Medicare Health Insurance Coverage for Alcohol & Drug Rehab

Discover how Medicare covers addiction treatment, including recent changes in 2024. Learn about covered services, medical options, and more.

Medicare Health Insurance Coverage for Alcohol & Drug Rehab

Discover how Medicare covers addiction treatment, including recent changes in 2024. Learn about covered services, medical options, and more.

Medicare is federal public health coverage for people ages 65 and older, in addition to some people under age 65 who have disabilities or specific health conditions. About 60 to 65 million people currently access health insurance through Medicare. Original Medicare has several parts: Part A, Part B, and Part D.

Another option is to get a Medicare Advantage plan, known as Medicare Part C, which offers the same coverage as Original Medicare with some additional benefits and limitations. Medicare Advantage plans are offered by private insurance companies rather than the federal government.

If you’re comparing treatment programs or looking for rehab centers that accept your Medicare plan, you can also learn more about rehab options to review available providers and levels of care.

By Rita Milios

Medically Reviewed by Cara Towle

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Name / Address / Rating	Description	Treatments / Payments / Programs	Review / Contact	Images
Legacy Recovery Center 1 Top 10 in Medicare Rehab Score Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now. 7.82 / 10 4.8 (52 reviews)	A rehab facility run by professionals in the field of mental health and substance abuse, we provide the highest-quality treatment based on evidence-based therapies and best practices. Legacy Recovery Center is owned and operated by two psychiatrists with over four decades of combined experience, as well as two other individuals with two decades of	Treatments Programs Payment Options AlcoholismDrug AddictionOpioid AddictionMental Health and Substance AbuseSubstance AbuseMental Health Teen ProgramAdult ProgramProgram For MenProgram For WomenYoung Adult ProgramChild ProgramSeniors Program Private InsuranceSelf-Pay OptionsFinancial Aid	I'm so happy to have Legacy be my first treatment center. I can say the experience was far much better than I expected. My mental health was the main priority and Legacy made sure that I was getting the help I need. The staff was great and was very helpful when needed. Everyone made me feel like home but also making sure I'm getting the treatment I deserve. Man this was truly a blessing being here. Thank you to everyone that made me feel comfortable and make me a better person these past 30 days. I'm so grateful for Legacy Recovery for everything. Koaluh 3 months ago Paul is THE best tech and human being in the entire world. He made a significant impact in my over all mental health healing with his shared wisdom and life experiences. The facilitation as a whole was fantastic. Their management needs a lot of work though. Lorena Valdez 4 months ago this is the third treatment center i have ever attended and i can say by far that this is the BEST one i have ever been to. they strictly focus on mental health and uncovering traumas i was always so scared to talk about. on top of that, the staff has always been so generous and genuine and that’s rare to find in treatment centers. it was a life changing experience for me that i’ll never forget- thank you! jacey 5 months ago	5 5
Virtue Recovery Center Texas Drug and Alcohol Rehab Killeen, TX 4.9 (220 reviews)	Virtue Recovery Center Texas is a nationally accredited addiction treatment facility offering personalized, trauma-informed care in a comfortable, residential setting. Located just outside Austin, our center provides a full continuum of care including medical detox, residential treatment, PHP, and IOP programs. We specialize in treating substance u	Treatments Programs Payment Options Opioid AddictionDrug AddictionSubstance AbuseAlcoholism Adult ProgramProgram For MenProgram For WomenYoung Adult ProgramSeniors Program Private InsuranceSelf-Pay Options	my stay here has been truly amazing. I learned so much about myself. My self esteem has gone up considerably. I want to give special thanks to all the people who work at Virtue and especially my case workers Miss Kerry and Gillian they have gone beyond my highest expectations. Thank you to everyone at Virtue for giving me a new life! Donald Winters 3 months ago I just did the 33 day program here and the staff was phenomenal! The therapists and case managers were on top of everything and made my recovery process so much easier. They were there for me from beginning to end. The nursing staff was on top of my meds and I never had any issues. Thank you Virtue for helping me grow and become the woman I am today. I couldn’t have done it without you! I have learned so much about myself and the disease I have to live with. You’ve given me the tools I need to help keep the disease at bay. Although it was hard for me to be away from my family, I would do it again because I am stronger now. The facility was nice and the food was amazing! Anything that I couldn’t eat because of diet, they always had something I could eat and made it for me! I’m gonna miss y’all but thank you again for helping my recovery and helping me leave a better and healthier person! Love y’all!! Amanda Pike 3 months ago Virtue Recovery saved my life. From Gina, to Naomi, and nurse Barbara, the staff was amazing. The groups were informative and life changing. I recommend Virtue to anyone who is serious about their Recovery. Luis S 3 months ago
