• You receive services from a Medicare-participating provider or facility;
• Your doctor states that the services are medically necessary; and
• Your doctor sets up your plan of treatment.

Inpatient care:

Medicare Part A helps pay for your care if you are hospitalized for substance abuse treatment. Your out-of-pocket costs are the same as for any other type of hospital stay.

To find out more about your how much you pay for hospital care and other Part A services, click on the link in the GO TO box.

Outpatient care:

Medicare Part B helps pay for outpatient substance abuse treatment services from a clinic or hospital outpatient department.

Medicare will pay 55 percent of its approved amount for mental health services, and you or your supplemental insurance are responsible for the rest.

To find out more about Medicare’s coverage of outpatient mental health services, click on the links in the GO TO box.

Covered services include, but are not limited to:

• Psychotherapy
• Patient education regarding diagnosis and treatment
• Post-hospitalization follow-up
• Prescription drugs administered during a hospital stay or injected at a doctor’s office
  • Methadone, because it is in pill form, is not generally covered by Medicare Part B. The new Medicare drug benefit (Part D) will not cover methadone for substance abuse treatment, although it may covered for other conditions.