Does Medicare Cover Rehab?
Medicare covers substance abuse treatment for adults 65+ and those with disabilities. Part A covers inpatient hospital-based treatment. Part B covers outpatient counseling, group therapy, and some MAT medications. Medicare Advantage plans may offer additional behavioral health benefits.
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Yes, Medicare covers addiction treatment. Under the Mental Health Parity Act, Medicare must cover substance use disorder treatment — including Hospital-Based Detox (Part A), Inpatient Rehab in Hospitals (Part A), Outpatient Counseling (Part B), Group Therapy (Part B), and more. 4 plan types accepted. Average out-of-pocket: $0–$5,000. Call (833) 546-3513 for free verification.
What Does Medicare Cover for Addiction Treatment?
Medicare provides coverage for substance use disorder treatment as part of its behavioral health benefits. Under federal law — specifically the Mental Health Parity and Addiction Equity Act (MHPAEA) and the Affordable Care Act — Medicare is required to cover addiction treatment at the same level as other medical conditions.
This means your Medicare plan covers multiple levels of care, from initial detox through long-term outpatient support. The specific costs, referral requirements, and network restrictions depend on your plan type — see the plan comparison below.
At RehabHive, we work with Medicare daily and can verify your specific benefits in under 5 minutes. We will tell you exactly what is covered, what your out-of-pocket costs will be, and which treatment centers near you accept your plan.
Treatment Levels Covered by Medicare
Medicare covers 6 levels of addiction treatment.
Medicare Plan Types & Coverage
Your coverage level depends on your specific Medicare plan.
| Plan | Network Type | Pre-Auth Required | Out-of-Network |
|---|---|---|---|
| Medicare Part A (Hospital) | PPO/Open | Usually | ✓ Yes |
| Medicare Part B (Outpatient) | PPO/Open | Usually | ✓ Yes |
| Medicare Part D (Prescriptions) | PPO/Open | Usually | ✓ Yes |
| Medicare Advantage | PPO/Open | Usually | ✓ Yes |
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What Will You Pay Out-of-Pocket with Medicare?
Typical costs after Medicare coverage is applied.
| Treatment Level | In-Network Cost | Out-of-Network Cost | Typical Duration |
|---|---|---|---|
| Medical Detox | $0–$500 | $500–$2,000 | 3–7 days |
| Inpatient Rehab | $500–$3,000 | $2,000–$10,000 | 28–90 days |
| PHP | $200–$1,500 | $1,000–$5,000 | 4–8 weeks |
| IOP | $100–$1,000 | $500–$3,000 | 8–12 weeks |
| Outpatient | $20–$50/visit | $50–$150/visit | Ongoing |
| MAT | $10–$75/mo | $50–$200/mo | 6–24 months |
* Costs are estimates assuming deductible is met. Actual costs depend on your specific Medicare plan, facility, and location.
Medicare & Rehab: Frequently Asked Questions
Does Medicare cover rehab?
How do I verify my Medicare benefits?
What treatments does Medicare cover?
Does Medicare require pre-authorization?
What Medicare plans cover addiction treatment?
How much does rehab cost with Medicare?
Can I use Medicare for out-of-state rehab?
What if Medicare denies my claim?
Your Rights with Medicare
Mental Health Parity Act
Medicare must cover addiction treatment at the same level as physical health conditions. They cannot impose higher copays, stricter visit limits, or more restrictive pre-authorization for rehab.
Right to Appeal
If Medicare denies your claim, you have the legal right to appeal. Request a written explanation and file a formal appeal. Many denials are overturned — especially with supporting documentation from your treatment provider.
Sources
- U.S. Department of Labor — Mental Health Parity and Addiction Equity Act
- HealthCare.gov — Mental Health & Substance Abuse Coverage
- SAMHSA — National Helpline (1-800-662-4357)
Last updated: March 17, 2026 • Reviewed by RehabHive editorial team
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