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More About Medicare
Understanding Medicare Costs for Addiction Treatment
Medicare coverage comes with cost-sharing responsibilities, which vary by plan:
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Original Medicare Part A includes an annual deductible ($1,676 in 2025) and coinsurance for extended hospital stays.
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Part B requires a monthly premium ($185 in 2025), an annual deductible ($257 in 2025), and coinsurance (typically 20%) for outpatient services, including addiction counseling.
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Medicare Advantage plans often have varying premiums, copays, and deductibles, so it’s important to review your specific plan details.
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Part D prescription drug plans have their own premiums, deductibles, and copay structures, varying by provider.
Telehealth Addiction Services Covered by Medicare
Medicare recognizes the importance of telehealth, especially for behavioral and addiction health services. During and beyond the COVID-19 pandemic, Medicare expanded coverage for telehealth addiction treatment, including virtual counseling, therapy sessions, medication management, and follow-ups.
Telehealth options help increase accessibility for beneficiaries who may face barriers such as transportation difficulties or reside in rural areas. Medicare Part B covers these services when provided by approved healthcare professionals, enabling flexible, convenient recovery support.
Better Addiction Care partners with telehealth providers to help you receive quality care, whether in-person or remotely.
Take the First Step: Check Your Medicare Coverage Today
Ready to explore your Medicare benefits and start addiction treatment? Contact Better Addiction Care for a no-obligation insurance benefits review and expert guidance tailored to your needs. Don’t let uncertainty delay your path to recovery.
Empower your recovery journey with confidence, knowing Medicare and Better Addiction Care have you covered.
Common Questions About Medicare Insurance
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Medicare offers essential coverage options for individuals seeking treatment for substance use disorders and related behavioral health conditions. Whether through Original Medicare or Medicare Advantage plans, beneficiaries have access to a range of medically necessary addiction treatment services. Understanding your Medicare benefits helps you take confident steps toward recovery.
Medicare covers various addiction treatment services when deemed medically necessary by healthcare professionals, including:
- Inpatient Rehabilitation and Detoxification: Medicare Part A covers intensive inpatient treatment stays in hospitals or accredited rehab facilities when a doctor deems it medically necessary.
- Partial Hospitalization and Intensive Outpatient Programs: Treatment that involves structured programs during the day or evening, allowing you to live at home but attend regular therapy sessions, is covered under Parts A or B.
- Outpatient Therapy and Counseling: Medicare Part B supports individual, group, and family therapy for addiction, including psychiatric assessments, ongoing monitoring, and medication management.
- Medication-Assisted Treatment (MAT): Medicare covers FDA-approved medications such as buprenorphine, methadone, and naltrexone, used alongside counseling to treat opioid or alcohol dependence.
- Behavioral Health Screenings and Periodic Evaluations: Regular screenings, toxicology tests, and follow-up assessments are covered services.
Certain treatments may require care within Medicare-certified or hospital-based programs for coverage eligibility.
- Part A (Hospital Insurance): Covers medically necessary inpatient stays, which include detox and rehab in hospitals and specialized facilities. Part A also covers hospital meals, nursing care, and prescription medications administered during inpatient care.
- Part B (Medical Insurance): Covers outpatient addiction treatment, including counseling, therapy sessions, psychiatric evaluations, and medication management. Part B may also cover partial hospitalization programs (PHP).
- Part C (Medicare Advantage Plans): These plans include all benefits of Parts A and B and often add prescription drug (Part D) coverage. They may offer extra benefits, but usually require using a network of providers.
- Part D (Prescription Drug Coverage): Covers prescription medications, including those used in MAT for opioid and alcohol use disorders. Part D plans must follow transition policies to prevent delays in medication access.
Medicare coverage requires that services be medically necessary and provided by Medicare-approved providers or facilities. Depending on your plan, prior authorization or a referral may be needed. Confirming coverage before beginning treatment helps avoid unforeseen expenses.
- Review your Medicare plan documents or online portal for addiction treatment benefits.
- Contact Medicare directly or the Better Addiction Care team for personalized insurance verification.
- Ask if prior authorization or referrals are necessary.
- Confirm which providers and treatment centers accept your Medicare plan.
Better Addiction Care assists with insurance verification and helps you connect with appropriate treatment providers.
Receiving adequate addiction treatment under Medicare significantly improves physical and mental health outcomes. Successful treatment reduces the risk of overdose, relapse, and co-occurring mental health disorders such as depression and anxiety.
Medicare’s coverage ensures access to integrated care approaches combining medication, therapy, and support services that promote lasting recovery. Early screening and intervention—covered by Medicare programs like SBIRT (Screening, Brief Intervention, and Referral to Treatment)—help identify substance use issues before they worsen.
Improved health outcomes translate into enhanced quality of life, lower healthcare costs, and reduced hospitalizations, making addiction treatment a vital Medicare benefit.
If your Medicare plan has gaps in addiction treatment coverage, consider:
- Utilizing in-network providers to reduce costs
- Exploring Medicare Advantage plans that offer expanded benefits
- Discussing alternative or sliding scale payment options with Better Addiction Care
- Accessing supplemental insurance or state assistance programs
Our team guides you through finding the best coverage and financial options for your recovery journey.
At Better Addiction Care, we specialize in helping Medicare beneficiaries understand and maximize their addiction treatment benefits. We ensure you have clarity on:
- What services does your Medicare cover?
- How to navigate insurance requirements and paperwork?
- Coordinating care with trusted treatment providers nationwide
- Preparing you for any potential costs in advance
Our goal is to make accessing quality addiction care through Medicare as seamless as possible.
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