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Medicare Rehab Insurance

What is Medicare

Medicare is a federally-funded healthcare program. Under the federal Affordable Care Act, all qualifying long-term healthcare insurance plans must cover medically necessary treatment for pre-existing conditions. That includes substance use disorders, but the level of treatment and where you get it may be decided for you.

Who Qualifies for Medicare Federal Health Insurance?

Medicare is a federal government healthcare plan that offers low-cost or free coverage for people who:

  • Are 65 years old or older, or
  • Under age 65 but have a qualifying disability or medical problem, or
  • Have end-stage renal disease requiring transplant or dialysis

Medicare comes in three parts:

  • Part A: Hospital insurance, which may be premium-free if you paid Medicare taxes for at least 10 years
  • Part B: Medicare insurance, which anyone eligible can get, but costs an additional premium for most people

Can You Have Both Medicaid & Medicare?

Some people qualify for both Medicare and Medicaid, even though it’s uncommon. You’re most likely to have both Medicare and Medicaid if you qualify for Medicaid and turn 65, which qualifies you for Medicare too.

When you have Medicare and Medicaid at the same time, it’s called dual eligibility. When you’re dually eligible, Medicare usually pays for healthcare costs first, and Medicaid pays for any covered costs that remain.

Medicare for Alcohol and Drug Rehab

Most Medicare programs cover alcohol rehab treatment and drug rehab treatment except for supplemental (temporary) plans. However, the amount of coverage may vary depending on your exact Medicare plan.

Medicare Eligibility

Medicare eligibility is simple: If you’re over 65 years old, you automatically qualify. You also qualify if you have a medical disability or end-stage renal disease (ESRD).

What is the Average Cost for Rehab with Medicare?

You can’t calculate the average cost of rehab with Medicare because it depends on your state’s plan and the program you attend. Call your Medicare office to learn what rehab may cost for you.

What is the Average Cost of Rehab With Medicare Supplemental Insurance?

With Medicare supplemental insurance, your cost of rehab could be 100% of the program cost. That’s because supplemental plans aren’t held to the same rules as long-term plans. Call your Medicare office to find out whether your supplemental plan covers rehab.

What Does Medicare Cover?

Medicare coverage varies from state to state, but in general, it usually covers:

How to Check Medicare Coverage

You can check your Medicare coverage by calling the phone number on your insurance card. If you don’t have Medicare yet but you want to know what your coverage may be, you can go to Medicare.gov to browse plans and coverage.

Dual Medicaid and Medicare Eligibility

Some people who are over 65 or have a physical disability or ESRD may have both Medicare and Medicaid. If that applies to you, then Medicare will pay for your treatment first, and Medicaid will cover the remainder.

Does Medicare Cover Detox Programs?

The detox services that Medicare may cover include:

  • 24/7 monitoring from care staff to ensure you’re safe and comfortable
  • A residential stay that can last anywhere from 3 days to a week or longer, depending on your history
  • Intravenous hydration to reverse the harmful effects of dehydration from drug abuse and withdrawal
  • Nutritional support to aid your body in recovering
  • Symptom management that can include medications for seizures, depression, or other serious effects of withdrawal.

Of course, you don’t know your Medicare rehab detox coverage until you check it, so don’t assume that detox is 100% covered; but in most cases, it’s covered at least partially.

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