Does Medicare Cover Gambling Rehab?

Aug 19, 2023

Key points:

  • Medicare provides coverage for behavioral health issues, including gambling addiction treatment, through various services such as inpatient and outpatient care, residential treatment programs, psychotherapy, and medication management.

  • Inpatient hospital care for gambling addiction is covered by Medicare Part A, offering up to 90 days of inpatient psychiatric care per benefit period. Outpatient coverage falls under Medicare Part B.

  • While Medicare covers inpatient mental health services for gambling addiction, outpatient treatment may be covered if deemed medically necessary and performed by a Medicare-approved provider. Alternative options are suggested if Medicare does not cover the treatment, including checking Medicaid eligibility, exploring private insurance, nonprofit programs, employee assistance programs, support groups, or considering self-pay or payment plans. Regularly checking for updates on Medicare's coverage policies is advised.

When it comes to treating behavioral health issues, such as gambling addiction, Medicare provides a wide range of coverage options. Medicare-covered services include inpatient and outpatient services, residential treatment programs, partial hospitalization programs, psychotherapy, and medication management. In short, yes, Medicare can cover gambling addiction treatment.

Inpatient hospital care is covered by Medicare Part A. This includes up to 90 days of inpatient psychiatric care per benefit period. Outpatient coverage for gambling issues falls under Medicare Part B

What is Medicare?

Medicare is a government-funded health insurance program in the United States designed to provide essential healthcare coverage to eligible individuals, primarily those aged 65 and older, as well as certain younger individuals with disabilities. Created in 1965, Medicare is administered by the Centers for Medicare & Medicaid Services (CMS) and is divided into several parts, each covering specific healthcare services:

Medicare Part A: Often referred to as hospital insurance, Part A covers inpatient hospital care, skilled nursing facility care, hospice care, and some home health services.

Medicare Part B: Known as medical insurance, Part B covers doctor visits, outpatient care, preventive services, and durable medical equipment. It requires a monthly premium.

Medicare Part C (Medicare Advantage): This is an alternative to Original Medicare (Part A and Part B) and is offered by private insurance companies. It often includes prescription drug coverage and additional benefits like dental and vision care.

Medicare Part D: This part provides prescription drug coverage through private insurance plans approved by Medicare.

Medicare provides crucial healthcare support to millions of Americans, helping them access necessary medical services and treatments. Eligibility, coverage options, and costs can vary, so it's essential for individuals to understand their specific circumstances and needs when enrolling in Medicare.


Typically you don’t pay a premium for Medicare part A. If you aren’t eligible for premium-free Part A, you can pay for Part A. In 2023, the monthly premium is $506 each month.

In 2023, the regular premium for Part B is $164.90. If your modified adjusted gross income, as documented in your IRS tax return from two years ago, surpasses a specified threshold, you will be responsible for both the standard premium and an additional fee known as the Income Related Monthly Adjustment Amount (IRMAA). IRMAA constitutes a supplementary charge added to your premium.

Behavioral Health Services And Rehab Covered By Medicare

Addiction treatment is an important part of healthcare and can be covered by Medicare. The type of addiction treatment that Medicare covers depends on the specific plan. Generally, Medicare Part A (hospital insurance) covers inpatient mental health services, including those that treat gambling addiction. Medicare Part B (medical insurance) may cover counseling services for individual, group, or family therapy related to a gambling addiction.

Does Medicare pay for outpatient treatment?

Medicare does not directly cover outpatient treatment of gambling addiction. However, it may cover some of the costs if the treatment is medically necessary and meets certain criteria.

In order to be eligible for coverage, the treatment must be performed by a Medicare-approved provider in an outpatient facility. The patient must also have a diagnosis that meets Medicare's definition of "medically necessary."

Does Medicare offer transportation to my appointments?

Original Medicare (comprising Parts A and B) typically provides coverage for transportation only in specific circumstances and does not generally cover routine trips from your residence to your healthcare provider. Part A might include emergency transportation services, while Part B could cover transportation if it's deemed medically necessary.

In contrast, a Medicare Advantage plan may include specialized transportation benefits that cater to your doctor visits. Some plans may even extend coverage to transportation for fitness center trips or healthcare-related transportation through services like Lyft or Uber. The extent of transportation services covered is contingent upon the precise Medicare Advantage plan you have, so it's advisable to contact your provider to ascertain what services are available and gain a clear understanding of how the coverage operates.

