Will Medicare cover my addiction treatment?

Will Medicare cover my addiction treatment?


In terms of whether Medicare will cover your treatment, the key variable is whether such care is proscribed as medically necessary, according to Patrice Muchowski, head of clinical services as AdCare Hospital, which operates treatment centers in Massachusetts and Rhode Island and is part of the larger, nationwide American Addiction Centers network.

Medicare will cover addiction treatment that doctors and other licensed caregivers think is medically necessary. If your doctors went through the proper steps, it’s likely that Medicare would cover your care, she said. But she said it’s not clear from what you described exactly what steps you and your doctor already have taken.

Odds are, however, that showing up at a hospital with your Medicare card is not going to get you the covered care you seek. Benzos are very powerful, she stressed, and the best way to come off of them is through “a very, very, very slow taper (program), done either by a physician prescribing it” or a hospital familiar with such treatments. Not all hospitals are equipped to provide that treatment, but ask for a “level 4” facility, Muchowski advised. This is rated as the highest level of addiction care by the American Society of Addiction Medicine.

Muchowski had these additional suggestions, while emphasizing that she would need to know much more about your situation to provide informed guidance:

  1. Not all drug rehabilitation facilities accept Medicare, so make sure you’re talking with one that does.
  2. A psychiatric facility might be worth pursuing, as they usually take Medicare. The American Academy of Addiction Psychiatry has a referral service.
  3. Speak to the person prescribing your Xanax to discuss outpatient programs that can provide you professional help in tapering off this drug. Your prescriber has the right to lower the dosage as well, which could be part of a formal tapering program.
  4. Your fiance’s employer might have a formal employee assistance