Does Medicare pay for drug or alcohol detox?

Yes, Medicare will usually pay for drug or alcohol detox, as long as the clinical treatment meets a few important criteria. Keep reading for more information about Medicare for detox here.

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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.

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
About the author
Lee Weber is a published author, medical writer, and woman in long-term recovery from addiction. Her latest book, The Definitive Guide to Addiction Interventions is set to reach university bookstores in early 2019.
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