Medicare binary sign concept illustration designMedicare is a state-operated health insurance plan for people who are over the age of 65 and other specific groups. In Kentucky, Part B is the main denomination that’s used. This is the part of Medicare that covers a range of outpatient services.

Read on to find out more about what’s included in Medicare Part B and how much it costs.

Plus, find out about Brookside Treatment’s partnership with Operation UNITE, which provides financial assistance for inpatient care.

What Does Medicare Cover in Kentucky?

Medicare Part A and Part B are the components that make up original Medicare medical insurance. The majority of people who are enrolled in the program are enrolled in original Medicare.

Part B covers a broad range of outpatient services on the proviso that they’re deemed medically necessary. Treatment is deemed as a medical necessity if it’s required to effectively diagnose or treat a health issue.

Some of the services included in the plan that can help someone with alcohol or drug addiction are:

  • Ambulances
  • Psychotherapy
  • Physician consultations
  • Emergency services, hospitalization and health care
  • Lab testing
  • Occupational therapy
  • Outpatient hospital and mental health services
  • Prescription drugs

Plan B can also help with some preventive measures related to substance use disorders, such as:

  • Screening for STIs
  • Screening for Hepatitis B, Hepatitis C and HIV
  • Bone density measurements
  • Cardiovascular disease screenings

Which Services Does Medicare Not Cover?

There are some treatment services that aren’t included in a Medicare Part B plan, including:

  • Inpatient treatment
  • Detox treatment (except for as part of an emergency hospital stay)
  • Routine physical exams
  • Dental care
  • Vision care
  • Hearing aids
  • Long-term care
  • Alternative treatments that aren’t evidence-based, such as acupuncture

If you opt for a Medicare Part C plan, you get access to all the services of original Medicare plus vision, dental and fitness programs. Medicare Part D is the most comprehensive plan, and it’s usually only available from private insurance programs.

Medicare Coverage Eligibility

In general, there are three groups that quality for Medicare Part B:

  • Seniors over age 65
  • Individuals with disabilities
  • People with end-stage renal disease

To be eligible for Part B, the individual must first qualify for Part A when they initially enroll in a Medicare advantage plan. If you need to purchase Part A, you still have to meet the following requirements:

  • Be over the age of 65
  • Be a citizen or legalized permanent resident for a minimum of five continuous years

Are Inpatient Addiction Treatment Programs Included?

If you or a loved one is struggling with a severe drug or alcohol addiction, residential rehab is usually the best course of action. However, in addition to taking you out of work, the costs can be pretty high. Medicaid Part B doesn’t cover this type of rehabilitation service. However, at Brookside Treatment, we’ve partnered with Operation UNITE to provide financial assistance for residential substance abuse services.

Are Outpatient Treatment Centers Covered?

If you’ve received a referral to treatment in an outpatient setting in Kentucky, chances are Plan B will cover at least some of the costs. Out treatment facility accepts Medicaid Plan B to cover psychotherapy, medication and physical consultations. There are co-pays, deductibles and monthly premiums, which we’ll discuss in more detail in the following section.

How Much Does Medicare Part B Cost?

There are several costs involved in Medicare Part B:

Monthly Charges

You’re charged an amount each month to cover the costs of a Part B Medicare insurance plan. This is currently around $140, although it changes every year. If your monthly income is higher than average, you might pay higher monthly premiums. Annual income is calculated based on tax returns from the previous two years.

Deductibles

Deductibles are the costs you pay out-of-pocket before Part B kicks in, currently around $200.

Coinsurance

Coinsurance refers to the percentage of the cost you pay out-of-pocket once you’ve met your deductibles. This is usually 20% for Part B.

Co-Pays

While co-pays aren’t really associated with Part B, you might need to pay them in settings such as hospital outpatient treatment providers.

Operation UNITE and Residential Rehab

If you need help paying for inpatient substance abuse treatment, Brookside Treatment is connected with Operation UNITE’s Treatment Voucher Program. Residents within the 32-county service region who are from low-income households might qualify for financial aid. Even if you need to cover a long-term stay in residential rehab, UNITE can pay up to $5,000 towards a stay of 90 days or more.

Eligibility Requirements for UNITE

In order to gain assistance from the Operation UNITE program, you must meet the following criteria:

  • Show evidence of being a resident of the Fifth Congressional District for more than 6 months before making an application
  • Meet the specific criteria based on household income
  • Successfully complete a UNITE assessment

The following applicants aren’t eligible:

  • Individuals who don’t admit that they have an alcohol or drug abuse problem
  • Anyone who has been awarded a voucher previously
  • A person who has an active breach warrant or pending criminal charge — unless approved by the court

Outpatient and Inpatient Drug Rehab

If you’re struggling with substance abuse and don’t know where to turn, Brookside Treatment can help. Call our drug rehab in KY today at 606-658-3078 to find out more about the programs we accept Medicare for.