Your costs in 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 and meets other requirements. However, the Part B
still applies for supplies and medications you get through an opioid treatment program provider.
What it is
These services, which help people recover from opioid use disorder, include:
- Medication (like methadone, buprenorphine, naltrexone, and naloxone)
- Substance use counseling
- Individual and group therapy
- Drug testing
- Intake activities
- Periodic assessments
- Opioid antagonist medications (like naloxone) approved for the emergency treatment of known or suspected opioid overdose
- Overdose education you get along with opioid antagonist medication
Medicare covers counseling, therapy, and periodic assessments both in person and, in certain circumstances, virtually (using audio and video communication technology, like your phone or a computer). Medicare also covers services given through opioid treatment program mobile units.
Things to know
Talk to your doctor or other health care provider to find out where to go for these services. You can also search for providers at the top of this page.
Medicare Advantage Plans must also cover opioid treatment program services. If you’re in a Medicare Advantage Plan and already in treatment, your opioid treatment program must participate with your plan and be Medicare-enrolled to make sure your treatment is covered and stays uninterrupted. If not, you may have to switch to a Medicare-enrolled opioid treatment program that participates with your plan. Since Medicare Advantage Plans can apply copayments to opioid treatment program services, you should check with your plan to see if you have to pay a copayment.