Opioid Treatment Program Through Medicare

Opioid Treatment Program

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Medicare coverage may be available to help individuals fighting opioid addiction. In the U.S., the opioid crisis has been going on for years, and many institutions are now working to help reverse the trend. The costs associated with treatment for opioid use disorder may be covered by Medicare. Individuals with Medicare may find help and workable treatment solutions to break the addiction.

Fanning the Flames

There are many factors that brought about the rise of the opioid crisis. Years of over-prescribing opioids for pain relief, combined with increased availability and low cost of synthetic opioids and heroin, all joined forces to create a public health crisis. During the 1990s, doctors in the medical field believed opioids were safe to prescribe for pain and did not include a risk of addiction. Years later we see that this was incorrect, and as many as 10% of patients receiving opioids for pain formed an addiction. Since the realization of the public health crisis and the risks of addiction, the medical community has begun taking measures to reduce prescribed opioids. However, addiction remains a problem, and in 2019 almost 50,000 people were reported to have died from an opioid-related overdose.

In the midst of increased monitoring and an active effort to minimize prescribed opioids, non-medical opioids and heroin use remain high. Some experts argue that the decrease in prescribed opioids has caused an unfortunate increase in heroin use as an estimated 80% of heroin users have misused prescription opioids.

Treatment for Opioid Addiction

Various institutions are working to provide resources and access to treatment in an effort to reverse the crisis. The U.S. Department of Health and Human Services, the National Institute of Drug Abuse, and the Centers for Medicare and Medicaid Services have all started implementing efforts to help improve the situation. Programs to treat and hopefully end opioid addictions are available through Medicare.

Part B Medicare insurance may cover the costs of treatment through an Opioid Treatment Program. The Part B deductible will still apply. The coverage is for office-based treatment programs and includes counseling, therapy sessions, and drug testing. Coverage may also include the prescription of agonist and antagonist medications to help combat the addiction. The antagonist medication naloxone was approved at the start of 2021 for emergency use treating overdose.


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We hope that this information on Medicare coverage for Opioid TreatCment Programs is helpful for you.

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About Cali Naughton

Cali Naughton graduated from the University of Texas at Arlington. She joined the marketing team at Empower Brokerage in the spring of 2021 as a marketing specialist and the department photographer.

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