Medicare Coverage for Opioid Treatment Program


Opioid Treatment Program

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People struggling with opioid addiction may find help through Medicare. The opioid crisis has been an ongoing problem for years and more establishments are working to solve the problem and help reverse the trend. Those with Medicare coverage may be able to get help treating their opioid addiction.

Multiple Catalysts

Several different factors are thought to have brought about the current opioid crisis. Overprescribed opioids for pain relief in addition to the lowered costs and increased availability of synthetic opioids and heroin seemed to all culminate together to create this public health crisis. The consensus, in the medical community during the 1990s, was that prescribed opioids for pain relief did not pose any risk of addiction to patients. However, time revealed that this notion was incorrect, and in fact, an estimated 10% of patients that received prescribed opioids formed an addiction. In light of the current information, doctors across the country are taking measures to reduce the number of prescribed opioids as well as examining other non-opioid pain relief options. However, for the time being, the problem remains and in 2019 nearly 50,000 people died from an opioid-related overdose.

Despite the efforts of the medical community to minimize prescriptions, problems with heroin and non-medical use of opioids continue to grow steadily. Arguments have been made that tightening up in the medical community has contributed to an increase in heroin users. Experts estimate that 80% of heroin users previously abused prescription opioids.

Help Treating Opioid Addiction

Several different institutions are working to help abate the crisis and provide access to treatment for those struggling with addiction. The U.S. Department of Health and Human Services, the National Institute on Drug Abuse, and the Centers for Medicare and Medicaid Services are each working to provide resources and solutions to help. In an effort to provide help to those suffering from addiction, Medicare offers coverage for opioid addiction treatments.

Through Part B medical insurance, Medicare may cover the costs of participating in an Opioid Treatment Program. The Part B deductible will also apply. Coverage includes office-based treatment providing counseling, therapy, and drug testing. Agonists and antagonist medications may also be covered. At the beginning of 2021, Medicare approved the coverage of naloxone in the emergency treatment of overdose.

 

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