Rehab Centers That Accept Medicare
Medicare is a federal health insurance program for adults 65+, people with disabilities, and those with end-stage renal disease, covering substance abuse treatment under Parts A, B, and D.
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What Does Medicare Cover for Rehab?
Medicare covers substance abuse treatment across its different parts — Part A for inpatient care, Part B for outpatient services, and Part D for prescription medications. Medicare Advantage (Part C) plans may offer additional behavioral health benefits.
Part A: Inpatient Treatment
Medicare Part A covers inpatient substance abuse treatment in hospitals and skilled nursing facilities. Benefits include up to 60 days per benefit period (after a deductible), with coinsurance for days 61-90. Medicare also provides 60 lifetime reserve days for extended stays.
Part B: Outpatient Services
Medicare Part B covers outpatient substance abuse treatment including individual and group therapy, partial hospitalization, screening and brief intervention, and alcohol misuse counseling. After meeting the Part B deductible, Medicare typically pays 80% of approved amounts.
Part D: Addiction Medications
Medicare Part D covers prescription medications for addiction treatment including buprenorphine, naltrexone, acamprosate, and disulfiram. Coverage varies by Part D plan formulary, and some medications may require prior authorization or step therapy.
How to Use Medicare for Addiction Treatment
Understanding how Medicare covers addiction treatment helps you maximize your benefits and minimize out-of-pocket costs.
Confirm Your Eligibility
Medicare eligibility typically begins at age 65 or earlier for people with certain disabilities. If you have both Medicare and Medicaid (dual eligible), you may have additional behavioral health benefits. Check your Medicare card to confirm your coverage parts (A, B, D).
Find Medicare-Accepting Providers
Not all treatment facilities accept Medicare. Use Medicare's provider search at medicare.gov or our treatment center search to find Medicare-accepting rehab facilities. Ensure the facility participates in Medicare (accepts assignment) to minimize costs.
Medicare Advantage Options
If you have a Medicare Advantage plan, contact your plan directly for substance abuse treatment benefits. Many Advantage plans offer additional behavioral health services, lower copays, and care coordination not available under Original Medicare.
Medicare Insurance Verification Process
Medicare benefits are standardized for Original Medicare, but it's still important to verify coverage details before treatment.
Verification Steps
- Confirm your Medicare parts (A, B, C, D) and effective dates
- Check if you have a Medicare Supplement (Medigap) policy
- Verify the treatment facility accepts Medicare assignment
- Confirm Part A deductible status for inpatient coverage
- Check Part D formulary for specific addiction medications
- If Medicare Advantage, verify plan-specific behavioral health benefits
Where to Get Help
Call 1-800-MEDICARE (1-800-633-4227) for questions about your coverage. Your State Health Insurance Assistance Program (SHIP) provides free counseling to help you understand Medicare benefits for substance abuse treatment.
