHSC and change, so ask the OSAR what applies to you.

Who gets in first

Texas's state-funded treatment is paid for partly by a federal block grant, which sets priority groups. HHSC adds its own.

Group	The rule
Pregnant women	Given preference for admission (45 CFR 96.131). If a program can't admit right away, interim services must be offered within 48 hours.
People who inject drugs	Admitted within 14 days of asking, or within 120 days if interim services start within 48 hours (45 CFR 96.126). Pregnant women who inject drugs come first.
Texas priority groups	HHSC's contracts also prioritize people at high risk of overdose, people referred by the Department of Family and Protective Services (DFPS), and people experiencing homelessness or unstable housing.

Tell the OSAR if any of these apply to you.

Free detox

HHSC funds withdrawal management (detox) as one of its adult substance use services, through the same OSAR referral. Detox programs that take Medicaid: Houston, Dallas, San Antonio and Austin. Detox with a sliding fee: Houston and Dallas.

Alcohol withdrawal and some other withdrawal can be dangerous. If someone has seizures, confusion or hallucinations, call 911. Our alcohol detox guide explains when detox needs medical care.

Rehab that takes Medicaid

Texas Medicaid covers substance use treatment at licensed programs: assessment, outpatient counseling, outpatient and residential detox, residential treatment and medication, with no copays. Detox and residential treatment need prior authorization, which the program requests. Most adults 19 to 64 who aren't pregnant, raising a child or disabled can't get Texas Medicaid, which is why state-funded treatment matters. See how to apply for Texas Medicaid and STAR, STAR+PLUS and CHIP explained.

Residential programs that accept Medicaid: Houston, Dallas, San Antonio and Austin. Every level, by city: Houston, Fort Worth and El Paso.

Other free and low-cost help

• SAMHSA's National Helpline, 1-800-662-4357, refers callers to state-funded and sliding-fee programs, free and confidential.
• Community health centers see you with or without insurance; their sliding fee scale gives a full discount, or a small nominal fee, at or below 100% of the federal poverty guidelines, and partial discounts up to 200%.
• Local mental health authorities offer crisis care and services to Texans without insurance, which matters if a mental health condition comes with the substance use. Call 2-1-1.
• Free naloxone for anyone at risk of an opioid overdose: free Narcan in Texas.
• Self-pay? You have a right to a written Good Faith Estimate before care: try our Good Faith Estimate tool.

Find programs

Counted from the Texas programs on Cima Find Care, from SAMHSA's FindTreatment.gov and the programs' own records. The last column counts programs that list a sliding-scale fee.

Level of care	Programs in Texas	Accept Medicaid	Accept Medicare	Accept private insurance	Sliding-scale fee
Detox	182	116	88	173	52
Residential	251	181	127	223	94
IOP (intensive outpatient)	221	136	86	190	92
Outpatient	488	342	275	419	212
MAT (medication)	236	160	130	213	87

Counted from Cima Find Care's Texas records as of 2026-10-27: one program per organization in each city, from SAMHSA's FindTreatment.gov and the programs' own websites. A program counts when any of its locations lists it.

City	Detox	Residential
Austin	13 programs, 7 take Medicaid	16 programs, 10 take Medicaid
Dallas	10 programs, 6 take Medicaid	12 programs, 8 take Medicaid
El Paso	3 programs, 3 take Medicaid	8 programs, 8 take Medicaid
Fort Worth	3 programs, 1 takes Medicaid	5 programs, 4 take Medicaid
Houston	24 programs, 13 take Medicaid	29 programs, 18 take Medicaid
San Antonio	10 programs, 9 take Medicaid	14 programs, 12 take Medicaid

More: every Texas city, treatment by insurance plan, or answer four quick questions to see where to start.