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Help may be available for those struggling with opioid addiction through Medicare coverage. The ongoing American opioid crisis has raged for years, and many organizations are working to help end the trend. Medicare may help to cover the costs of opioid use disorder treatment. Individuals on Medicare may find covered treatment options and help through their plan.
The Crisis
The opioid crisis is a result of many different factors. The over-prescription of opioids for pain relief, in addition to the affordability and increased supply of synthetic opioids and heroin, all seemed to work together to form a perfect storm. In the 1990s, the medical community believed that patients being treated for pain with opioids were not at risk for addiction; however, hindsight revealed that as many as 10% of patients receiving opioids formed an addiction. While the medical community has since taken measures to reduce opioid prescriptions, the problem remains. In 2019, it was reported that almost 50,000 people in the U.S. died from an opioid overdose that year.
As doctors become more vigilant about monitoring opioids and providing fewer opioid prescriptions, the use of heroin and non-medical opioids remains steady. There is some argument that tightening up on prescriptions may have had an unintended consequence of increased heroin use. Nearly 80% of users report having first struggled with misusing prescribed opioids.
Battling the Opioid Addiction
In an effort to bring the crisis under control, many organizations are helping to provide access to treatment for those battling addiction. The National Institute on Drug Abuse, the U.S. Department of Health and Human Services, and the Centers for Medicare and Medicaid Services are all taking steps to confront and improve the situation. Medicare offers access to treatment programs to help end an active addiction.
Medicare Part B medical insurance will cover the costs of an Opioid Treatment Program and the Part B deductible will apply. This includes the costs for office-based treatment programs. Medicare may cover drug testing, counseling, and therapy sessions. Approved agonist and antagonist medications may be provided as a way to help treat the disorder. As of January 2021, the antagonist medication naloxone has been approved for emergency overdose treatment.
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