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Information on Medicare Drug Rehabilitation

Last updated on: Friday, 20 October 2023
  • What You'll Learn

Medicare drug rehabs are available for people that does not have private insurance. However, you or your loved one may face barriers when finding a rehab that accepts Medicare health insurance. You or your loved one should not have to spend a significant amount of time contacting countless programs to determine if they take state health insurance. We want to ensure you get the treatment needed immediately. With that, you can choose a state in the menu below in order to find a Medicare drug rehab program in your area.

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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.

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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:

    • Psychotherapy
    • 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
  • Want to know more?

    The questions from Addicted.org’s “Learn from our Experts” are answered by Michael Leach, CCMA. If you need further clarification on any of the questions above or have any other questions you can contact him directly at mike@addicted.org.




More Information

Marcel Gemme has been helping people struggling with addiction for over 19 years. He first started as an intake counselor for a drug rehabilitation center in 2000. During his 5 years as an intake counselor, he helped many addicts get the treatment they needed. He also dealt with the families and friends of those people; he saw first-hand how much strain addiction puts on a family and how it can tear relationships apart. With drug and alcohol problems constantly on the rise in the United States and Canada, he decided to use the Internet as a way to educate and help many more people in both those countries. This was 15 years ago. Since then, Marcel has built two of the largest websites in the U.S. and Canada which reach and help millions of people each year. He is an author and a leader in the field of drug and alcohol addiction. His main focus is threefold: education, prevention and rehabilitation. To this day, he still strives to be at the forefront of technology in order to help more and more people. He is a Licensed Drug and Alcohol Treatment Specialist graduate with Honours of Stratford Career Institute. Marcel has also received a certificate from Harvard for completing a course entitled The Opioid Crisis in America and a certificate from The University of Adelaide for completing a course entitled AddictionX: Managing Addiction: A Framework for Succesful Treatment.