Medicare Coverage for Addiction Treatment in Las Vegas Nevada

Medicare is a federally-funded public health insurance program that may be able to help you cover some or all of the cost of attending rehab in Nevada.¹  According to the National Mental Health Services Survey (N-MHSS), there are 66 mental health treatment facilities in Nevada, out of which 71.2% accept Medicare as a payment option.^{(4 Page 117-118)} In order to take full advantage of their Medicare insurance, they’ll need to know what Medicare is, what aspects of substance abuse rehab it covers, and how to use it to attend rehab in Nevada.

Does Medicare Cover Rehab in Las Vegas and Nevada?

Medicare is designed primarily for individuals over the age of 65.^1,2 Generally, to be eligible for Medicare, one must be over 65 years of age, and had paid Medicare taxes for at least ten years.² Medicare is also open to individuals with certain disabilities and those with end-stage renal disease.^{1, 12}

The Affordable Care Act (ACA) extended the 2008 Mental Health Parity and Addiction Equity Act, which requires that all insurance plans cover substance use disorders treatment in the same way it covers medical and surgical services.^{(5 Enhanced Parity)} This applies to Medicare as well, and most Medicare plans provide some type of coverage for medically necessary mental and behavioral health treatment programs. Among these services are mental health screenings, evidence-based inpatient and outpatient services, and telehealth services.³ It’s important to note that Medicare may not provide full coverage depending on various factors, so you should check your coverage before committing to rehab in Nevada.

Types of Treatment Covered by Medicare in Nevada

While Medicare doesn’t list any specific addiction services covered in the state of Nevada, there are several common treatment types that may be covered in part by Medicare. These common treatment types may include:

• Detox: Detox is the process by which the body clears itself of substances. Generally considered a precursor to treatment, detox can entail physical withdrawal symptoms that can range from mild to severe and potentially fatal. Medical detox is oftentimes a safe option, as it occurs under 24/7 supervision by licensed medical staff, and may include the prescription of medications to help manage withdrawal symptoms.⁷
• Inpatient and Residential Treatment: Inpatient treatment is a short-term, intensive treatment. Usually taking place in a hospital setting, inpatient treatment will see patients living at a facility while receiving various types of therapies. Similarly, residential treatment will involve a patient staying at a rehab facility to undergo treatment. Inpatient treatment normally lasts a few weeks to a few months, while residential treatment can last a few months to a year.⁷
• Outpatient: Often considered a follow-up to more intensive, inpatient rehab, outpatient treatment is a more flexible program that allows patients to live at home and return to daily life while still receiving treatment.⁷
• Medication therapies: Medication-assisted treatment (MAT) is a type of treatment that combines medications with counseling and behavioral therapies.⁽⁸⁾
• Telehealth: Medicare telehealth services may include psychotherapy, office visits, and other health services provided by a doctor or other healthcare provider using audio and video communication technology.⁽⁹⁾

How To Verify Your Medicare Rehab Benefits in Nevada

There are several ways you can verify Medicare’s rehab benefits in Nevada, including:

• Using the Medicare coverage verification tool.
• Checking the list of Medicare contractors, providers, and healthcare professionals that accept Medicare.
• Calling Medicare directly at 1-800-633-4227.
• Visiting a local Medicare office to review the coverage in person.

Parts of Medicare That Cover Treatment in Nevada

There are different parts or plans to Medicare that determine the treatment types it covers:⁽¹⁰⁾

• Part A: Helps with payment for inpatient treatment at a hospital or inpatient rehab center in Nevada.
• Part B: Helps with payment for outpatient treatment services through a clinic or a hospital outpatient center in Nevada.
• Part C: Refers to Medicare Advantage Plans that are offered by private companies and approved by Medicare. These plans may include Parts A, B, and D and may even cover more benefits outside of original Medicare.
• Part D: Helps to pay for drugs and medications that are medically necessary to treat substance use disorders.

Medicare may also cover screenings, brief intervention, and referral to treatment (SBIRT) services provided in a doctor’s office.⁽¹¹⁾ SBIRT is an early intervention approach for individuals who have not yet reached substance use disorder severity. Most SBRIT services are provided in outpatient settings, like a doctor’s office or outpatient rehab center. Medicare may also cover screening and counseling services for people who show signs of substance misuse but are not dependent and don’t show signs of abuse.⁽¹¹⁾

Does your insurance cover treatment at Desert Hope in Las Vegas? 

Check your insurance coverage or text us your questions to learn more about treatment by American Addiction Centers (AAC).

How To Use Medicare for Addiction Treatment in Las Vegas

In order to use your Medicare plan at a Las Vegas or Nevada rehab, there are certain requirements you may need to meet. It’s important first to contact your doctor and build out a treatment plan. Many insurance plans, including Medicare, may only provide coverage for treatment services deemed medically necessary. It’s also important to confirm that a rehab facility accepts Medicare. Finally, you may need pre-authorization before attending treatment. Everybody’s circumstances are different, so it’s a good idea to reach out to your Medicare representative to determine how to use your Medicare plan.

Finding Alcohol or Drug Rehab Centers That Accept Medicare in Las Vegas, NV

Once you’ve decided to seek substance abuse treatment, you’re going to have to find a Nevada facility that’s best for you. An important first step would be to reach out to your Medicare representative to determine the full extent of your coverage. It’s also a good idea to make sure any potential rehab facilities accept Medicare. To start looking for rehabs in Nevada, you can ask for a referral from your doctor, or use SAMHSA’s treatment locator.

Nevada is a big state, and you may find rehabs that accept Medicare anywhere from Carson City to Las Vegas and anywhere in between. For those seeking treatment in Las Vegas, American Addiction Centers, a leading provider in addiction treatment, operates a 24/7 addiction helpline that can help answer any questions about the treatment process and even help you find a facility. AAC also operates Desert Hope Treatment Center, an evidence-based treatment facility located in Las Vegas.

Can I Use Both Medicaid and Medicare for Rehab in Las Vegas and Nevada?

If you qualify for both Medicare and Medicaid, you may be able to use both insurance plans to help cover the cost of rehab in Nevada. To be considered dually eligible, you must be enrolled in Medicare Part A or B. You also need to be enrolled in your state Medicaid program.⁽¹³⁾ Since Medicaid requirements vary by state, you should reach out to your Medicaid representative to determine the extent of your coverage.