Medicare Part B Facts about Addiction and Mental Health Treatment

Mental Health Disability

Lighthouse Network is the recognized leader for Medicare addiction and mental health treatment solutions.

Outpatient care:

Medicare Part B helps pay for outpatient substance abuse treatment services from a clinic or hospital outpatient department for a mental health disability.

Medicare will pay 65 percent of its approved amount for mental health services, and you or your supplemental insurance are responsible for the rest in 2013. You or your supplemental insurance will be responsible for the remaining 35 percent.

Covered services include, but are not limited to:

  • Psychotherapy
  • Patient education regarding diagnosis and treatment
  • Post-hospitalization follow-up
  • Prescription drugs administered during a hospital stay or injected at a doctor’s office
    • Methadone may be covered if provided to hospital inpatients but not provided in outpatient clinics.
  • Outpatient prescription drugs covered under Part D
    •   Part D plans must cover medically necessary drugs to treat drug abuse either through a formulary (list of covered drugs) or through the exception process

Note: Plans cannot cover methadone to treat substance abuse, but can cover methadone for other conditions, such as pain.

  • Structured Assessment and Brief Intervention (SBIRT) services provided in a doctor’s office or outpatient hospital department. SBIRT is covered by Medicare when patients show signs of drug abuse or dependency. This is a public health approach to treat substance abuse.

Medicare covers a new preventive benefit that offers screening and counseling for people who show signs of alcohol misuse but are not alcohol dependent and do not necessarily show signs of abuse.

Lighthouse Network can help…

To Speak with a LN Medicare Treatment Specialist

Please call the LN Addiction & Counseling Helpline (844) 543-3242


Click here to learn about Medicare Part A  Addiction and Mental Health Treatment


Get help now! Call (844) 543-3242