Best Drug Rehab Centers That Will Accept Medicare (2023)

Finding drug rehab centers that accept Medicare can be a difficult topic to think about if there is someone in your life that struggles with addiction.

Addiction to substances can wreak havoc in a person’s life. Drug abuse not only affects the life of the person struggling but also impacts the families and loved ones, too.

Finding the appropriate rehab center that accepts your health insurance will be the first step toward feeling independence again.

Keep reading for more information on drug rehab centers that accept Medicare. Enter your ZIP code into our free tool to compare Medicare quotes in your area.

Inpatient Drug Rehab Centers That Accept Medicare Near Me

To find a facility near you, you will first need to identify the type of care and treatment you’re seeking for you or your loved one.

The Substance Abuse and Mental Health Services Administration (SAMHSA) covers many avenues for treatment facilities around the U.S. and what specialized care each facility offers.

Each state has different policies and procedures, while following guidelines that are set by the federal government. Qualifications will be based on income and other circumstances relating to accessibility.

Finding a treatment center that Medicare will cover is a bit tricky because the services will vary from state to state.

The Affordable Care Act has lifted many past limitations that made addiction treatment difficult to obtain. Insurance companies are no longer allowed to decline coverage for preexisting conditions, so those seeking recovery are able to find affordable coverage for their treatment.

Is drug rehab covered by Medicare?

While Medicare covers a broad spectrum of treatments for those with mental illnesses and substance abuse disorders, there are limits to coverage and reimbursement.

Depending on the amount of treatment that is needed, understanding the health care deductibles that fit into your budget will be the starting point in figuring out which treatment facilities you’ll qualify for.

Treatment

Medicare will pay for the treatment of alcoholism and substance use disorders in both inpatient and outpatient settings:

• Medicare Part A: pays for inpatient substance abuse treatment; individuals will pay the same copays as for any other type of inpatient hospitalization
• Medicare Part B: pays for outpatient substance abuse treatment services from a clinic or hospital outpatient department

Covered items and services for the treatment of alcoholism and substance use disorders include:

• Psychotherapy
• Patient education regarding diagnosis and treatment
• Post-hospitalization follow-up
• Out-patient prescription drugs though Medicare Part D
• Inpatient prescription drugs, including Methadone
• Structured Assessment and Brief Intervention (SBIRT)

Medicare will also cover any new preventive benefits that offer screening and counseling for people who show signs of alcohol or drug misuse but are not substance dependent.

Hospitalization

Medicare will cover the care of an individual in need of specialized psychiatric hospitalization. This treatment will cover mental illness related to in-patient care in regards to substance and alcohol abuse.

Medicare pays for necessary in-patient hospitalization for up to 90 days per benefit period. Medicare users who need to be in a hospital for more than 90 days are entitled to a 60 day lifetime reserve after the initial 90 days, which can be used only once.

Care in a specialized psychiatric hospital is limited to a total of 190 days during an individual’s lifetime, so once this maximum has been reached, Medicare coverage of psychiatric hospitalization cannot be used or renewed again.

This limitation can be harsh for individuals who need frequent or lengthy in-patient treatments in a specialized hospital. However, this limitation applies only to treatment in psychiatric hospitals.

Outpatient Services

Medicare covers medically necessary diagnostic and treatment services. These services include treatments provided by:

• Physicians (including psychiatrists)
• Clinical psychologists
• Social workers
• Psychiatric nurse specialists
• Nurse practitioners
• Physicians’ assistants

Medicare does not cover treatment by licensed professional counselors. Counselors must be enrolled in a Medicare program as a provider in order to bill and be reimbursed by Medicare.

At-Home Care

Medicare pays for home health services for individuals who require skilled care on a part-time or intermittent basis and those who are confined to their homes.

Individuals with mental health needs, in addition to substance abuse issues, who also meet a certain criterion are eligible for at-home care, even if they have no physical limitations.

An individual can be considered “homebound” if their substance abuse or mental illness has made it difficult to leave the home, or made it difficult without the help of outside resources, and would not be safe for the individual if left unattended.

Special Needs Plans

There are specific Medicare Advantage plans created for people with chronic disease, including mental illness and substance abuse disorders. However, these plans do not exist all over the country and the quality of each individual plan will vary.

Medicare Advantage plans contract with Medicare and pays a fixed amount to provide Medicare benefits. These are generally considered as managed care plans.

The Best Drug Rehab Centers That Will Accept Medicare: Key Takeaways

“Does Medicare cover drug rehab centers?” is a tough question to consider when dealing with drug addiction. It can be hard on everyone involved, especially if you, or a loved one, need immediate care.

Thankfully, as long as you qualify, Medicare does cover inpatient and outpatient, as well as an array of other services that will help with aftercare and ongoing recovery.

Looking for drug rehab centers that accept Medicare is never an easy topic, but there are plenty of resources to help you, or your loved one, on their journey to recovery. Enter your ZIP code below to start comparing Medicare quotes in your area today.