Does Medicare Cover Drug Rehab?

Medicare covers addiction treatment for Americans 65 and older and qualifying individuals with disabilities. Coverage spans Parts A, B, and D — each covering different aspects of addiction care. While Medicare's SUD coverage has historically been more limited than Medicaid, it has expanded significantly in recent years — especially for MAT medications and outpatient services.

The 2020 Medicare Opioid Treatment Program (OTP) benefit was a landmark expansion — Medicare now covers methadone treatment at licensed OTPs under a monthly bundled payment. Medicare Part D covers buprenorphine (Suboxone) prescriptions, and Part B covers outpatient therapy, PHP, and IOP. Medicare Advantage (Part C) plans from carriers like Humana, UnitedHealthcare, and WellCare often provide even broader addiction treatment benefits than Original Medicare.

Medicare Part A — Inpatient Drug Rehab Coverage

Medicare Part A covers inpatient hospital care including medically supervised alcohol and drug detox. When admitted to a hospital for detox or a psychiatric facility for SUD treatment, Part A covers the stay after your deductible ($1,632 per benefit period in 2024). After 60 days in a benefit period, daily copays apply ($408/day days 61–90).

For freestanding psychiatric hospital stays, Medicare Part A covers up to 190 days over your lifetime. There is no lifetime limit for psychiatric units within general hospitals — which is where most inpatient SUD treatment occurs. For most people seeking addiction treatment, the 190-day limit is not a concern.

Medicare Part B — Outpatient Addiction Treatment

Part B covers the majority of outpatient addiction services:

• Partial Hospitalization (PHP) — 30+ hours/week structured treatment covered as medically necessary outpatient care
• Intensive Outpatient (IOP) — 9–19 hours/week covered under Part B
• Individual and group therapy — Sessions with psychiatrists, psychologists, licensed clinical social workers
• Annual alcohol misuse screening and counseling — Covered at $0 for Medicare members with a primary care doctor

You pay 20% coinsurance after your annual deductible ($240 in 2024). Once you hit your out-of-pocket maximum, Medicare covers 100%.

Medicare Part D — MAT Medication Coverage

Part D covers prescription medications including MAT medications for opioid use disorder:

• Buprenorphine (Suboxone, Subutex, Zubsolv, Sublocade): Covered under Part D plans. Copay typically $10–$75/month for generic buprenorphine depending on plan tier.
• Naltrexone (oral tablet): Covered under Part D pharmacy benefits.
• Vivitrol (injectable naltrexone): Often covered under Part B as a medical benefit rather than Part D.

The Medicare OTP Benefit — Methadone Covered Since 2020

In January 2020, CMS introduced the Medicare Opioid Treatment Program (OTP) benefit — the first time Medicare covered methadone treatment. The monthly bundled payment covers: methadone dispensing, take-home medication, individual and group counseling, toxicology testing, and other ancillary services. This means eligible Medicare members no longer pay out-of-pocket for OTP methadone treatment. Learn more at the CMS OTP resource center.

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How to Access Medicare Addiction Treatment Benefits

Medicare is available to US citizens or permanent residents age 65+ who have paid Medicare taxes for at least 10 years (40 quarters). Younger individuals with qualifying disabilities who have received SSDI for 24 months, those with End-Stage Renal Disease (ESRD), or ALS also qualify automatically.

Enroll through the Social Security Administration at ssa.gov. If you're already on Medicare and need addiction treatment, call (844) 561-0606 — our specialists verify your exact Medicare benefits and identify Medicare-accepted accredited treatment programs in your area at no cost.