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Does Medicare pay for drug or alcohol detox?

Insurance

Drug and alcohol addiction is one of the most common mental health problems in the country. Even elderly and disabled individuals can suffer from a substance abuse problem. Fortunately, Medicare, a government health insurance program for senior citizens and the disabled, will often pay for addiction treatment services, including drug or alcohol detox.  We review Medicare benefits for detox here and invite your questions about drug or alcohol detox at the end.

Does Medicare cover drug or alcohol detox?

Yes, Medicare can cover the costs of drug or alcohol detox.  In fact, drug or alcohol detox generally falls under the broad category of “Mental Health Services”. Therefore, Medicare covers drug or alcohol rehab (in most cases).

There are a few stipulations you should be aware of when using Medicare to cover the cost of detox. For instance:

  • Medicare Part A will only cover inpatient services such as inpatient detox
  • Separate detox clinics may also not be covered by Medicare
  • Individuals on Medicare will usually need to undergo detox in an approved general or psychiatric hospital

Medicare coverage for drug or alcohol detox

So how do you get Medicare coverage for drug or alcohol detox? Many individuals are automatically enrolled in Medicare. This usually happens when a person is receiving Social Security benefits and just before they turn 65 years old. If you don’t receive your Medicare cards by the time you turn 65 years old, you may need to enrol in Medicare during the proper enrolment period. You may also be eligible for Medicare if you’re receiving Social Security disability benefits as well.

Individuals can enrol in Medicare a couple of different ways. First, they can enrol online through the Social Security Administration website at SSA.gov. They can also visit their local Social Security office. Social Security professionals can also usually help Medicare recipients find facilities that accept Medicare coverage for drug or alcohol treatment. The Substance Abuse and Mental Health Services Administration website also has a substance abuse treatment facility locator. This tool can be used to search for local facilities that offer detox services and accept Medicare.

Medicare for drug and alcohol detox questions

Understanding Medicare and its benefits isn’t always an easy thing to do. Keep in mind, though, that the professionals in the Social Security Administration will be willing to help you make sense of this confusing time. The same is usually true for substance abuse treatment facilities.

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If you have any other questions about Medicare for drug or alcohol detox, you can also leave them in the comments section below. We look forward to addressing every one of your questions and concerns, in hopes that you’ll be well on your way toward overcoming a substance abuse problem.
Reference Sources: Treatment USA: How Do I Find an Alcohol Detox That Accepts Medicare
CMS.gov: National Coverage Determination (NCD) for Inpatient Hospital Stays for Treatment of Alcoholism (130.1)
US GAO: Health Care:Payment for Inpatient Alcoholism Detoxification and Rehabilitation Services Under Medicare Needs Attention
DHS Wisconsin: Alcohol Detoxification Services in Psychiatric Hospitals
Medicare

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17 Responses to “Does Medicare pay for drug or alcohol detox?
Chris S.
1:45 am November 4th, 2014

After doing some previous research on both the issues of substance abuse in the United States and our overall healthcare policies and practices, I found this blog to be really assuring. I had no idea that Medicare would cover treatment for substance abuse, and I only assumed this due to all the news about federal cuts to programs like this. I think because there is such a negative social stigma attached to substance abuse people do not want to address this problem, but its good to see that people can get help and assistance through inpatient treatment facilities. Substance Abuse is a serious medical condition, and should be treated as one. This policy is definitely a step in the right direction!
-Chris S.
Miami University

3:39 pm November 7th, 2014

Thank you for your feedback, Chris.

KC
10:59 pm July 22nd, 2015

My Dad is currently in an inpatient addiction recovery rehab and he has what they are calling Medicare connect which he has his own insurance and also medicare, but they are saying they have to call every 3 or 4 days to get him more time there. He has only stayed there for about 10 days now and they are saying that it is going to run out at the end of 14 days. I feel like this might not be true and they are trying to get out of treating him for the time he needs in rehabilitation. Can you please provide me with some resources that might help clear this up for me?

Thanks KC

1:15 pm August 24th, 2015

Hello KC. For specific billing questions and questions about your claims, medical records, or expenses call 1-800-MEDICARE (or 1-800-633-4227). Also, call the health insurance provider to speak with them and check what services does your father’s insurance plan cover. If Medicare and the health insurance don’t cover certain costs, you may need to pay some amount cash, though.

larry
7:29 pm December 5th, 2015

I have a 34 yr old friend who is a long term crack addict. She very much desires to enter a long term rehab and realizes any thing less will not work for her. With limited employment over the years and no income source would she qualify for and state or federal disability programs. To help pay for treatment. She is very motivated and if allowed to have the chance to recover would be a productive asset to her community without a doubt.

Lydia @ Addiction Blog
1:11 pm December 9th, 2015

Hello, Larry. I suggest you call the helpline number displayed on our site to get in touch with our trusted treatment providers who can help your friend access adequate treatment program.

Brian
2:19 pm January 17th, 2016

If I just got out of a detox do I have to wait to go to another one?

Spenceri
6:52 am March 29th, 2016

I have no money but Medicare insurance is there a detox I can get into

Lydia @ Addiction Blog
1:57 pm March 29th, 2016

Hi Spenceri. You may start your search here:
https://findtreatment.samhsa.gov/TreatmentLocator/faces/servicesSearch.jspx

Also, I’d suggest you call the number on our site to talk with a trusted treatment consultant who can help you find a treatment program that fits your needs.

Keith
9:40 pm April 6th, 2016

I live in Orange County, CA. I have been on Percocet and Morphine Contin for about 9 years now. The miracle of my pain going away is GREAT but now I am stuck addicted on these opiods. I have tried to wean myself off of them but I think I need to be in an inpatient setting to detox. I hate taking them and the whole situation is making me depressed. What can I do? I have Medicare and Tricare for Life

Lydia @ Addiction Blog
3:17 pm April 7th, 2016

Hi Keith. Why don’t you call the number you see on the website to speak with a trusted treatment consultant who can help you find a program that fits your needs.

Lois
8:17 pm May 9th, 2016

Need help with alcohol detox,have medicare and disability through state and molina Healthcare as secondary

Lydia @ Addiction Blog
6:00 pm May 11th, 2016

Hi Lois. I’d suggest you call the number on our site to talk with a trusted treatment consultant who can help you find a treatment program that fits your needs.

Luis
1:04 am July 26th, 2016

I’ve got Medicare and State of Florida Gold Card Medicade with Humana part D… Need an alcohol Detox Center in Florida

thanks

Lydia @ Addiction Blog
2:46 pm July 29th, 2016

Hi Luis. I suggest to start your search on SAMHSA’s treatment locator here:
https://findtreatment.samhsa.gov/TreatmentLocator/faces/servicesSearch.jspx

Also, you may call the helpline displayed on the website to speak with a trusted treatment consultant.

Susan
8:53 pm September 16th, 2016

I have a long-term history of alcohol abuse, and in need of an inpatient facility that accepts medicare. Thank you

Lydia @ Addiction Blog
5:35 pm September 20th, 2016

Hi Susan. Call the number you see on the website to get in touch with a trusted treatment consultant who can help you find a treatment program that fits your needs. Or, you may search on the SAMHSA’s treatment locator:
https://findtreatment.samhsa.gov/locator?sAddr=&submit=Go

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