Medicare coverage for opioid use disorder
Medicare pays for methadone, buprenorphine and counseling at enrolled programs. Here is what each part covers and what you pay.
Find treatment near youUpdated October 2026. Sources are linked on this page.
The short answer
- What is covered
- Part B covers opioid treatment program services, including methadone, buprenorphine, naltrexone and counseling.
- What you pay
- No copayments at a Medicare-enrolled opioid treatment program, though the Part B deductible applies.
- How to check
- Ask the program if it is enrolled in Medicare, then confirm with 1-800-MEDICARE or your plan.
What Medicare Part B covers at an opioid treatment program
Medicare is for people 65 and older and for younger people with certain disabilities. Since 2020, Part B has paid for care at opioid treatment programs, the clinics that are allowed to give methadone for opioid use disorder.
According to Medicare, the covered services include:
- Medications to help stop or reduce opioid use, including methadone, buprenorphine and naltrexone
- Medications that reverse an opioid overdose, including naloxone
- Counseling and therapy, in person and in some cases by video or phone
- Periodic assessments
Coverage lasts as long as the treatment is reasonable and necessary. There is no set end date.
One condition matters: the program must be enrolled in Medicare. Not every methadone clinic is. Ask before your first visit.
What you pay under Original Medicare
If you get these services from an opioid treatment program that is enrolled in Medicare, you pay no copayments. The yearly Part B deductible still applies. Medicare.gov lists the current deductible amount.
If you get treatment from a doctor’s office instead, such as a prescriber who writes buprenorphine prescriptions, the usual Part B copayments and deductible apply.
If you have a Medigap policy, it may pick up some of those costs. Ask the company that sold it to you.
Which part of Medicare pays for what
| What it pays for | What to ask | |
|---|---|---|
| Part B | Opioid treatment program services, and visits with a doctor or other prescriber. | Is this program enrolled in Medicare? |
| Part D | May cover buprenorphine and naltrexone you pick up at a pharmacy, and overdose reversal drugs. | Is my medication on the plan’s drug list, and what is my copay? |
| Medicare Advantage | Everything Original Medicare covers, through a private plan with its own network and costs. | Is this clinic in my plan’s network, and do I need approval first? |
Methadone for opioid use disorder is given at the program itself, so it is paid through Part B, not picked up at a pharmacy under Part D.
Medicare Advantage plans must cover what Original Medicare covers, but your costs and your choice of clinics can differ. Call the number on your plan card before you start.
Medicare before 65 if you get disability benefits
You do not have to be 65. If you get Social Security disability benefits, Medicare starts automatically after you have received those benefits for 24 months.
That waiting period can leave a gap. During it, check whether you qualify for Medicaid, or look at the routes on our page about treatment with no insurance.
Some people have both Medicare and Medicaid. If that is you, Medicare says you pay nothing for the services you get through your state Medicaid program.
Getting treatment when you are older
Opioid use disorder in later life can start with a prescription for pain. It is a medical condition, and the same medications are used to treat it at 70 as at 30.
Two things are worth raising with your prescriber. First, give them the full list of everything you take, including sleep and anxiety medicines, because some combinations with opioids raise overdose risk. Second, ask whether visits can be done by video or phone if travel is hard. Medicare covers some counseling that way, and says you may be able to start buprenorphine without an in-person exam.
Do not stop or change a prescribed medication on your own. Talk to the prescriber first.
Our overview of medication for opioid use disorder explains how the three medications differ, and telehealth treatment covers remote visits.
Who can answer your Medicare questions for free
- 1-800-MEDICARE (1-800-633-4227). They can tell you what your coverage includes.
- Your State Health Insurance Assistance Program. Free, unbiased counseling on Medicare choices. Medicare can give you the local number.
- Your plan’s member services line. For Medicare Advantage and Part D, the plan decides networks and drug lists.
When you are ready to look for a program, our treatment directory lists centers by state. Always confirm Medicare enrollment with the program itself. For other ways of paying, see what treatment costs.
Find treatment in your state
Real, licensed facilities from public records. No paid placements.
Questions people ask us
Does Medicare cover methadone treatment?
Yes. Medicare Part B covers methadone for opioid use disorder when you get it from an opioid treatment program that is enrolled in Medicare. You pay no copayments for those services, though the Part B deductible applies. Ask the program directly whether it is enrolled.
Does Medicare Part D cover Suboxone?
Medicare says Part D drug coverage may cover buprenorphine and naltrexone, along with medications that reverse an overdose. Each plan has its own drug list and copays, so call your plan and ask about your exact medication and the pharmacy you use.
Can I get Medicare if I am under 65?
Yes, if you get Social Security disability benefits. Medicare starts automatically after you have received those benefits for 24 months. Until then, check whether you qualify for Medicaid, which covers medication for opioid use disorder in every state.
Does Medicare Advantage cover opioid treatment?
Medicare Advantage plans must cover everything Original Medicare covers, including opioid treatment program services. Your costs, the clinics you can use and any approval rules are set by the plan, so call the member number on your card before your first visit.
Sources
- Medicare.gov: Opioid use disorder treatment services
- Medicare.gov: Getting Medicare before 65
- Medicaid.gov: Substance use disorders resources
- SAMHSA: National Helpline
This page is general information, not medical advice. Talk with a clinician about your own situation.