Yes. Medicare covers some substance use disorder treatment, including inpatient care, outpatient programs and medication treatment, when it is medically necessary and the provider accepts your Medicare coverage. Which facilities you can use depends on whether you have Original Medicare or a Medicare Advantage plan.
Rehabs That Take Medicare: Where Our Campuses Stand
Original Medicare and Medicare Advantage plans are not on our current contract list. The one Medicare-related contract is for Horizon Blue Cross Blue Shield of New Jersey dual Medicaid and Medicare plans, at our Cherry Hill campus. If you have Medicare plus other coverage, such as an employer or retiree plan, admissions can check whether that other plan is one we take.
Call 855-520-2898 Verify your benefits
Checked against our contract list on September 25, 2026. Plans change; admissions confirms coverage before you travel.
Does Medicare Cover Rehab?
Medicare does cover treatment for substance use disorders, and the coverage is spread across three parts. Part A pays for care you get as a hospital inpatient [1]. Part B pays for outpatient services, including partial hospitalization and intensive outpatient program services [2]. Part D covers certain prescription drugs [3]. What any individual plan pays still has to be checked against that plan.
This page explains how the three parts fit together for addiction treatment. It covers the difference between hospital detox and residential rehab under Medicare, how outpatient tiers are paid for, and how medication for opioid use disorder is handled. It also covers Medicare Advantage networks, what Medicare will not pay for, and how Medicare works alongside a supplement or Medicaid. Start by getting your benefits checked. You can verify your insurance before you call. Our page on insurance coverage for rehab explains the terms you will hear.
Medicare Part A, Part B and Part D in substance use treatment
Each part does a different job. Knowing which is which saves a lot of confusion on the phone.
Part A is hospital insurance. It covers mental health care services you receive when you are admitted as a hospital inpatient [1]. If your treatment involves a hospital admission, Part A is the part that applies.
Part B is medical insurance. It covers a wide range of outpatient mental health services [2]. Its list explicitly includes partial hospitalization and intensive outpatient program services [2]. It also names mental health services delivered as part of substance use disorder treatment, and medications used for substance use disorder [2]. Part B covers the services a doctor provides while you are a hospital inpatient too [1].
Part D is drug coverage. Medicare says Part D may cover buprenorphine and naltrexone [3]. It may also cover drugs that rapidly reverse an opioid overdose, such as nalmefene and naloxone [3]. Medicare tells people to contact their plan for details [3]. That instruction is the important part: Part D formularies differ by plan.
Inpatient hospital detox vs residential rehab under Medicare
This is where most confusion sits. Medicare pays for inpatient care in a hospital. It is not written around the residential rehab model that private plans often cover.
Under Part A, what you pay is organized by benefit period rather than by calendar year, and it changes as a stay lengthens [1]. Medicare describes tiers for days 1 to 60, days 61 to 90, and days 91 to 150, with the last band drawing on 60 lifetime reserve days [1]. After day 150 in a benefit period, you pay all costs [1].
There is a separate limit worth knowing before anyone plans a long admission. Medicare says these inpatient services can be delivered either in a general hospital or in a psychiatric hospital, which it defines as a facility that only cares for people with mental health disorders [1]. If you are in a psychiatric hospital rather than a general hospital, Part A pays for up to 190 days of inpatient psychiatric hospital services during your lifetime [1]. So the facility type is a question to ask on the admissions call, not a detail to discover later.
One more Part A cost catches people out because it is not part of the benefit-period table. On top of those amounts you also pay 20% of the Medicare-approved amount for mental health services you get from providers while you are a hospital inpatient [1]. That is the physician side of the bill rather than the facility side, and on a long stay it adds up.
Medical detox itself is withdrawal care under supervision, and where it happens decides which part pays. Our page on medical detox explains the clinical side, and our page on inpatient rehab covers the residential tier. If a residential program is not a hospital admission, ask specifically how it will be billed before you accept a bed.
If someone is having a seizure, is unresponsive or has trouble breathing, call 911. For a mental health crisis, call or text 988.
Treatment options in Florida
The Recovery Village Umatilla is in Umatilla, Florida, and its own page publishes medical detox, residential inpatient rehab, inpatient mental health care, a partial hospitalization program, outpatient care and aftercare planning; anything you do not see named there is a question for the admissions call. Having the tiers on one campus means a benefits review at each step stays inside one organization rather than restarting somewhere new.
See treatment options in Florida
Verify your insurance
The Recovery Village Umatilla is part of our family of treatment centers. See The Recovery Village Umatilla campus page.
