Does Medicare Cover Addiction Treatment?

Posted on March 25th, 2021

  • What is Medicare?
  • Medicare Coverage Levels and Plans
  • Does Medicare Pay for Substance Abuse Rehab?
  • Checking Your Insurance Benefits
  • Does Your Plan Cover Addiction Treatment?

Yes, when you need addiction treatment, Medicare healthcare coverage can help with costs and cover at least some parts of your care. Depending on your plan and qualifications, it can make addiction treatment more accessible for those who need it.

Medicare has 3 parts that cover different services for people age 65 and older and people under 65 who have a disability and meet certain income-based requirements.1 Medicare also works with the Federal Employee Health Benefits (FEHB) program and Veterans Affairs to provide additional coverage to federal employees and veterans.

American Addiction Centers (AAC) strives to provide you with the most updated information on each carrier’s addiction insurance coverage, but policy changes and errors do occur. Please check with your insurance carrier directly to confirm coverage levels.


What is Medicare?

Medicare is state and federally funded to provide people with the financial resources they need for healthcare, including addiction treatment. The program provides health insurance to people who meet specific age, disability, and income requirements.

Medicare has 3 main parts—A, B, and D—that cover health services including both inpatient and outpatient drug rehab as well as partial hospitalization programs (PHPs) and intensive outpatient programs (IOPs). To qualify for Medicare, you must be a US citizen or have been a permanent legal resident for at least 5 years.1


Medicare Coverage Levels and Plans

Medicare has 3 components that cover different areas of care as follows:1

  • Part A: Covers hospital insurance, including inpatient care associated with addiction treatment.
  • Part B: Applies to outpatient care, including doctor visits, preventative care, and outpatient addiction treatment.
  • Part D: Covers prescription drug costs, including medication-assisted treatment.

There are 2 types of Medicare coverage:1

  • Original Medicare: This plan includes Medicare parts A and B. It covers partial costs for care, including addiction treatment. You can also add Part D for more coverage.
  • Medicare Advantage: This plan includes parts A, B, and D in one package and allows you to combine your Medicare coverage with other Medicare-approved insurance plans.

Does Medicare Pay for Substance Abuse Rehab?

Medicare generally does cover substance abuse rehab, but it may not cover all aspects of addiction treatment. Original Medicare Part A covers inpatient care for up to 190 days. 2 The cost depends on your plan. You typically pay your deductible for the first 60 days and then cover a portion of the cost if you stay longer.

Costs vary further for outpatient care, depending on the type of treatment you need. Medicare mental health coverage is also included as required by the Affordable Care Act (ACA). It covers therapy for co-occurring disorders like anxiety, depression, and other mental health disorders.


Verify Your Benefits at an American Addiction Centers Facility

The cost of alcohol or drug addiction treatment may appear to be an obstacle, but we are here to help. Insurance may cover all or some of your rehab.

Find out if your insurance covers long-term addiction rehabilitation.

Check Online Now

Checking Your Insurance Benefits

You can search the Medicare website to find out if your service is covered, or contact Medicare representatives by calling the number on your Medicare ID card.3 Representatives at AAC are also available to advise you about addiction insurance coverage; call them at +1 (888) 341-7785 .


Does Your Plan Cover Addiction Treatment?

People with Medicare who need addiction treatment must go to a Medicare-approved facility, like AAC, to receive coverage. Medicare won’t cover the full cost, but if you have trouble affording care, you can apply for financing or scholarships through your treatment facility. AAC will also help you talk with friends or relatives who can help you pay for treatment. You can find out if your treatment is covered and to what extent when you verify your insurance online.

Medicare may not cover everything, but it can make treatment more affordable. Your coverage depends on your plan and what kind of treatment you need. Take the first step toward getting help: go online or call AAC at +1 (888) 341-7785 to speak with an admissions navigator today.


Sources

  1. Medicare.gov. (n.d.). What’s Medicare?
  2. Medicare.gov. (n.d.). Inpatient Rehabilitation Care.
  3. Medicare.gov. (n.d.). Your Medicare Coverage.

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