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Does Medicare Cover Rehab?

Yes. Under the Mental Health Parity and Addiction Equity Act (MHPAEA), Medicare must cover substance use treatment at parity with medical care. This page covers typical benefits, in-network facilities, and how to verify your specific plan.

Quick answer: Medicare covers medically necessary detox, inpatient/residential, IOP/PHP, outpatient therapy, and MAT. Typical deductible range: $240-1,632. Typical copay/coinsurance: 20%. Pre-authorization is common for inpatient/residential.

Medicare Rehab Coverage at a Glance

Parent company

Centers for Medicare & Medicaid Services

Members covered

65+ million

Typical deductible range

$240-1,632

Typical copay/coinsurance

20%

Member services phone

1-800-MEDICARE

Call the number on your member card for plan-specific details.

Medicare Part A covers inpatient detox/rehab. Part B covers outpatient. Part D covers MAT medications.

What Does Medicare Typically Cover?

Medical Detox

3–7 days medically supervised withdrawal

Find Medical Detox centers →

Inpatient / Residential

28–90 days of 24/7 care

Find Inpatient / Residential centers →

Partial Hospitalization (PHP)

20+ hours/week daytime program

Find Partial Hospitalization (PHP) centers →

Intensive Outpatient (IOP)

9–15 hours/week

Find Intensive Outpatient (IOP) centers →

Standard Outpatient

Individual + group therapy

Find Standard Outpatient centers →

Medication-Assisted Treatment

Buprenorphine, methadone, naltrexone

Find Medication-Assisted Treatment centers →

How to Verify Your Medicare Coverage

  1. 1
    Find your member ID card — member services phone is on the back. For Medicare: 1-800-MEDICARE.
  2. 2
    Ask specifically: "Is behavioral health / substance use treatment covered under my plan? What's my deductible and coinsurance? Is pre-authorization required?"
  3. 3
    Ask for in-network providers — or call our helpline and we'll verify while you wait.
  4. 4
    Get written confirmation of benefits (BOB letter) to take to the facility. Most rehab centers call to re-verify before admission.
  5. 5
    Check our facility directory — facilities that accept Medicare.

Related Resources

Finance guide

How to Pay for Rehab Without Insurance

8 proven funding paths if Medicare doesn't apply.

Finance guide

Credit, Lease & Bills During Rehab

30-day pre-rehab financial checklist.

Tool

Rehab Cost Calculator

Estimate your out-of-pocket with Medicare.

Directory

All Insurance Providers

Compare coverage across 10 major providers.

Frequently Asked Questions About Medicare Coverage

Does Medicare cover all types of rehab?
Under MHPAEA, Medicare covers medically necessary levels of care: detox, inpatient/residential, PHP, IOP, outpatient, and MAT. "Medically necessary" means a licensed provider has assessed and recommended the level of care. Luxury/experiential amenities beyond clinical care are usually not covered.
Do I need pre-authorization with Medicare?
Most Medicare plans require pre-authorization for inpatient/residential and PHP. Outpatient and MAT typically do not. Your intake coordinator at the facility usually handles this — but confirm during your initial call to the facility.
What about out-of-network facilities?
HMO plans typically don't cover out-of-network rehab except in emergencies. PPO/EPO plans may offer partial out-of-network coverage at higher cost-share. Verify your specific plan type on your member card or by calling 1-800-MEDICARE.
Does Medicare cover family therapy during my treatment?
Yes, family therapy sessions are covered as part of an evidence-based treatment plan under most Medicare plans. Out-of-session family counseling (without the patient present) may have different rules — confirm with your provider.
How long will Medicare cover my stay?
Coverage follows medical necessity, not a fixed day limit (per MHPAEA). Initial authorization is typically 7–14 days of inpatient; extensions are based on clinical review. Most 30-day programs are approved in 2–3 rounds of concurrent review.