Medicare coverage for opioid use disorder treatment

If you or someone you know is struggling or in crisis, call or text 988, the free and confidential Suicide & Crisis Lifeline, or chat at 988lifeline.org.

Opioid Treatment Programs

Medicare covers treatment through comprehensive Opioid Treatment Programs, including their mobile units. Covered services include:

• Medicines for opioid use disorder, like methadone, buprenorphine and naltrexone, and giving them to you.
• Medicines that quickly reverse an overdose, like naloxone and nalmefene.
• Substance use counseling, individual and group therapy, and intensive outpatient services.
• Drug testing, intake and regular check-ins.

Counseling, therapy and check-ins can sometimes be done by phone or video.

What you pay

• Original Medicare: no copays at a Medicare-enrolled Opioid Treatment Program that meets the requirements. The Part B deductible still applies.
• Medicare Advantage: plans must cover these services but may require an in-network program and may charge copays or coinsurance. Check with your plan.

Treatment at a doctor's office

Medicare also pays doctors and other providers for office-based treatment, including management, care coordination, counseling and medicines.

Prescriptions

Part D drug plans cover medicines like buprenorphine for opioid use disorder. They don't cover methadone for opioid use disorder; that's covered through Opioid Treatment Programs.

To find a program, ask your doctor or use Medicare.gov's opioid treatment program finder. For other mental health care, see mental health coverage.