If you are looking for an alcohol detox that accepts Medicare, it’s essential to understand what Medicare will and won’t cover. We’ll go over that in this article.
What Is Medicare?
Medicare is a federal health insurance program in the United States primarily designed for people aged 65 and older, though it also covers some younger individuals with specific disabilities. Established in 1965, Medicare helps beneficiaries access necessary medical services and is divided into several parts:
- Part A – covers hospital insurance, including inpatient hospital stays, skilled nursing facility care, hospice care, and some home healthcare services.
- Part B – Covers medical insurance, such as doctor visits, outpatient care, preventive services, and medical supplies.
- Part C – Also known as Medicare Advantage, this offers an alternative to traditional Medicare through private insurers, often bundling Parts A, B, and sometimes Part D.
- Part D – Provides prescription drug coverage, helping beneficiaries afford necessary medications.
Most individuals are automatically enrolled in Medicare when they turn 65 and have paid Medicare taxes during their working years.
Does Medicare Cover Alcohol Detox?
Yes, Medicare can be used to treat alcohol addiction, but the specific coverage depends on the type of care required and the Medicare plan.
Here is a breakdown of how Medicare addresses alcohol detox:
Medicare Part A:
- Used mainly in hospitals.
- Covers inpatient detoxification services if medically necessary.
- Includes hospitalization for complications from alcohol use, such as alcohol withdrawal symptoms.
- It covers rooms, meals, nursing, and other hospital services.
- Beneficiaries are responsible for deductibles and coinsurance.
Medicare Part B:
- Covers outpatient detox treatments, including counseling, therapy, and medication management.
- It may cover visits to doctors or specialists to manage withdrawal symptoms or co-occurring mental health conditions.
- Includes partial hospitalization programs (PHPs) if medically necessary.
Medicare Advantage (Part C):
These plans must cover everything that Original Medicare (Parts A and B) covers, but they often include additional benefits, such as expanded mental health and addiction treatment services.
Medicare Part D:
This covers medications prescribed for alcohol detox or treatment, such as drugs to manage withdrawal symptoms or prevent relapse (e.g., naltrexone or disulfiram). Coverage depends on the specific Part D plan formulary.
If you’re considering alcohol detox and have Medicare, consult with your healthcare provider to find an alcohol detox that accepts Medicare.
Is All Addiction Treatment Covered by Medicare?
Coverage depends on the type of Medicare, the type of treatment, and whether the service is deemed medically necessary.
Medicare will cover inpatient and outpatient treatment, as well as medication-assisted treatment.
Importantly, Medicare will not cover holistic therapies luxury rehab centers, because these are considered “not medically necessary”.
Get confidential help from our addiction treatment specialists in Orange County. Call to join our rehab program today!
Call 866-881-1184Other Rules to Know Before Rehab Starts
Before entering rehab, it’s essential to understand the facility’s rules and guidelines to ensure a smooth transition and make the most of the program.
Here are some common rules and considerations to be aware of:
- Personal Belongings: Rehab centers often restrict items like drugs, alcohol, weapons, and certain medications. Personal electronics such as smartphones or laptops may also be limited to reduce distractions.
- Privacy and Confidentiality: While your privacy is protected by law, you are also expected to respect the confidentiality of other participants and avoid sharing their details outside the program.
- Attendance and Participation: Attending all scheduled therapy sessions, group meetings, and activities is mandatory. Skipping sessions or refusing to engage may lead to consequences.
- Abstinence: Rehab facilities enforce a zero-tolerance policy for substance use. Bringing in or using drugs, alcohol, or unauthorized medications may result in dismissal from the program.
- Medications: Prescribed medications must usually be approved by the facility, and medical staff will typically handle and administer them to prevent misuse.
- Visitation Rules: Visitors are allowed only during specific times and often require prior approval. Some programs restrict visitation during the initial stages of treatment to help you focus.
- Relationships and Boundaries: Romantic or sexual relationships with other patients are generally prohibited. Maintaining personal boundaries is essential for a safe and supportive environment.
- Chores and Responsibilities: In residential programs, patients may be assigned small chores to contribute to the community and establish routines. Neglecting these responsibilities can lead to disciplinary action.
- Communication Limitations: Many facilities place restrictions on phone use, internet access, or outside communication, especially early in treatment, to help reduce distractions.
- Financial Considerations: Understand program costs, insurance coverage, and payment plans before starting. Some facilities may require upfront payments for uncovered services.
- Commitment to Recovery: You are expected to stay for the full duration of the program. Leaving early can hinder progress and may forfeit financial investments.
By familiarizing yourself with these rules, you’ll be better prepared to succeed in your rehab program and focus entirely on your recovery.
Looking for quality substance abuse treatment that’s also affordable? South Coast accepts most major insurance providers. Get a free insurance benefits check now.
