Medicare could cover Methadone for patients that require the drug in an inpatient setting. One in three adults on Medicare uses opioid pain killers for some chronic pain.
Opioid medications are a class of drugs that come from opium, although these synthetic opioids are from your medical provider to treat acute, chronic, or cancer pain.
When uses correctly, opioid pain medications work by attaching to the brain’s pain receptors, therefore reducing pain. Also, your body can build up a tolerance to the pain pills and start requiring stronger medications.
What many don’t anticipate is an addiction that comes along with taking pain medications. Even if the pain medication is from your healthcare provider, this can happen to you.
Opioid addiction doesn’t discriminate. Although, anyone taking daily opioids is at risk for addiction as your body becomes physically dependent.
Eventually, withdrawal symptoms can present if you abruptly stop taking the medication. In some cases, healthcare providers will provide an RX, methadone, to prevent opioid withdrawal symptoms.
Medicare Can Cover Methadone
With Part A, in a hospital and on methadone for pain or drug addiction, then the medication may have coverage. Then, Part B provides coverage for methadone if the medicine is in an actual methadone clinic.
Part D is a standalone plan that gives you coverage on Part D costs. Also, this plan alone can save you hundreds, if not thousands, on your cost of drugs each year.
A Part D Plan will likely cover methadone if used for pain; however, it won’t cover the cost of the medication used for other reasons.
Beneficiaries can save money is by purchasing a Part C or Advantage Plan. However, you can have a plan with value by buying a Supplement Plan.
Part C plans are replacement plans as they take over the coverage of Medicare. They also have some added benefits like vision, hearing, and Part D.
Advantage Plans can be cheaper by having lower deductibles and copayments. They often can have policy limitations and may require prior authorization for treatment and drug coverage.
Although, a better option to Advantage Plans is the Supplement Plans.
These plans work alongside your benefits. Depending on which policy you choose, coverage on deductibles, copayments, coinsurance, and other out of pocket, medical costs is possible.
The Purpose of Methadone and How Medicare Will Cover Cost
Methadone is a synthetic opioid analgesic that can provide long-term pain relief. The medication itself is stronger than morphine. Medicare may cover Methadone in certain situations.
In most cases, the medication can be a form of treatment for opioid and heroin addiction. Also, the drug itself weakens the urge to use opioids and can prevent withdrawal symptoms. The drug likely lasts longer than most regular opioid prescriptions.
Methadone comes from a pain physician, a certified psychiatrist specializing in addiction, or a Methadone Clinic.
The Risk for Opioid Dependence
When a person has an uncontrollable urge to use a substance, despite adverse effects, this is an addiction.
In the late ’90s, pharmaceutical companies were targeting prescribers; also, advising them that patients wouldn’t become addicted to potent pain relievers. The false statements led to a rapid increase in written prescriptions.
Despite the promise of the pharmaceutical, opioids became more and more popular as a drug of misuse. Due to the euphoric feeling, patients felt when taking the medications.
Since being on the market, despite all the warnings out there, synthetic opioids have led to countless overdoses.
As of 2017, about 1.7 million Americans alone dealt with opioid drug addictions. Then more than 47 000 individuals lost their life due to opioid overdoses.
Several pre-existing factors can contribute to:
- If the patient has any drug or alcohol dependence
- the patient currently smokes cigarettes products or has ever been a user of tobacco products
- If the patient has a history of depression or anxiety
Research has shown the risk of tolerance and abuse now makes opioids a poor choice for chronic pain. Although, providers are using these powerful medications more for acute pain instead. Then, using other treatment options for those suffering from chronic conditions.
If given opioid pain medication as a treatment option from your physician, it’s essential to use them only as intended; to treat pain.
Recognizing Signs of Opioid Addiction and Withdrawals
With opioids being more and more common, it’s essential to realize if someone is suffering from addiction. Medicare will cover Methadone in certain situations. To better understand how your prescription plan pays, contact the company or agent that sold you the policy.
Symptoms of addiction include:
- An obsession with their pain medications
- Poor performance at work
- The need to take more to achieve the effect
- Failed success in trying to taper off pain medication
- Less interest in socializing, hobbies, and engaging with family
- Lack of motivation
- Signs of depression or an increase in anxiety
- Weight loss
- Loss of concentration
- Mood swings and substantial behavioral changes
- A distorted perception of reality
- Confusion and disorientation
- Stealing from loved ones
- Slurring of words or slowed speech
- Once addicted to opioids, withdrawal symptoms can begin in 12 hours of the last dose.
While signs of addiction may be harder to recognize, withdrawal symptoms are much easier to realize.
Withdrawal symptoms include:
- Severe cravings
- Irritation and agitation
- Flu-like symptoms including sweating, muscle aches, and pains and cramping
- Nausea and vomiting
- Suicide ideation
If you know someone suffering from opioid addiction, call a nationwide hotline for help. Also, if they have Medicare to cover the Methadone, getting them help is extra essential.
Fast Facts About Opioid Addiction
Every year, millions of Americans take opioid pain medications for the management of pain.
Here are some staggering facts regarding the opioid crisis in our country:
- 214 million pain medication scripts in 2016
- In the same year, greater than 11 million people had opioids
- More than 1,000 people are in a hospital setting each day for misusing opioids
- 1 in 5 people had opioids for an extended period for noncancer issues.
- Opioid abuse continues to claim more lives than illicit drugs
Over the last two years, more prescriptions for addiction medications happen than actual opioid pain killers.
It’s essential to know the risks and benefits of any medication. Even more so when it’s an opioid, also, make sure to discuss any concerns with your healthcare provider.
More Help with Your Medicare Benefits
If you have any questions regarding how Medicare will cover Methadone, we’d be happy to help. We can also walk you through the application process for coverage Medicare doesn’t provide.
Benefits are best with a Supplement Plan and a Part D. However; we recommend discussing your options with one of our brokers. They can help you find your best policy.
Call our toll-free number or click on our online forms for more information. Our licensed insurance agents are ready to answer any questions you may have and help you start saving money today.