Lakeside Behavioral Health System – Dual Diagnosis Memphis, TN 5.0 (1 reviews)	For over 55 years, Lakeside Behavioral Health System has been an addiction treatment center for adults. You'll find 'em located out in Memphis, Tennessee. Services include residential (IP), partial hospitalization (PHP), and intensive outpatient programs (IOP). They also offer medically supervised detox. The Patriot Support Program helps members of	Treatments Programs Payment Options AlcoholismDrug AddictionDual DiagnosisMental Health and Substance AbuseOpioid Addiction Adult ProgramYoung Adult Program MedicaidPrivate insuranceSelf-Pay OptionsMedicareMilitary Insurance	Lakeside Behavioral Health System – Dual Diagnosis has no reviews yet. Leave a review.
Rolling Hills Recovery Center New Jersey Drug & Alcohol Rehab Ad This is an ad and Rolling Hills Recovery Center New Jersey Drug & Alcohol Rehab is a paid advertiser. Paid advertisers may be listed first in search results. This ad may contain content provided by the advertiser. Rehab.com does not verify ad content or any reviews that are displayed. Learn More Chester, NJ 5.0 (280 reviews)	Rolling Hills Recovery Center is state licensed, and one of the best outpatient drug and alcohol rehab facilities in Chester, New Jersey. Providing a continuum of treatment from partial hospitalization care to intensive outpatient programs, their interdisciplinary team looks at addiction from all angles. This includes the whole person, the communit	Treatments Programs Payment Options AlcoholismDrug AddictionOpioid AddictionSubstance Abuse Adult ProgramYoung Adult Program Private InsuranceSelf-Pay Options	View Website (973) 606-9170	This was hands down one of the best treatment centers I have ever delt with before. Giamo Zepp 2 weeks ago Rolling Hills Recovery Center in New Jersey truly stands out for drug and alcohol treatment. The admissions process was smooth, and their team helped verify insurance quickly. RH staff is professional, ethical, and genuinely caring. If you’re looking for quality inpatient treatment in Morris County, I highly recommend them. Chloe Demko 2 weeks ago ⭐⭐⭐⭐⭐ Amazing Recovery Center Rolling Hills Recovery Center truly changed my life. The staff is compassionate, supportive, and genuinely cares about every person who walks through their doors. I was treated with respect, kindness, and understanding from day one. They helped me heal, grow, and believe in myself again. This place doesn’t just treat addiction — they treat people. I’m forever grateful for everything they’ve done for me. Highly recommend to anyone seeking real recovery and real support. 💙 Ashley 2 weeks ago	11 11
Via Dolorosa Recovery Morehead, KY	The purpose of Via Dolorosa is to serve as a beacon of hope and healing for those affected by substance use disorders. Rooted in spiritual principles, we strive to create a nurturing community that supports personal growth.	Treatments Programs AlcoholismDrug AddictionOpioid AddictionSubstance AbuseDual DiagnosisMental Health Adult programProgram for men	Via Dolorosa Recovery has no reviews yet. Leave a review.	11 11

Frequently Asked Questions

Does Medicare Cover Addiction Treatment?

Original Medicare and Medicare Advantage plans generally cover medically necessary mental health and substance abuse treatment. The amount of out-of-pocket costs you pay, such as your copayment, coinsurance, and deductible, may vary depending on your specific plan options.

Different types of treatment are covered by different parts of Original Medicare. For example, Medicare Part A covers hospitalization and, therefore, would be the coverage that applies to inpatient or residential treatment. Medicare Part B covers doctor’s visits and outpatient addiction care. Medicare Part D covers many of the prescription drugs used for mental health and substance use treatment, although coverage may depend on where the medication is administered.

Medicare Advantage plans operate similarly to private insurance. You’ll get at least as much coverage as Original Medicare and often additional benefits as well. You’ll usually have specific copayments instead of paying a percentage of the cost in coinsurance. However, you may need to stay within the plan’s provider network to get coverage, and you may need referrals to visit specialists such as mental health professionals and addiction treatment centers.

