Does Medicare cover drug rehab?

Drug addiction treatment can be financially challenging. If you or a loved one is struggling with drug addiction, you should know that Medicare is an option. Navigating your way through all of Medicare’s rules and regulations can be hassle, but we’re here to help!

To take advantage of Medicare coverage and benefits, you generally need to be age 65 or older and eligible for social security benefits. However, you may qualify even if you’re under age 65 if you have already been approved for disability benefits. Since drug rehabilitation treatment falls under the federal government’s mental health services umbrella, Medicare may cover some (or all) of your treatment.

Covered services

If you have Medicare Part A, you may be granted coverage for inpatient rehab and associated hospital stays. Part A care has a 190-day lifetime limit for specialized psychiatric hospitals. Necessary treatment beyond 190 days will occur at a general hospital facility. This can add both cost and complexity to your treatment options.

If you have Medicare Part B, you may be eligible to receive outpatient drug rehab coverage. It’s worth noting that Part B patients are usually responsible for 20% of the treatment costs beyond the deductible.

If you have Medicare Part D, you may be eligible to receive prescription medication coverage related to your drug rehab treatment. Specific drug plans vary, so be sure to consult with a Medicare specialist to determine if the Part D plan benefits you.

Enrolling in Medicare for treatment

If you haven’t already enrolled in Medicare, you can do so immediately at the Social Security Administration website. Generally, you’ll receive Medicare enrollment cards via U.S. Mail before your 65th birthday. If you haven’t received them – or if you’ve misplaced them – you can apply online at any time. If you prefer to speak with a Medicare representative, you may call the office directly (1-800-633-4227).

Once you’re enrolled, you’ll work with a Medicare or Social Security professional to determine the appropriate coverage based on your needs. Medicare typically requires recovering addicts to seek outpatient treatment first. More extensive inpatient or detox services can follow if determined to be reasonable and necessary by a physician. Medicare coverage includes patient education, medication therapy, and psychotherapy. It also includes aftercare services on an ongoing basis following the primary treatment program.

To expedite your treatment options, you should research local drug rehabilitation programs that accept Medicare coverage. You can view treatment centers based on your state of residence or search the facility locator on the Substance Abuse and Mental Health Services Administration website.

Understanding Medicare and its benefits can be a confusing process, which is made even more challenging if you or someone you love is suffering from drug addiction. The good news is that Medicare does cover many facets of drug rehab treatment, and help is a phone call (or an email) away.

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