Does Medicare Cover Alcohol Rehab? 

Many people assume that alcohol abuse only affects younger adults, but in fact, seniors are even more susceptible to alcohol addiction than their younger peers. Seniors are more vulnerable to substance abuse because they are more likely to experience depression, chronic pain, anxiety disorders, loneliness, and other conditions that often accompany older age.  

In the United States, statistics show that close to one million adults over the age of 65 have reported having a substance abuse disorder (mainly with alcohol and/or prescription opioids) within the past year. 

If you are experiencing addiction, contact your doctor immediately. Help is available. Fortunately, seniors and Medicare recipients under the age of 65 have access to addiction rehabilitation and mental health programs where you can get professional counseling and treatment covered by Medicare insurance plans. 

Does Medicare cover alcohol rehabilitation services? 

Original Medicare Part B provides coverage for the following screenings, programs, and services for the treatment of mental health and substance use disorders:

• One annual screening for alcohol misuse for eligible adults who use alcohol but aren’t medically defined as alcohol dependent. Original Medicare Part B pays 100 percent of the screening cost if your health care provider accepts Medicare assignment. 
• Up to four face-to-face counseling sessions annually if your physician finds that you’re misusing alcohol. Original Medicare Part B pays 100 percent of the cost for these counseling sessions if you get them at a medical facility that accepts Medicare assignment. 
• Behavioral health integration services if your Medicare-affiliated physician certifies that you have a behavioral condition like depression or anxiety. You pay a monthly fee for these services, your annual Part B deductible, and coinsurance charges. 
• One annual screening for depression is covered 100 percent by Medicare Part B if the health care provider accepts Medicare assignment and the screening takes place in a primary care setting that also provides follow-up treatments or referrals. 
• Mental health care services as an inpatient, outpatient, partially hospitalized patient, or through intensive outpatient services. Medicare Part A covers inpatient care services and Medicare Part B covers outpatient care services.  
• Telehealth care services (Medicare Part B covers 80 percent of the cost). 

How Medicare Advantage plans help cover alcohol addiction rehab

If you are enrolled in Medicare Advantage (MA), your insurance provider is obligated to cover, at a minimum, all benefits included in Original Medicare Parts A and B. However, depending upon the type of MA plan you’re enrolled in, you may need to visit health care providers or use medical facilities, hospitals, and medical suppliers that are in your plan’s preferred network of providers. 

Today, most MA plans include additional coverage and extra benefits that Original Medicare doesn’t cover. If you aren’t certain about the details of your coverage regarding alcohol rehab services, you should call your provider for more information. 

How Medicare helps cover addiction to other substances

Medicare covers counseling for the prevention of tobacco use and tobacco-related health issues. Medicare Part B covers up to eight counseling sessions during a 12-month period to help patients stop smoking or using tobacco products. Medicare pays 100 percent of the cost for these counseling sessions if they are provided by a health care provider who accepts Medicare assignment.  

Treatment services for opioid use disorder are also included in Medicare benefits. The counseling sessions are covered 100 percent by Medicare Part B if you get them from a qualified opioid treatment program provider who accepts Medicare assignment. Medicare Part B covers its share (80 percent) of the cost of supplies and medications you get during treatment. Medicare Part B recipients must pay 20 percent of the cost after paying the annual Part B deductible.