Does Medicare cover addiction treatment?

What addiction treatment does Medicare cover?

Medicare covers certain screenings, services and programs that aid in the treatment and recovery of mental health and substance use disorders, across inpatient and outpatient care:

• Part A: services you get when you're admitted to a general or psychiatric hospital as an inpatient
• Part B: inpatient services you get from a doctor or other health care provider while you're in the hospital
• Part B: outpatient services you usually get outside a hospital, like in a doctor's office or community mental health center, including outpatient services you get as part of substance use disorder treatment
• Part B: intensive outpatient program services at a hospital, community mental health center, Federally Qualified Health Center, Rural Health Clinic or Opioid Treatment Program
• Part B: partial hospitalization services through a hospital outpatient department or community mental health center, if you meet certain requirements
• Part B: medications used for substance use disorder

What does Medicare cover for opioid use disorder?

Medicare covers medications to help stop or reduce opioid use, including methadone, buprenorphine and naltrexone, and medications to rapidly reverse the effects of an opioid overdose, including nalmefene and naloxone. Part A covers methadone, buprenorphine and naltrexone when you get them as a hospital inpatient, and Part B covers them in a doctor's office or through an Opioid Treatment Program. Medicare drug coverage (Part D) may cover buprenorphine, naltrexone and overdose reversal drugs; contact your plan for more information.

Opioid Treatment Programs, including mobile opioid treatment units, must be enrolled in Medicare. Their Medicare-covered services include:

• Medications for opioid use disorder, like methadone, buprenorphine and naltrexone
• Medications to reverse the effects of an opioid overdose, like naloxone and nalmefene, and overdose education
• Preparation and help taking medications that are part of your recovery process
• Drug testing
• Substance use counseling, and individual and group therapy
• Intake activities and other periodic assessments
• Coordinated care and referral services
• Peer recovery support services
• Intensive outpatient services

What do I pay for addiction treatment with Medicare?

If you get opioid use disorder services from an Opioid Treatment Program that's enrolled in Medicare and meets other requirements, you won't have to pay any copayments, but the Part B deductible ($283 in 2026) applies, including for supplies and medications you get as part of treatment. If you get these services from a doctor or other health care provider, you pay copayments and the Part B deductible. If you have both Medicare and Medicaid, you pay nothing for the services you get through your state Medicaid program.

For other outpatient mental health and substance use visits, you pay 20% of the Medicare-approved amount after the Part B deductible. For an inpatient hospital stay, the Part A deductible is $1,736 for each benefit period in 2026; see what Medicare pays for inpatient mental health care.

Can I get addiction treatment through telehealth?

In some cases, yes. Medicare covers opioid use disorder counseling, therapy and periodic assessments in person and, in certain circumstances, by audio and video communication, like your phone or a computer, and Medicare may also cover periodic assessments that use audio-only communication. You may be able to start buprenorphine treatment without an in-person exam if your provider can adequately evaluate you by audio and video or audio-only, but you may need an in-person exam if you need other medications.

Does Medicare cover alcohol and tobacco screening and counseling?

Yes. Medicare Part B covers these preventive services:

• An alcohol misuse screening once a year for adults who use alcohol but don't meet the medical conditions for alcohol dependency. If your provider determines you're misusing alcohol, you can get up to 4 brief, face-to-face counseling sessions each year in a primary care setting. You pay nothing if your provider accepts assignment.
• Counseling to stop smoking or using tobacco: up to 8 sessions in a 12-month period, and you pay nothing if your provider accepts assignment.
• A review of your potential risk factors for substance use disorder, with a referral for treatment if needed, at the "Welcome to Medicare" preventive visit and the yearly "Wellness" visit.

Does Medicare Advantage cover addiction treatment?

Medicare Advantage Plans must cover all Medicare-covered Opioid Treatment Program services, but they may require you to go to an in-network Opioid Treatment Program. If you join a Medicare Advantage Plan while you're already getting treatment, your Opioid Treatment Program must participate in both Medicare and your plan for your treatment to stay covered and uninterrupted; if not, you may have to switch programs. Medicare Advantage Plans can apply copayments to Opioid Treatment Program services, so check with your plan about what you pay.