Medicare

Medicare

We believe you should be able to afford the treatment you need. Pine Grove accepts Medicare for those seeking freedom from addiction and co-occurring mental illness.

Treatment With Medicare

Medicare is available for anyone over the age of 65 or those with a disability. Those who have Medicare coverage are eligible for a reduction in the cost of medical expenses, including addiction treatment. The insured’s monthly income dictates your monthly premium which helps ensure Medicare is an affordable option for all.

We know Medicare can feel complicated, and it can be difficult to know what is covered, so we have broken down some of the most common addiction-related treatment options available to you.

According to Medicare Interactive, Medicare covers inpatient and outpatient substance abuse treatment if you meet the following qualifications:

  • Your provider certifies that the services are medically necessary;
  • You receive services from a Medicare-approved provider or facility;
  • And, your provider sets up your plan of care.

Treatment with Medicare

Medicare is divided into four parts which each cover different addiction treatment options.

Part A should cover hospital stays and inpatient rehabilitation without a co-payment. It covers up to 60 days in treatment, but you will be responsible for paying up to your deductible. If you are receiving care at an inpatient psychiatric hospital, Medicare only covers 190 total lifetime days.

Part B should cover outpatient substance use disorder treatment from a clinic, hospital outpatient department, or treatment programs at 80% of the Medicare-approved amount. If you are receiving treatment from a participating provider, you pay a 20% coinsurance after you meet your Part B deductible. Those enrolled in a Medicare Advantage Plan should contact your plan for specific cost and coverage information for this type of treatment.

Part C is also known as Medicare Advantage. This is a Medicare-approved plan from a private company and usually is a “bundled” plan that includes Part A, Part B, and usually Part D. Plans may have a lower out-of-pocket cost, but you will need to work with your provider to determine exact coverage and benefits.

Part D helps cover the cost of prescription drugs which often aid in the effective treatment of substance use disorders and can help ensure lasting recovery. All Medicare prescription drug plans cover antidepressant, antipsychotic, and anticonvulsant medications used to treat a variety of mental health conditions.

We know the strength it takes to seek treatment, and we are here to answer any questions you have along the way. If you have questions about coverage or would like additional information, you can contact our admissions office at 1-888-574-4673 or visit our FAQ Page.

Pine Grove is open and accepting new patients while taking all necessary precautions to protect against COVID-19. Learn More
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