Yes — Medicare covers substance use disorder treatment. The more useful question is which part of Medicare applies to which level of care, because the answer changes what you'll actually pay out of pocket.
The short version, by part
| Medicare part | What it covers here |
|---|---|
| Part A (hospital insurance) | Inpatient detox and inpatient rehabilitation care in a hospital setting |
| Part B (medical insurance) | Outpatient treatment: therapy, counseling, intensive outpatient programs (IOP), opioid treatment program services, and doctor visits |
| Part D (prescription drug coverage) | Medications used in treatment, including for medication-assisted treatment (MAT) — buprenorphine and naltrexone are commonly covered, though formularies vary by plan |
| Medicare Advantage (Part C) | Must cover at least what Original Medicare covers, often with different cost-sharing and network rules — check your specific plan |
What you'll typically pay
For Part A inpatient care, standard hospital deductible and coinsurance rules apply, the same as any other hospital stay — this can be a real cost even with coverage, which is worth planning for. For Part B outpatient services, you'll typically owe 20% coinsurance after meeting the Part B deductible, once your provider accepts Medicare assignment. Part D costs vary significantly by plan — deductibles, copays, and which specific medications are on the formulary all differ, so it's worth checking your specific plan's formulary before assuming a medication is covered.
A detail worth knowing: Opioid Treatment Programs (OTPs)
Since 2020, Medicare Part B specifically covers opioid treatment program services — this includes methadone (which historically had coverage gaps for Medicare beneficiaries) alongside counseling and other services, bundled into a weekly payment to the OTP. If a program tells you Medicare doesn't cover methadone treatment, that's outdated information worth double-checking directly with the OTP and with Medicare.
Practical steps
Confirm the specific facility accepts Medicare assignment before starting care — not all providers do, even if the service category is generally covered. If you have a Medicare Advantage plan, check whether the facility is in-network, since Advantage plans use their own networks rather than Original Medicare's broader acceptance. And if a facility's website is vague about Medicare acceptance, a direct phone call asking "do you accept Medicare assignment for [specific level of care]" gets a clearer answer than any marketing page will.
You can filter our directory for centers that accept Medicare directly, alongside other payment types.