If you or someone you know is in crisis right now: call or text 988 (Suicide & Crisis Lifeline). For a possible overdose or any medical emergency, call 911. For help finding treatment, the SAMHSA National Helpline is free and open 24/7 at 1-800-662-4357.
The short answer
Yes. Medicare covers addiction treatment at most levels of care: Part A for hospital-based inpatient care, Part B for outpatient services, and Part D for many prescriptions. You still pay deductibles and coinsurance, and Original Medicare has no annual cap on what you can owe.
What each part covers
| Part | What it generally covers for addiction treatment |
|---|---|
| Part A (hospital insurance) | Inpatient care in a hospital, including detox and inpatient treatment when medically necessary |
| Part B (medical insurance) | Outpatient counseling, therapy, intensive outpatient programs, partial hospitalization and opioid treatment programs |
| Part D (prescription drugs) | Many medications, including some used for substance use disorders |
| Medicare Advantage (Part C) | Everything Original Medicare covers, often with networks and extra rules |
Part A: inpatient care
Part A helps pay for substance use treatment when you are admitted to a hospital. In 2026, you owe $1,736 per benefit period before Part A begins paying for a hospital stay. Medicare also has a lifetime limit on inpatient care in psychiatric hospitals, which does not apply to stays in general hospitals. Ask the facility how it affects you. rehabs
Part B: outpatient and day programs
Part B covers individual and group therapy, counseling and other outpatient services. In 2026, you pay a $283 annual Part B deductible and then 20% of the Medicare-approved amount for most outpatient care. rehabs
Intensive outpatient programs (IOP). Part B covers IOP services for mental health conditions, including substance use disorders, if your care plan says you need at least 9 hours of therapeutic services each week, and you pay 20% after the deductible. (See [PHP vs IOP: Partial Hospitalization and Intensive Outpatient Compared].) medicare
Opioid treatment programs (OTPs). Part B covers services at OTPs for opioid use disorder, and you usually will not pay copayments at a participating program that meets Medicare’s requirements. The bundled benefit covers counseling, testing and medications such as methadone and injectable buprenorphine. (See [Medication-Assisted Treatment (MAT): How It Works and Who It’s For].) medicarecoveredusa
Part D: medications
Part D plans, sold by private insurers, generally cover prescription drugs, including many medications for addiction treatment. Prescription drugs are generally not covered by Part A or Part B, so you need a Part D plan for most medications. Plans differ, so check your plan’s formulary. medicaresupplement
What you might pay in 2026
| Item | 2026 cost |
|---|---|
| Part A deductible | $1,736 per benefit period |
| Part B deductible | $283 per year |
| Outpatient therapy, IOP or PHP after the deductible | 20% of the Medicare-approved amount |
| OTP services for opioid use disorder | Often $0 copay at a participating program |
Original Medicare has no annual out-of-pocket cap. Medigap can cover the 20% coinsurance. rehabscoveredusa
Medicare Advantage
Medicare Advantage plans may require referrals or prior authorization for mental health and substance use services. If you have one, check: ritterim
- Whether the program is in your plan’s network
- Whether you need prior authorization
- What your copays are for each level of care
Medicare and Medicaid together
If you qualify for both, Medicaid may cover costs Medicare does not, and many people pay little or nothing for covered services. People eligible for both pay $0 for services received through their state Medicaid program. (See [Does Medicaid Cover Addiction Treatment? How It Works by State].) aol
How to use Medicare for rehab
- Check which parts you have: Original Medicare, Medicare Advantage, Part D or Medigap.
- Ask a doctor for an assessment and a referral if your plan needs one.
- Look for Medicare-participating providers. Ask any program whether it accepts Medicare.
- Confirm what you will owe for each service, including the deductible and 20% coinsurance.
- Ask about prior authorization if you have Medicare Advantage.
- Appeal denials. You have the right to appeal Medicare decisions.
You can also call 1-800-MEDICARE or visit Medicare.gov, and your State Health Insurance Assistance Program (SHIP) offers free counseling.
Alcohol and prescription drug issues in older adults
Older adults often face alcohol use and problems with prescription medications, and symptoms can be mistaken for aging. If you are concerned about yourself or a family member, talk to a doctor. (See [Rehab for Older Adults: Alcohol and Prescription Drug Issues After 60].)
If you are a family member
Help your loved one list their Medicare cards and plans, gather questions and make calls together. Keep copies of any denial letters.
Frequently asked questions
Does Medicare cover rehab?
Yes, at most levels of care, with deductibles and coinsurance.
Does Medicare cover inpatient rehab?
Part A covers hospital-based inpatient care when medically necessary, subject to deductibles and limits.
Does Medicare cover outpatient addiction treatment?
Yes, under Part B, with a 20% coinsurance after the deductible.
Does Medicare cover medication for opioid use disorder?
Yes. Opioid treatment programs are covered under Part B, and other medications may be covered under Part D.
Does Medicare cover intensive outpatient programs?
Yes, if you need at least nine hours of therapy a week and the program meets Medicare’s requirements.
How much will I pay?
The 2026 Part B deductible is $283, then 20% for most services. A Medigap or Medicaid plan may cover some of it.
Sources
- Medicare.gov. Mental Health Care: Intensive Outpatient Program Services. medicare.gov
- CMS. Opioid Treatment Program benefit. cms.gov
- Medicare.gov. Mental health care (inpatient and outpatient). medicare.gov
This article is for general information only and is not legal or financial advice. Medicare costs and rules change each year, so confirm details at Medicare.gov