Will Medicare Pay for Addiction Treatment?

Medicare will pay for treatment of alcoholism and substance use disorders in both hospitalized and. Medicare can cover treatment for AUD and SUD. Both the original Medicare plan and the Medicare Advantage plan cover several treatment options, including inpatient care, outpatient services and prescription drugs, depending on the plan you choose. Yes, Medicare generally covers treatment for a wide range of substance use disorders, including alcohol use disorder.

As with other types of substance abuse, your provider must consider that treatment for alcohol abuse or alcohol addiction is medically necessary for you to receive coverage. The American Psychological Association (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM-V) lists criteria for alcohol use disorder as the presence of two or more of the following physical and behavioral symptoms in the past year. Medicare will cover treatment for alcoholism and substance use disorder if you are enrolled in Medicare and meet certain eligibility requirements. Inpatient and outpatient treatment is covered, but it must be medically necessary and must be performed by a Medicare-approved provider.

Medicare Part A covers inpatient alcohol and substance abuse treatment, while Medicare Part B covers treatment. Jeffrey's mission is to educate and inform the public about addiction problems and to help those in need of treatment find the best option for them. How long Medicare pays for your rehabilitation treatment depends on the type of treatment you receive as an inpatient or outpatient. If your treatment takes place in a specialized psychiatric hospital, Medicare Part A will not pay for more than 190 days of treatment during your lifetime.

However, you may owe copayments of 20% of the Medicare-approved amount for addiction disorder treatment services you receive from doctors and other providers while you are hospitalized. Medicare Part B health insurance covers your treatment if you receive it in an outpatient setting, such as a clinic, hospital outpatient department, or opioid treatment program. But there are rules about what providers people can use with Medicare, and some types of addiction treatment aren't covered by Medicare at all. If you are being treated as an inpatient in a specialized psychiatric hospital, you should know that Medicare will only pay 190 days of treatment in a psychiatric hospital during your lifetime.

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