Is Inpatient Rehab Covered By Medicare?

Inpatient Rehab

If you’re suffering from an addiction, you might be considering going into inpatient rehab. It’s an effective method of addiction recovery, so you’re pinning your hopes on it. But there’s just one thing that makes you hold back: the cost.

The expenses that go into inpatient rehab are no joke. Not a lot of people are able to pay that much money upfront, much less afford the entire treatment.

Thankfully, there is Medicare. It covers a lot of healthcare methods, but is inpatient rehab one of them? Find out if you’re covered.

What is inpatient rehab?

Inpatient RehabInpatient rehab is an addiction recovery method where you are confined to a rehab center for the entire length of the rehab program. These can range from 30 days to six months, depending on the kind of treatments that you need.

Essentially, you would live inside the rehab center for a while. They will provide you with a room, food, and water. They would even wash your clothes for you. Aside from that, you get round-the-clock care provided by medical professionals and mental health practitioners. At any time that you need help, they’re just within reach.

Being confined in a facility has some advantages. First of all, it keeps you away from your usual environment, which could have a lot of temptations to take addictive substances. Secondly, you’ll be exposed to new routines, which will help you develop a healthy lifestyle. Rehab professionals will let you do activities designed to make you get used to a sober life.

Inpatient rehab also includes detox procedures, which are designed to clear all traces of addictive substances from your body. Medical professionals will be by your side, and they will help you manage any withdrawal symptoms that may show up. After your body is accustomed to taking no more drugs, behavioral therapies can begin.

After your rehab program is done, many inpatient rehabs would still give you support. This is known as aftercare, and it’s an important part of your road to recovery. Once you’re sent home, therapists may continue to check up on you regularly. Doing this reduces the risk of relapse. Rehab personnel may even involve your family members in aftercare. They will teach your family how to help you maintain your new, sober lifestyle.

How much would it cost me?

Inpatient RehabInpatient rehab is known to be costly. The price depends on how long you have to stay in the rehab center. The longer your stay, the more expensive the treatment gets. Also, some rehab centers have more luxurious amenities like saunas, pools, and alternative therapies. These would also drive the cost higher.

To put it into perspective, the least expensive inpatient rehabs can cost about $2,000 for 30 days. Many programs last for 90 days, and they can cost as much as $60,000.

Rehab indeed costs a lot, but at least there’s Medicare. Does it cover rehab, though?

What does Medicare cover?

The good news is you do get coverage for inpatient rehab through Medicare. But there is no one-size-fits-all rule. Medicare has rules about which rehab centers you can go to and which treatments are covered. Some types of treatments are not covered, so it’s best to check first.

Also, there are some requirements for being eligible for Medicare. You need to be:

  • 65 years of age or older
  • Younger than 65 but have a disability
  • Younger than 65 but have permanent kidney failure

Thus, Medicare is only for senior citizens or persons with disabilities. If you qualify, Medicare can help you pay for inpatient rehab, but there are additional conditions that need to be met:

  • You need to enroll in a Medicare-approved rehab center or receive care from a Medicare-approved provider.
  • Your care provider must declare that the treatments they will give you are medically necessary.
  • Your care provider must have a plan of care in place.

Medicare covers many aspects of rehab:

  • Part A can help you pay for the cost of inpatient treatment at either a hospital or a rehab center.
  • Part D can help you pay for medications that are needed to treat substance use disorders.
  • Medicare covers SBIRT as well. This is short for Screening, Brief Intervention, and Referral to Treatment, which are services often rendered in the doctor’s office.

What is covered under Medicare Part A?

Inpatient RehabPart A of Medicare is often considered hospital insurance. It mainly covers inpatient care at hospitals, but it can also cover inpatient treatment for addictions if these services are deemed necessary.

Part A allows for at most 190 days of total treatment from an inpatient facility. This includes treatment from an inpatient rehab center. Thus, Medicare can cover up to a six-month (180 days) rehab program with 10 days to spare. Take note, though, that 190 days is a lifetime limit. Once they’re used up, any extra time spent in rehab is no longer covered.

What is Part D for?

Part D of Medicare covers any necessary medications for treating your addiction. For example, Suboxone, which is used in treating opioid addiction, is covered under Part D. It also covers anticonvulsant, antidepressant, and antipsychotic drugs used in mental health treatments. If ever you would need these, Medicare can help with the costs too.

But it’s always a wise idea to check if your particular medications are covered under Part D. Not all drugs are included, so double-check first with your care plan.

What if I’m not sure of my coverage?

A lot of the time, Medicare can be quite confusing to navigate. If you have any questions, it’s best to get in touch with Medicare directly. Ask them your questions and you’ll get detailed answers on which services in inpatient rehab are covered.

Finding a Medicare-approved rehab center can likewise be a daunting task. To make it a lot easier, contact the Substance Abuse and Mental Health Services Administration (SAMHSA). They have a comprehensive list of rehab centers, and they can help you choose the ones that are Medicare-approved.

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