Original Medicare (Parts A & B): Opioid Use Disorder (OUD) Treatment Services
Treatment for opioid use disorder (OUD). Tolerance and dependence are physical, addiction is psychological, and both need support to overcome.
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How To Receive
Details on how to apply
Talk to your loved one's healthcare provider to find out where to go for these services, or click here to find a nearby program.
Obtain a provider referral for opioid treatment.
Schedule an intake assessment appointment with an OUD treatment provider that accepts Medicare.
Attend the appointment and complete the intake. Develop a care plan and schedule future visits for counseling, therapy, medications, and/or activities.
Attend all visits and complete the program, as designed.
Program completion depends on meeting individualized goals.
Arrange ongoing maintenance visits with the OUD treatment provider or your loved one's primary care provider and attend those as scheduled.
For more information on Medicare benefits and coverage, call 1-800-MEDICARE (1-800-633-4227) or visit the Medicare Benefits Website. TTY users, call 1-877-486-2048.
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Opioid use disorder (OUD) comprises:
An overpowering desire to use opioids
Increased opioid tolerance (it takes more and more of the drug to achieve the desired effect)
Withdrawal syndrome when stopped (mood swings, flu-like symptoms, sweating, shaking, nausea and vomiting, diarrhea, and full body aches and pain, as well as more severe symptoms).
OUD can occur in older adults, especially those who use opioids for chronic pain control.
OUD treatment includes the following services:
FDA-approved opioid agonist and antagonist medication-assisted treatment (MAT), which are methadone, buprenorphine, or naltrexone.
Dispensing and administration of MAT medications (if applicable)
Substance use counseling
Individual and group therapy
Toxicology testing
Intake activities
Periodic assessments
OUD programs are conducted at both inpatient and outpatient hospital-based and sometimes university-based treatment sites and rehabilitation centers, and may be delivered in conjunction with drug therapy at independent MAT clinics (once commonly referred to as “methadone clinics” or “drug depots”). In more rural settings, outpatient counseling may be delivered in more community-based settings such as activity centers, churches, and legion-type facilities (VFW, Elk’s Club, etc.).
Not all OUD programs are medication-assisted. There are also programs (commonly called “detox”) that rely on abstinence-based treatment wherein there is no medication transition, though these are typically inpatient programs lasting from 21-28 days or residential programs lasting more than 30 days. However, there are inpatient and residential programs that are also MAT. Be sure to ask about the facility’s approach (abstinence or MAT) before intake and admission.
Outpatient programs, which are generally MAT, may vary in intensity and duration, but typically last anywhere between 3 months and a year.
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