Mental illness and substance abuse disorders are covered by Medicare, but special rules limit coverage and reimbursement. Mental health, behavioral health, and substance abuse disorders are not as well covered by Medicare as other services.
Treatment for Alcoholism and Substance Use Disorders
Alcoholism and substance use disorders can be treated both inpatient and outpatient under Medicare. Individuals will pay the same co-pays for inpatient substance abuse treatment that they would for any other inpatient hospitalization. Furthermore, Medicare Part B pays for outpatient substance abuse treatment provided by a clinic or hospital outpatient department.
Items and services covered for the treatment of alcoholism and substance abuse disorders include:
– Psychotherapy
– Patient education regarding diagnosis and treatment
– Post-hospitalization follow-up
– Out-patient prescription drugs though Medicare Part D
– Inpatient prescription drugs including Methadone
– Structured Assessment and Brief Intervention (SBIRT)