Opioid use disorder treatment services
Medicare covers opioid use disorder treatment services in opioid treatment programs. The services include medication (like methadone, buprenorphine, naltrexone, and naloxone), counseling, drug testing, individual and group therapy, intake activities, and periodic assessments. Medicare covers counseling, therapy services, and assessments both in-person and by virtual delivery (using audio and video communication technology, like your phone or a computer).
Medicare pays doctors and other providers for office-based opioid use disorder treatment, including management, care coordination, psychotherapy, and counseling activities.
Under Original Medicare, you won’t have to pay any copayments for these services if you get them from an opioid treatment program provider who’s enrolled in Medicare. However, the Part B deductible still applies. Talk to your doctor or other health care provider to find out where to go for these services. You can also visit Medicare.gov/talk-to-someone and select “Opioid Treatment Program Services” to find a program near you.
Medicare Advantage Plans must also cover opioid treatment program services. If you’re in a Medicare Advantage Plan, your current opioid treatment program must be Medicare-enrolled to make sure your treatment stays uninterrupted. If not, you may have to switch to a Medicare-enrolled opioid treatment program. Since Medicare Advantage Plans are able to apply copayments to opioid treatment program services, you should check with your plan to see if you have to pay a copayment.