Alcoholism is a disease that takes its toll on way too many people in our country.
Not just those addicted to alcohol, but to their family, friends and co-workers. It is also an extremely hard disease to treat. Getting someone to admit they have a problem is the first step. Getting them into a treatment program comes next.
If you or a loved one are ready for an alcohol rehab program, a common question many people have is, “Does Medicare cover Alcohol Rehab?” In this article, we answer that question in clear, plain English. You will also find the average costs of alcohol rehabilitation and other helpful info.
Does Medicare Cover Alcohol Rehab?
The short answer is yes; Medicare will cover the cost of alcohol rehab. But not 100% of the time. As is often the case with Medicare, certain conditions have to be met in order for Medicare to pay for your alcohol rehab. Below we look at what these are so you know what to expect.
Original Medicare (Medicare Part A and Part B) provides coverage for alcohol rehab costs. Medicare Part A covers inpatient care that you may receive in a rehabilitation center or hospital. Medicare Part A will cover services related to alcohol and drug rehabilitation which includes:
- Inpatient hospitalization
- Inpatient drug rehabilitation services
- The care given by the nurses and doctors
- Medications that are necessary to treat your drug addiction and substance abuse while you are an inpatient
If an inpatient stay lasts longer than 60 days, then after day 60 you will pay an additional $352 per day in coinsurance. If your inpatient stay lasts longer than 90 days, you will pay $704 per “lifetime reserve day.”
Part B Coverage
Medicare Part B covers drug and alcohol rehabilitation that takes place in an outpatient setting. Services related to drug and alcohol rehab that Medicare Part B covers include:
- Mental health counseling
- Alcohol misuse screenings
- Individual or group therapy
- Certain prescription drugs
- Intensive outpatient drug rehabilitation
- Outpatient hospital services
- Partial hospitalization
Medicare Part B may also cover Screening, Brief Intervention, and Referral to Treatment (SBIRT). SBIRT is a screening and intervention technique to determine who is or may be at risk of developing a drug and/or alcohol addiction.
Medicare Part B covers 80 percent of the cost of alcohol rehabilitation services.
Medicare Advantage plans (Medicare Part C) also provide coverage for alcohol rehabilitation. They cover everything Original Medicare covers as well as offer some additional benefits. However, out-of-pocket costs will vary depending on the specifics of your plan.
How Much Does Alcohol Rehabilitation Cost?
Outpatient alcohol rehabilitation programs cost $2,400 on average. Some programs may have a higher cost than that. Private rehabilitation programs can cost $17,000 per month.
Some high-end luxury alcohol rehabilitation programs may cost from $26,000 to $100,000 per month. But most of the time those high-end luxury alcohol rehabilitation programs are for high-profile patients such as celebrities or executives.
Many factors may affect the cost of alcohol rehabilitation programs. Some of the main ones is the type of program, the length of the treatment and the types of treatments.
Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage and Medigap plans. Always be sure to double check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.
Additional Info on Medicare Coverage
This article is part of our series on “What does Medicare cover?”
Also, you can check out other articles in this series including: Does Medicare cover PRP injections?