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Medicare Insurance Cover for Drug & Alcohol Rehab

Medicare is a federal health insurance program that helps people over the age of 65 afford quality healthcare. Does Medicare cover drug and alcohol addiction treatment? Yes, when you need addiction rehab, Medicare healthcare coverage can help with costs and cover at least some parts of your care. Depending on your plan and qualifications, it can make addiction treatment more accessible for those who need it.

This page is meant to help you find out about eligibility and how Medicare can help make the cost of rehab more affordable.


Does Medicare Cover Addiction Treatment?

Medicare generally does cover substance abuse rehab, but it may not cover all aspects of addiction treatment. Original Medicare Part A covers inpatient care for up to 190 days.1 The cost depends on your plan. You typically pay your deductible for the first 60 days and then cover a portion of the cost if you stay longer.

Costs vary further for outpatient care, depending on the type of treatment you need. Medicare mental health coverage is also included as required by the Affordable Care Act (ACA). It covers therapy for co-occurring disorders like anxiety, depression, and other mental health disorders.

The amount of coverage you have can vary widely based on your state of residence, whether the facility is in- or out-of-network, the length of your stay, and your insurance plan level. The cost of drug and alcohol addiction treatment will vary from person to person and will also depend on the rehab center, the type of program attended, and specific services received.

Check if Medicare Covers Drug and Alcohol Rehab

Before choosing the right drug and alcohol addiction treatment center for you, check your Medicare policy benefits to determine which costs will be covered by your insurance company and which will be out-of-pocket for you. Call the number on the back of your insurance card or log in to your account on Medicare’s website to learn more about what your specific policy plan covers.

Knowing exactly what your Medicare plan covers can give you peace of mind while you or your loved one is in rehab. You can do the work of getting and staying sober without worrying about unexpected costs or financial struggles. For more information on Medicare insurance plans and to check what your plan covers, call , click here, or fill out the form below.


What Types of Rehab Treatment Does Medicare Cover?

With most Medicaid plans covering at least some of the costs of rehab treatment for alcohol addiction or drug addiction, the types of treatment can vary in intensity and frequency. Types of treatment may include:4,5

  • Detox services: In some cases, you may need assistance when detoxing from drugs and alcohol, which can potentially be uncomfortable, painful, or even life threatening. Medical detox helps you safely withdrawal from drugs and alcohol, as you’ll receive around-the-clock medical supervision. You might also be given medications to help minimize withdrawal symptoms.
  • Inpatient or residential care: Inpatient/residential live-in treatment centers provide drug and alcohol rehab while you live onsite at the facility. Most inpatient programs last anywhere from 15–90 days, depending on the program you’re in and your individual needs.
  • Partial hospitalization (PHP): Partial hospitalization programs give you the opportunity to live at home while attending treatment during the day.
  • Intensive outpatient program (IOP): Intensive outpatient programs involve attending treatment programs a few evenings a week. In an intensive outpatient program, you can live at home and even go to work during the day.
  • Outpatient treatment: Individuals who have completed inpatient treatment often attend outpatient treatment for ongoing support on their journey to sobriety. You live at home and spend 10–12 hours a week at the treatment facility for therapy and support.

When you decide to get treatment for a drug or alcohol addiction, you will need to decide what type of treatment is best for you.


Do Rehab Centers Need to Be In-Network to Accept Medicare?

In most cases, you will need to seek treatment at a facility that is in-network with Medicare to receive your full benefits. Even if you choose a treatment facility that is in-network, you may still be responsible for some of the treatment costs.

If you choose a facility that is out-of-network, you may be responsible for all the costs of your addiction treatment. You may be able to discuss financing options such as a payment plan or scholarships offered by the facility.

What Are Medicare’s Coverage Levels and Plans?

Medicare has 3 components that cover different areas of care as follows:3

  • Part A: Covers hospital insurance, including inpatient care associated with addiction treatment.
  • Part B: Applies to outpatient care, including doctor visits, preventative care, and outpatient addiction treatment.
  • Part D: Covers prescription drug costs, including medication-assisted treatment.

There are 2 types of Medicare coverage:3

  • Original Medicare: This plan includes Medicare parts A and B. It covers partial costs for care, including addiction treatment. You can also add Part D for more coverage.
  • Medicare Advantage: This plan includes parts A, B, and D in one package and allows you to combine your Medicare coverage with other Medicare-approved insurance plans.

American Addiction Centers (AAC) strives to provide you with the most updated information on each carrier’s addiction insurance coverage, but policy changes and errors do occur. Please check with your insurance carrier directly to confirm coverage levels.


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