Medicare: Treatment for Opioid Addiction

Opioid Treatment Program

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Opioid addiction treatment may be covered for people with Medicare. The opioid crisis has been going on for years now and there are several organizations providing help in hopes of reversing it. Medicare may provide cost relief for those needing opioid use disorder treatment. Help and treatment options are available under the coverage.

Understanding the Crisis

A variety of factors seems to have led to the current opioid crisis. Over a decade of overprescribing opioids for pain relief combined with easier access to synthetic opioids and heroin all seemed to culminate to provide the perfect climate for aiding addictions. Doctors during the 1990s believed that opioids could be prescribed for pain relief without the concern of an addiction forming. This however proved to be wrong in the years following. Experts estimate that as many as 10% of patients prescribed opioids will form an addiction. Doctors and the medical community have started taking steps to cut back opioid prescriptions, but the problem remains for now. In the U.S., 50,000 people were reported to have died from an opioid-related overdose in 2019.

Even though the medical community has made progress in decreasing opioid prescriptions, the use of non-medical opioids and heroin continues to rise. Some argue that the decrease in prescribed opioids has led to an unintended increase in the use of heroin. An estimated 80% of heroin users were first abusing prescription opioids.

Help Fighting Addiction

Several institutions are providing help and resources to those battling addiction in hopes of reversing the crisis. The U.S. Department of Health and Human Services, the National Institute on Drug Abuse, and the Centers for Medicare and Medicaid Services have all started working towards solutions to help the situation. Medicare has included coverage for treatment programs helping to end opioid addiction.

Opioid Treatment Programs may be covered under Medicare Part B medical insurance. The Part B deductible will apply. Coverage includes care received in an office-based treatment program. While in the program, counseling, therapy, and drug testing may all be included. Medication agonists and antagonists may also be covered to assist in treating the addiction. In January of 2021, Medicare approved the use of the antagonist medication naloxone for emergency use in treating overdose cases.



We hope that this information on Medicare coverage for Opioid Treatment Programs is useful to you.

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