Check Your CoverageWhat Are the Benefits of Using Medicare for Addiction Treatment?
Using Medicare for addiction treatment offers several advantages, including:
- Reduced Financial Heartache: Addiction treatment can be incredibly expensive, so finding an alcohol detox that accepts Medicare can be a game-changer.
- Encourages Early Treatment: Medicare Part B covers screenings for alcohol and drug use, allowing people to identify issues early without having to worry about out-of-pocket costs.
- Peace of Mind: Insurance ensures that treatment is available when needed, removing a major barrier to seeking help.
Using Medicare or other insurance for addiction treatment not only makes care affordable but also ensures that individuals receive high-quality, evidence-based services that support long-term recovery.
What To Know Before Using Insurance for Rehab
Before using insurance for rehab, it’s important to understand that not all insurance plans provide the same coverage for addiction treatment.
First, there are employer-sponsored plans. These are the most common ways people get health insurance in the US. They typically cover a range of addiction treatments, including inpatient and outpatient, as well as MAT. However, the extent of the coverage will vary by plan and employer.
There are also individual plans, most of which are provided by the Affordable Care Act. Silver, Gold, and Platinum plans may have different out-of-pocket costs and coverage levels.
Those who are unemployed or who cannot afford an ACA plan will typically receive Medicaid. Medicaid provides comprehensive coverage for low-income individuals, including inpatient and outpatient care, medication, and counseling.
Military personnel and veterans have access to TRICARE and VA benefits, which include inpatient and outpatient addiction treatment, often with low out-of-pocket costs.
Finally, there’s Medicare, which covers inpatient and outpatient treatment, MAT, and medications under Parts A, B, and D. However, it may not cover residential rehab unless it is part of a hospital stay.
Alcohol Detox Centers That Accept Medicare
If you or a loved one are seeking an alcohol detox that accepts Medicare, South Coast Behavioral Health is here to help. The first step in treating addiction is a medical detox. This means using drugs to manage withdrawal symptoms.
Our medical detox program in California is staffed by caring and compassionate professionals who can provide you with medications to manage your withdrawal symptoms.
At South Coast, we take pride in offering care that is closely tailored to specific issues. To that end, we offer gender-specific detox programs, with medical detox for men in Irvine, CA, and medical detox for women in Huntington Beach, CA.
After detoxing, proper treatment can begin.
Treatment for substance abuse takes place along an entire spectrum of care. Along that entire spectrum are various behavioral therapies, support groups, and the use of medically-assisted treatment (MAT).
These levels of treatment are, in order, as follows:
Residential Treatment in California
After successfully completing medical detox, you’ll receive inpatient treatment in Orange County, California. There, you’ll receive medically-assisted treatment and dual diagnosis treatment to deal with any cravings or co-occurring mental health issues you may be battling.
We also offer residential treatment facilities in Costa Mesa, Irvine, and Huntington Beach for those who desire gender-specific treatment. There, patients get round-the-clock medical attention and monitoring while living at the institution full-time.
In addition to individual and group counseling and medication management, you’ll also have access to leisure activities and family support services.
Partial Hospitalization in California
Most clients start substance abuse treatment with South Coast in our residential treatment program. After completing that, many desire something that still provides structure and support but with extra space and time to oneself. For that, we offer Partial Hospitalization in Newport Beach.
A step down from inpatient care but with more structure than conventional outpatient programs, partial hospitalization offers a good balance for those looking to ease back into normal life. Clients can receive care five to seven days a week for a number of hours each day, returning back to their homes in the evening.
This way, they can recover without putting their daily lives completely on hold, receiving intense therapeutic interventions like group and individual therapy, skill development, and medication management as necessary.
Intensive Outpatient Treatment in California
For those leaving inpatient residential treatment or partial hospitalization, intensive outpatient programs (IOP) are yet another gradual step forward on the road to recovery.
With a focus on group therapy, individual counseling, and education, clients undergoing Intensive Outpatient Treatment in Newport Beach can meet three to five days a week. Each session lasts three hours.
This level of care requires the least amount of attendance at a facility.
Start Today
If you or a loved one are looking for an alcohol detox that accepts Medicare but has questions, call us at 866-881-1184 or contact us here. The highly qualified staff at our treatment centers will be happy to help give you an idea of what to expect from your addiction recovery timeline, help verify your insurance, and assist with any other questions you may have about our recovery center.
- Facts About Aging and Alcohol | National Institute on Aging
- Treatment for alcoholism and substance use disorder – Medicare Interactive
- Medicare Coverage of Mental Health and Substance Abuse Services – Center for Medicare Advocacy
- Medications for Alcohol Use Disorder | AAFP
- Talk to Someone | Contact Medicare | Medicare
