Medicare is defined as a federal social insurance program which provides basic health care coverage for persons 65 years or older whom have paid into social insurance throughout his or her life, it also provides health coverage for young people with disabilities. By the year 2010, Medicare was providing coverage for close to 50 million Americans, almost 10 million of those Americans were young people with disabilities. Medicare uses about 30 different private insurance companies across the United States to help determine coverage needs and amounts. Almost 50 percent of the health care charges are covered my Medicare, and the rest are covered out of pocket or by the users other insurance company if applicable.
To be eligible for Medicare you must be a United States citizen for at least five years and be 65 years or older. If people with disabilities under the age of 65 are receiving Social Security Disability Insurance, they may also be eligible for Medicare. If you are 65 years or older and a US resident for more than 5 years, you must also have been paying your Medicare taxes for at least ten years. The coverage of Medicare has four different parts; there are hospital insurance, medical insurance, Medicare advantage plans, and prescription-drug plans. Medicare does not pay for all of individual medical costs; you will have out of pocket costs involved, unless you have other private health insurances, there are premiums, deductibles, and coinsurance, which must be paid out of pocket.
Medicare can be beneficial health programs for people 65 years or older and persons with disabilities, for as long as you have paid into it over the years and meet the other requirements you are eligible for coverage. For many seniors and retirees, private health insurance is not always an option as they may be living on a fixed income. Medicare offers a solution for that were close to 50 percent of your medical and health needs can be covered. Many senior Americans are currently enrolled in this federal program across the United States.
Medicare will pay for treatment of alcohol addiction and drug addiction. According to a National Survey on Drug Use and Health. In 2017, around 9.4% of men and 5.2% of women 12 years of age and older had a substance abuse disorder. Men are more likely to abuse illicit drugs than women, yet women are just as prone to addiction. American Indians and Alaska Natives had the highest rate of substance abuse and dependency in 2017. Demographics from all across the United States struggle with drug addiction. Many Americans who are 65 years old, have a disability, or who live well below the poverty line have Medicare insurance.
Part A of the Medicare program will pay for inpatient drug rehabilitation. Someone who uses their Medicare will pay the same co-pay as for any other type of inpatient hospitalization. Part B of Medicare will pay for outpatient treatment. This will include treatment at a clinic or a hospital outpatient department for example. Regardless of the type of substance abuse problem you are struggling with, Medicare can help cover some of the cost. This can also include things such as patient education regarding diagnosis and treatment.
Some Medicare beneficiaries will use his or her coverage for post-hospitalization follow-up. Structured Assessment and Brief Intervention is also covered by Medicare. This is the early intervention approach to help addicts. When someone has not quite reached the severity level of a full-blown addiction, early intervention is used. This can be done through a primary care physicians office or an outpatient hospital department. Early intervention is important to prevent severe drug addictions from taking hold. If someone can intervene early, many of the problems will be prevented.
Public health services within the United States treat drug and alcohol addiction with three major components. Initially, this is screening and assessments, such as an assessment to determine if drug addiction is there. There is brief intervention done by engaging the patient and helping them understand there is a drug problem. Lastly, there is a referral to treatment for brief therapy, or drug addiction treatment.
Ask a Professional
What treatment settings for substance use disorders does Medicare cover?
Medicare covers and pays for the treatment of alcohol addiction or a substance use disorder in an inpatient or outpatient setting.
What does Medicare pay for within a drug rehab setting?
Medicare Part A pays for inpatient drug rehab, and individuals pay the same co-pays as any other inpatient hospitalization. Medicare Part B pays for outpatient drug rehab or hospital outpatient treatment.
What forms of treatment are covered by Medicare?
Covered therapies for the treatment of alcohol addiction and drug addiction include:
- Patient education regarding diagnosis and treatment
- Post-hospitalization follow-up
- Outpatient prescription drugs through Medicare Part D
- Inpatient prescription drugs, including Methadone
- Structured Assessment and Brief Intervention (SBIRT)
Medicare Part A will likely cover the following:
- Inpatient hospitalization
- Inpatient drug rehabilitation services
- Coordinated care from nurses and physicians
- Any drugs necessary for treatment while you’re an inpatient
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