For Medicare beneficiaries, treatment for substance use disorders is more accessible and affordable than ever before. Adults aged 65 and older tend to face a higher number of health problems than their younger counterparts, which puts them at greater risk for substance abuse and related comorbidities. If you have Medicare or qualify for Medicare benefits, your insurance plan may help you receive addiction treatment at America’s Rehab Campuses.
What Is Medicare?
When it comes to addiction recovery, understanding your insurance options is essential. Medicare provides important coverage for individuals seeking treatment for alcohol and drug use disorders, but navigating the specifics can be tricky. Fortunately, we’ve broken it down for you. Whether you need inpatient or outpatient care, Medicare has got your back — but you’ll need to know what’s covered, what’s not, and how to maximize your benefits. Let’s take a closer look at how Medicare Part A, B, and D come together to help you on your recovery journey.
Medicare Part A is hospital insurance that provides coverage for inpatient hospital stays, hospice care, care in a nursing facility, and some home health care. Medicare Part B is medical insurance that provides coverage for outpatient care, preventive services, certain doctors’ services, and medical supplies. Some people may qualify for Medicare Part C or Medicare Advantage, which is an “all-in-one” alternative to Original Medicare that bundles Part A and Part B. Medicare Part D offers prescription drug coverage for those who need affordable medication.
It is worth noting that Medicare Part A offers essential coverage for inpatient rehab, but it’s important to know that there are limits. Medicare Part A covers inpatient treatment for substance use disorders, but there is a lifetime limit of 190 days at specialty treatment facilities. That means if you reach this limit, you may need to explore other options for extended care, whether through outpatient services, community programs, or other insurance providers. It’s crucial to plan to ensure your recovery journey continues smoothly.
Does Medicare Cover Addiction Treatment?
Substance abuse and addiction treatment services are covered by Medicare when deemed reasonable and medically necessary. Inpatient and outpatient drug rehab, partial hospitalization programs, and drugs used to treat opioid dependence are typically covered by Medicare.
Inpatient drug and alcohol rehab services may include drug detox, alcohol detox, individual therapy, group therapy, substance abuse education, relapse prevention, 12-step meetings, and aftercare planning. Many of these same services are also available with some outpatient and partial hospitalization programs.
MAT and Medication Coverage
Addiction recovery isn’t just about therapy and counseling — medication-assisted treatment (MAT) plays a crucial role in many people’s recovery journeys. Medicare Part D provides coverage for essential medications like methadone, buprenorphine, and naltrexone that help manage withdrawal symptoms, reduce cravings, and support long-term sobriety. Whether you’re recovering from alcohol use disorder or opioid addiction, these medications are vital tools that can help you maintain your recovery. Be sure to check with your Medicare plan for full details on your coverage for MAT medications.
Telehealth Services – Treatment from the Comfort of Home
In today’s world, convenience is key, and telehealth services are making a huge difference in how individuals access addiction treatment. Through Medicare Part B, outpatient care for substance use disorders now includes telehealth options, meaning you can access counseling, therapy, and even intensive outpatient programs (IOP) without ever leaving your home. Whether it’s through video calls or phone consultations, telehealth ensures that help is always within reach, especially for those who might face barriers like transportation or mobility issues.
Statistics on Substance Abuse Among Adults 65 and Older
- Alcohol remains the most commonly used substance among older adults aged 65 or older, according to Clinics in Geriatric Medicine.
- Among adults aged 65 and older who use illicit drugs, 11.7% meet the criteria for a past-year substance use disorder.
- In 2014, more than 1 million adults aged 65 or older had a substance use disorder, according to SAMHSA.
- In 2014, an estimated 978,000 older adults had alcohol use disorder, while 161,000 older adults had an illicit drug use disorder.
- In 2014, 3.4 million older adults reported past-month binge alcohol use, while 772,000 reported heavy alcohol use.
- In 2014, an estimated 132,000 adults aged 65 or older reported using marijuana on an average day, while 4,300 reported regular cocaine use.
- In 2011, there were 750,529 drug-related emergency department visits by older adults aged 65 or older, 105,982 of which involved illicit drug use, polydrug use involving alcohol, or nonmedical use of prescription drugs.
Out-of-Pocket Costs – What You’ll Need to Know
Understanding your out-of-pocket costs is an essential part of planning your addiction treatment. While Medicare covers a large portion of your rehab services, there are still costs to consider. Medicare Part A typically requires a deductible for inpatient stays, and Part B usually covers 80% of outpatient treatment, leaving you with the remaining 20% of the costs. It’s also important to note that Medicare Advantage plans may have different co-pays or coverage rules, so it’s worth reviewing your specific plan to avoid surprises. And remember — if you have dual eligibility for Medicare and Medicaid, you could receive additional support to reduce these costs.
ARC Accepts Most Medicare Insurance Policies
America’s Rehab Campuses accepts most insurance providers, including Medicare insurance policies. If you are 65 or older and want to know if you qualify to receive Medicare, visit the Medicare website to determine your eligibility and calculate your premium. If you are under the age of 65, you may be eligible for Medicare if you have received Social Security Disability Insurance checks for at least 24 months, or if you have been diagnosed with end-stage renal disease.
If you already have Medicare, Medicaid, or another insurance plan, fill out our free insurance benefits form to quickly and easily verify your plan benefits for addiction treatment. Or, call us today at 833-272-7342 to speak with one of our treatment consultants who can verify your insurance benefits for you and discuss all your available treatment options.