Outpatient, PHP and IOP coverage
Part B is where most addiction treatment sits, and its coverage list is unusually explicit. Medicare names partial hospitalization and intensive outpatient program services directly among covered outpatient mental health services [2]. It also names mental health services provided as part of substance use disorder treatment, and medications used for substance use disorder [2].
Part B also covers individual and group psychotherapy [2]. It covers family counseling where the main purpose is to help your treatment [2]. Psychiatric evaluation, medication management and diagnostic testing are on the list as well [2]. So are safety planning interventions for people at risk of suicide or overdose [2]. So is a follow-up call after discharge from an emergency department following a behavioral health crisis [2].
Provider type matters under Part B. Medicare lists psychiatrists and other doctors, clinical psychologists and clinical social workers [2]. It also lists clinical nurse specialists, nurse practitioners and physician assistants [2]. Marriage and family therapists and mental health counselors are included too [2]. If a program’s clinicians fall outside those categories, the billing question changes.
Costs follow the usual Part B pattern. You meet a deductible first. After that you pay a percentage of the Medicare-approved amount [2]. There may be an extra charge if the service is delivered in a hospital outpatient department [2]. Our pages on levels of care and outpatient rehab describe what each tier involves.
Medication-assisted treatment and Part D
Medicare covers medications for opioid use disorder, and it covers them under more than one part [3]. Which part applies depends on where you receive the medication.
Part A covers methadone, buprenorphine and naltrexone when you receive them as a hospital inpatient [3]. Part B covers the same three medications when you get them in a doctor’s office or through an opioid treatment program enrolled with Medicare [3]. Part B also covers nalmefene and naloxone to reverse an opioid overdose [3]. Part D may cover buprenorphine, naltrexone and the overdose-reversal drugs, depending on the plan [3].
Counseling, therapy and periodic assessments alongside those medications are covered too [3]. They can be delivered in person and, in some circumstances, by video [3]. Medicare also allows some assessments by audio only [3]. That matters for people in rural areas.
Which medication, if any, is right for a person is a prescriber’s decision made in person. This page gives no doses and no comparisons. Our page on medication-assisted treatment explains how prescribing and counseling run together.
Medicare Advantage plans and network rules
Medicare Advantage is Part C, and it changes the rules of the game. Medicare describes these plans as health plans that provide Part A and Part B benefits and are generally offered by private companies that contract with Medicare [4].
Because a private company administers the plan, that company sets the network and the authorization process. So there are three questions to ask before admission. Is the program in network. Is prior authorization required. How often will the plan review the stay.
An out-of-network admission is not automatically refused. It is a different financial conversation, and it should happen before you arrive rather than after. Our page on how much rehab costs covers deductibles, coinsurance and authorization.
You may be comparing commercial coverage instead. Our pages on Aetna rehab coverage, Cigna rehab coverage and Humana rehab coverage set out the same questions for those plans.
What Medicare does not pay for
Medicare is specific about some exclusions, and they catch people out. For an inpatient stay, Medicare says it does not cover private duty nursing [1]. It does not cover a phone or television in your room where there is a separate charge [1]. Personal items such as toothpaste, socks or razors are excluded, and so is a private room unless it is medically necessary [1].
The bigger exclusions are structural rather than itemized. On opioid use disorder specifically, Medicare says people diagnosed with it can get treatment services for as long as it is reasonable and necessary [3]. That phrasing is the tell: duration is a clinical judgment the record has to support, which is why documentation drives how long an authorization runs.
Medicare also gives a warning worth reading twice. A provider may recommend services Medicare does not cover, or recommend them more often than Medicare allows, and that can leave you with extra costs [1]. Asking what is billable before you agree is a reasonable thing to do.
None of this means a stay is unaffordable. It means the coverage question has to be answered plan by plan, before admission rather than during it.
Coordinating Medicare with a supplement or Medicaid
Original Medicare leaves a share of costs with you, and there are two common ways people close that gap.
The first is a Medicare Supplement policy, also called Medigap. Medicare describes it as extra insurance bought from a private company [5]. It helps pay your share of out-of-pocket costs in Original Medicare, such as copayments, coinsurance and deductibles [5]. Generally you must have both Part A and Part B to buy one [5]. Ask the insurer how a policy sits alongside the rest of your coverage before you buy it.
The second is Medicaid, for people who qualify for both programs. Coordination rules vary by state, so this is a question for your state Medicaid office as well as the program’s admissions team.
