Medicare coverage for alcohol misuse screening and counseling is available. If your doctor suspects the misuse of alcohol, you’re eligible for four brief counseling sessions each year.
In the United States, alcohol abuse is the 3rd leading cause of avoidable deaths. Doctors may refer their patients for further treatment after proper screening.
Your doctor may determine help is essential to decrease usage or help you stop drinking. Beneficiaries that screen positive may receive up to 4 in-person behavioral counseling interventions.
Medicare Alcohol Misuse Screening and Counseling
Doctors may decide to use screening and counseling to identify, maintain, and treat alcohol misuse. Alcohol misuse is an unnecessary daily usage of alcohol drinks. Like binge drinking, which is having 4-5 drinks during a single affair.
Part B has coverage for one annual screening for alcohol misuse. Although, even without symptoms, you may qualify for testing and counseling.
However, the medical requirements for alcohol dependency are slightly different. Detecting an abuse problem isn’t always obvious, making it tough to treat.
Alcohol dependent people may suffer from a range of symptoms. Alcohol damages the body in many ways, from organ damage to poor sleeping habits. Liver and heart disease are common among those who misuse alcohol.
Over time, the body builds a higher tolerance, and you may begin to drink more. When you start drinking more, a gradual loss of control and decision making is likely to occur.
Withdrawal symptoms happen. Misusing alcohol causes invasive thoughts and constant desire to drink with little to no will power to stop.
Warning signs that you have an unhealthy alcohol habit include many unsuccessful attempts to quit drinking.
Other signs to look out for are the avoidance of occupational, social, or recreational activities. Also, having to drink during any social functions.
Continuing to use even after negative results are all warning signs. Luckily, coverage is available for eligible people.
Qualifying for Alcohol Misuse Screening and Counseling Coverage
Medicare pays for counseling and screening when your doctor deems it’s medically necessary.
To decide who qualifies, doctors review drinking habits by using the following rule:
- Women under 65 and having 3+ drinks at a time or seven days a week
- Men under 65, consuming 4+ drinks at a time or 14 glasses within a week
- Woman or Man 65 or older drinking 3+ drinks at a time or seven drinks each week
- After your doctor clarifies eligibility, Medicare pays for up to 4 brief counseling sessions each year. To qualify patients must:
- Be mentally competent at the time of counsel
- Receive counsel in a primary care facility; doctor’s office/clinic
- Receive counsel by a doctor or nurse practitioner
Medicare waives the costs of coinsurance and Part B deductible when getting this service. However, Medicare does NOT offer coverage for alcohol misuse screenings during hospital stays or emergency rooms.
Does Medicare Cover Alcohol Rehab
As of May 2019, the benefit category for alcohol abuse rehab isn’t clear. However, Medicare does cover these services when vital.
Substance abuse disorders may warrant a recovery facility, and Medicare may help pay some of the costs.
Medicare Alcohol Treatments
If services are essential, Part B covers the costs in full. That means you pay no deductibles or coinsurances.
Medicare covers most fees for in-patient treatment for up to 90 days each benefit period. Recipients have 60 lifetime reserve days that are only available once per lifetime.
Inpatient treatment centers may bill Medicare to pay for services as part of the stay. Coverage includes the care you get from doctors during your visit.
Part A covers 190 days of treatment from a specialty facility. The maximum lifetime amount a patient may obtain within their life is 190 days.
Once coverage reaches its maximum, you may not renew unless your condition demands more time in the hospital for treating specific physical ailments.
There is no limit on how many hospitalizations have coverage.
In-patient services include critical access, inpatient rehab centers, long-term care hospitals, mental health care, and inpatient care.
Outpatient treatments are a bit different. There’s no obligation to live in the facility; although, coverage for outpatient services depend on the doctor.
Both coverage and payments occur on a service basis. For example, Medicare covers the cost when a specialist gives counseling services.
Medicare Supplement Coverage for Alcohol Misuse Screening and Counseling
When looking for the right coverage for your needs, consider supplement insurance. Carefully consider the need for Medigap coverage.
A Supplement plan may help you afford treatment costs for alcohol misuse. Part A and B benefits leave gaps in coverage.
Depending on the level of treatment, copayments alone can become quite costly. Supplement insurance help cover the coinsurance, copayments, and deductible costs.
Medicare Advantage for Alcohol Misuse Screening and Counseling
Let’s say your doctor advises treatment more often than coverage allows. When this happens, you have the burden of costly medical bills.
Ask your doctor before taking treatment. It’s essential to understand your doctor’s advice and potential costs.
Medicare Advantage (MA) plans often include extra benefits.
MA plans must offer at least the same coverage as Part A and B; however, these plans expect people to stay in-network when seeing mental health doctors.
Enrollees should contact their plan to find in-network doctors that treat substance abuse, mental illness, and alcoholism. Your agent can discuss the best option for people with chronic diseases.
These include substance abuse and mental illness. However, these MA plans aren’t in all areas; benefits and costs vary by location.
Part D for Alcohol Misuse Screening and Counseling
Part D covers the costs of drugs. However, Part B covers drugs you get in an outpatient facility.
There are over 3 million cases of alcohol misuse in the USA, and Medicare offers coverage; if you need help, please get it.
If you or someone you love needs assistance because of an alcohol issue, contact the national helpline. The National Helpline is open 24/7, and they offer free services.
To find the best plan for you, call us at the number above or fill out an online rate form. Our agents are experts in the insurance industry.
We can help find the right plan by reviewing rates and benefits. Also, our agents have quotes from the top companies in the nation.
Helping people is the goal of our team, give us a call so we can help you too!