Yes. Medicare covers addiction treatment, including outpatient substance use disorder services, counseling, and Medication-Assisted Treatment (MAT). If you are 65 or older, or qualify for Medicare due to a disability, you have access to behavioral health benefits that can help cover the cost of treatment at Heartfelt Recovery Centers in Hudson, NH.
Medicare coverage for addiction treatment is primarily provided under Medicare Part B (outpatient services), with some inpatient coverage available under Part A. Medicare Advantage plans may offer additional behavioral health benefits beyond Original Medicare.
What Does Medicare Cover for Addiction Treatment?
Original Medicare (Parts A and B) covers the following addiction-related services:
- Outpatient counseling and therapy sessions (Part B)
- Intensive Outpatient Program (IOP), covered as outpatient mental health services under Part B
- Medication-Assisted Treatment (MAT) including Suboxone and other FDA-approved medications
- Screening for alcohol and substance use disorders
- Annual wellness visit with depression screening
Medicare Part B typically covers 80% of approved outpatient behavioral health costs after your deductible is met. You are responsible for the remaining 20% unless you have supplemental coverage (Medigap).
Does Medicare Cover IOP?
Yes. Medicare Part B covers Intensive Outpatient Programs for substance use disorders. As of recent CMS rule changes, Medicare has expanded IOP coverage to include a broader range of outpatient addiction treatment services. IOP is covered when it is medically necessary, as established by a clinical assessment.
At Heartfelt Recovery Centers, our admissions team will verify your Medicare benefits and confirm IOP coverage before you begin treatment. We will also clarify your cost-sharing responsibility so there are no surprises.
Does Medicare Cover Drug Rehab?
Yes. Medicare covers outpatient drug treatment programs when services are medically necessary and provided by Medicare-certified providers. Heartfelt Recovery Centers works with Medicare to cover outpatient addiction treatment including IOP, individual therapy, group therapy, and MAT for eligible members.
Medicare Advantage and Addiction Treatment
If you have a Medicare Advantage plan (Medicare Part C) through a private insurer such as Humana, Aetna, or UnitedHealthcare, your addiction treatment benefits are managed by that plan. Medicare Advantage plans must cover at least the same services as Original Medicare, and many offer enhanced behavioral health benefits.
If you have Medicare Advantage, Heartfelt’s team will verify your plan’s specific benefits and confirm coverage for our services.
Frequently Asked Questions
Does Medicare cover IOP for addiction treatment?
Yes. Medicare Part B covers IOP for substance use disorders when treatment is medically necessary. Coverage is provided at 80% of the Medicare-approved amount after your Part B deductible. Our team will verify your specific Medicare benefits before treatment begins.
Does Medicare cover outpatient drug rehab?
Yes. Medicare Part B covers outpatient drug treatment including counseling, group therapy, and Medication-Assisted Treatment when provided by eligible providers. Heartfelt Recovery Centers will verify your Medicare coverage as part of our admissions process.
What is my cost for addiction treatment with Medicare?
Under Original Medicare Part B, you typically pay 20% of approved costs after your annual deductible. If you have a Medigap supplement policy, it may cover some or all of the remaining 20%. Contact our admissions team to get a clear picture of your specific costs.
Ready to Verify Your Coverage?
Contact Heartfelt Recovery Centers today. Our admissions team will verify your insurance benefits, explain your costs, and handle prior authorization, before you commit to anything.
Call: (603) 207-1633
Online: Verify Insurance online at Heartfelt Recovery Centers