One nuance is worth naming. Federal parity rules are written for employer and individual-market health plans. Under the Mental Health Parity and Addiction Equity Act, a plan that covers mental health and substance use care may not apply harsher limits to it than it applies to medical and surgical care, and that reaches prior authorization and step therapy as well as visit and day caps [6]. The regulation implementing it applies to non-federal governmental plans with more than 50 employees, to group health plans of private employers with more than 50 employees, and to individual-market coverage [6]. Small-employer group plans are generally outside it, although non-grandfathered small-group and individual plans must cover mental health and substance use disorder services as an essential health benefit under the Affordable Care Act [6]. Original Medicare is not the setting those rules were written for. Do not assume a parity argument will move a Medicare coverage decision.
Verifying Medicare benefits before admission
Verification is a short call and it prevents the expensive version of this problem. Have your Medicare card, any supplement or Advantage plan card, and your Part D plan details in front of you.
Ask four things. Which part will pay for this level of care. Whether prior authorization is needed. How many days or sessions are authorized at a time. And whether the program is in network, if you hold an Advantage plan.
Our admissions teams run that verification for you as part of the assessment, and the answer usually comes back the same day. Our page on how to get into rehab covers where verification sits in the wider admissions sequence.
If you are looking beyond our campuses, you can also search the federal locator at FindTreatment.gov. Our own directory of rehab facilities lists the campuses in our family under their states, and our state-by-state rehab directory starts from where you live. If work is the obstacle rather than the money, our page on going to rehab and keeping your job covers leave and disclosure.
Frequently Asked Questions
Does Medicare cover drug and alcohol rehab? Yes, across more than one part. Part A covers mental health care you receive as a hospital inpatient. Part B covers outpatient services, and its list names partial hospitalization, intensive outpatient program services and mental health services delivered as part of substance use disorder treatment. Part D covers certain medications. What your own plan pays still has to be verified before admission.
Does Medicare cover medical detox? Withdrawal care is covered, but which part pays depends on the setting. If detox happens during a hospital admission, Part A applies. If it is delivered on an outpatient basis, Part B applies. Because that distinction changes both the authorization and your share of the cost, ask the program to confirm how your detox will be billed before you are admitted.
How many days of residential treatment will Medicare authorize? There is no single answer. Part A costs are organized by benefit period, with tiers at days 1 to 60, 61 to 90, and 91 to 150 using lifetime reserve days. A separate lifetime cap of 190 days applies to inpatient care in a psychiatric hospital rather than a general hospital. For opioid use disorder, Medicare says treatment services are covered for as long as it is reasonable and necessary, so the clinical record is what sets the length.
What if our campus is out of network for my Medicare plan? That applies mainly to Medicare Advantage, which is administered by private companies that set their own networks. An out-of-network admission is not automatically refused, but your share of the cost is usually different and prior authorization may still be required. Ask the admissions team to check network status and authorization at the same time, before you travel.
How do I verify my Medicare benefits? Have your Medicare card, any Advantage or supplement plan details, and your Part D plan to hand. Then ask four questions. Which part pays for the level of care you need. Whether prior authorization is required. How many days are approved at a time. And whether the program is in network. Our admissions team runs this check during the assessment.
Sources
- Centers for Medicare & Medicaid Services. Mental Health Care (Inpatient) Coverage. Medicare.gov. https://www.medicare.gov/coverage/mental-health-care-inpatient
- Centers for Medicare & Medicaid Services. Outpatient Mental Health Coverage. Medicare.gov. https://www.medicare.gov/coverage/mental-health-care-outpatient
- Centers for Medicare & Medicaid Services. Opioid Use Disorder Treatment Coverage. Medicare.gov. https://www.medicare.gov/coverage/opioid-use-disorder-treatment-services
- Centers for Medicare & Medicaid Services. Medicare Advantage and Other Health Plans. Medicare.gov. https://www.medicare.gov/health-drug-plans/health-plans
- Centers for Medicare & Medicaid Services. What’s Medicare Supplement Insurance (Medigap)?. Medicare.gov. https://www.medicare.gov/health-drug-plans/medigap
- Centers for Medicare & Medicaid Services. The Mental Health Parity and Addiction Equity Act (MHPAEA). U.S. Department of Health and Human Services. https://www.cms.gov/marketplace/private-health-insurance/mental-health-parity-addiction-equity
This page is for general information and is not medical advice. Only a licensed clinician who knows your history can tell you what is right for you. If you or someone you know is in immediate danger, call 911. For free, confidential support 24/7, call or text 988.
Author
Chief Medical Officer,
The Recovery Village