What Types of Addiction Treatment are Covered by Medicare?

Original Medicare and Medicare Advantage both cover medically necessary treatment. You can work with your doctor to get a treatment plan showing what levels of care you need and for how long.

Inpatient drug rehab, delivered in a clinic or a hospital, is covered by Medicare Advantage plans or Original Medicare Part A when an inpatient setting is medically necessary. There can be limits on the number of days covered depending on the type of facility, so be sure to check your plan details.

Original Medicare may cover partial hospitalization, or day programs, that are located in a hospital outpatient department or community mental health center if you meet specific requirements. Here, patients attend treatment during the day and return to their homes at night. PHP program sessions often take place for 4-8 hours a day, three to five days a week, and provide at least 20 hours of treatment a week. Day programs typically last for 3-4 weeks, but it can go up to several months.

Original Medicare and Medicare Advantage also cover intensive outpatient substance abuse rehab treatment. Intensive outpatient programs typically involve 9 to 20 hours of treatment per week, with these hours spread over 3 to 5 days. Intensive programs generally last around 90 days and include individual, group, and family counseling, and addiction and relapse prevention education. This category also includes medication assisted treatment (MAT).

Medicare Advantage and Original Medicare Part B cover telehealth visits for substance use disorder and co-occurring mental health disorders along with mental health treatment and behavioral health services. For these services you don’t have to worry about being in a rural medical facility — you can receive them at home.

How Did Medicare Mental Healthcare Change in 2024?

The most significant change to Medicare substance abuse coverage that occurred on January 1, 2024, is the inclusion of additional mental health providers who are now eligible to be reimbursed by Medicare for their services and can therefore be more available to Medicare patients.

Previously only psychiatrists and psychologists along with clinical social workers were Medicare eligible providers. Now licensed professional counselors and mental health counselors along addiction counselors are Medicare eligible. The list also includes marriage and family therapists and alcohol and drug counselors.

This long awaited change makes it possible for many clients who could not afford to pay out of pocket for their treatment to access the services they need. According to the American Counseling Association about 200,000 new mental health counselors will enroll as Medicare providers.

Does Medicare Cover Methadone & Suboxone (MAT)?

Medicare covers opioid use disorder treatment (OUD) services using MAT that includes methadone and buprenorphine (Suboxone) along with naltrexone (Vivitrol). Original Medicare coverage applies and you only pay the Part B deductible when you get the medications and supplies through an approved Opioid Treatment Program (OTP).

If you get your medications and supplies through a different clinic or pharmacy you may need to pay Part B copays and you may need to use a Part D prescription plan to get the medication. Medicare Part A is hospital insurance and will cover MAT during inpatient treatment.

If you have a Medicare Advantage plan you’ll need to check with your insurance company to find in network providers and learn more about your out of pocket costs.

What to Do if Medicare Won’t Cover the Cost of Rehab

Medicare is selective about which programs are covered and some centers may not accept Medicare due to lower payouts. That means you may face a situation where Medicare won’t cover the substance use treatment you’re interested in.

It’s still important to get the care you need. You can look into whether you also qualify for Medicaid, which can allow you to get a Dual Eligible plan that offers more coverage. Another option is to look for a treatment program that has a sliding scale of fees based on income where you can get affordable high quality care.

Some treatment facilities offer scholarships or payment plans that can make it easier to afford care. You may also be able to borrow money from friends and family. The most important thing is that you get the treatment you need to break free from substance use.

Can I Travel Out of State for Treatment With Medicare?

This is an important question because with Original Medicare, the answer is yes you can see any Medicare approved provider. However if you have a Medicare Advantage plan you are often limited to the plan’s medical network.

You can switch from Advantage back to Original Medicare during open enrollment but you’ll need to be sure to buy a Part D drug plan to go with Parts A & B. You’ll also want to be mindful of the changes in out of pocket costs because Medicare charges a percentage coinsurance rather than a set copayment. It’s not necessarily more — although it can be — but it’s definitely different.

Medicare advantage plans can be Health Maintenance Organizations (HMO) or Preferred Provider Organizations (PPO). These plans will have different networks and different rules about whether you can get coverage for out of network care. Communicating with the insurance company is the best way to know if a treatment is covered and what deductibles or copays apply along with what medications are supported and other details.