One option when considering gambling treatment with medicare is an online provider. An online provider will offer many of the same treatment benefits as in-person treatment without the need to travel. Additionally, online treatment is private and discreet. 

How To Find A Rehab Program That Accepts Medicare

If you or someone you care about is struggling with gambling addiction, it is important to find a rehab program that accepts Medicare. Gambling addiction can be a devastating condition, and help from the right program can make all the difference.

Calling a provider and asking about their coverage options is a great initial first step to determine if they accept Medicare. The Medicare website can also provide information on which gambling addiction treatment providers accept Medicare.

Options if Medicare Doesn’t Cover Your Treatment

If Medicare doesn't cover your gambling addiction treatment, it's essential to explore alternative options to get the help you need. Here are some steps to consider:

  • Contact Medicare: Start by reaching out to Medicare to verify the specific reasons for non-coverage. Sometimes, there may be exceptional circumstances or additional documentation that could potentially qualify your treatment for coverage.

  • Medicaid: If you meet certain income and resource requirements, you might be eligible for Medicaid, a state and federally funded program that provides comprehensive healthcare coverage, including mental health services. Each state has its own Medicaid program, so eligibility and coverage may vary.

  • Private Insurance: Investigate whether private health insurance plans cover gambling addiction treatment. Some private insurers offer more extensive coverage for mental health services, which might include addiction treatment.

  • Nonprofit and State Programs: Look for nonprofit organizations or state-funded programs that specialize in addiction treatment. These programs often provide financial assistance or sliding-scale fees based on your income.

  • Employee Assistance Programs (EAPs): If you're employed, inquire about EAPs offered by your workplace. These programs often provide confidential counseling and support for addiction issues.

  • Support Groups: Join support groups such as Gamblers Anonymous, which can provide emotional support and coping strategies.

  • Self-Pay or Payment Plans: If all else fails, consider self-pay options or negotiate payment plans directly with treatment facilities.

Remember that healthcare policies can change, so periodically check for updates on Medicare's coverage policies regarding gambling addiction treatment. Your health and well-being are a priority, and there are often options available to help you access the treatment you need.


Signs of Gambling Addiction in a Spouse

Nov 30, 2023


​​Signs of Sex Addiction

Nov 27, 2023


Gambling and Divorce: Statistics and Information

Nov 26, 2023


What is DFS Gambling?

Nov 19, 2023


Addiction Specialist: Helping You Overcome Addiction

Nov 18, 2023


Exploring the Different Types of Gambling

Nov 8, 2023


Technology Addiction: Signs and Treatment

Oct 30, 2023


Is Sex Addiction Real? 

Oct 25, 2023


Is Options Trading Gambling?

Oct 23, 2023


Gambling Addiction and Treatment

Oct 16, 2023


Sex Addiction Treatment and Therapy Options

Oct 14, 2023


Signs of Gambling Addiction

Oct 7, 2023


Is the Stock Market Gambling?

Sep 25, 2023


Tips for Finding a Gambling Rehab Center

Sep 24, 2023


Cognitive Behavioral Therapy for Pathological Gambling

Sep 23, 2023


What Causes Porn Addiction?

Sep 18, 2023


Video Game Addiction

Sep 16, 2023


Porn Addiction Signs & Symptoms

Sep 11, 2023


Gambling Addiction Withdrawal Symptoms & Signs

Aug 29, 2023


How to Stop Online Gambling

Aug 27, 2023


Does Medicare Cover Gambling Rehab?

Aug 19, 2023


Gambling and Dopamine

Aug 12, 2023


How to Stop a Porn Addiction: Tips & Treatment

Aug 11, 2023


Porn Addiction Counseling

Aug 7, 2023


Is Fantasy Football Gambling?

Jul 24, 2023


Signs of a Day Trading Problem

Jul 19, 2023


Why is Gambling Addictive?

Jul 18, 2023


The Arizona Lottery and Gambling

Jul 16, 2023


Is Poker Gambling?

Jul 15, 2023


Is Crypto Gambling?

Jul 14, 2023


Gambling and Sports Betting Among College Students

Jul 8, 2023


Updates made to gambling disorder across the DSM-III, DSM-IV, DSM-5

Updates Made to Gambling Disorder Clinical Criteria Between DSM-III, DSM-IV, and DSM-5

Jul 8, 2023

Cara Anderson

Combatting Gambling and Alcohol Addiction

Jun 30, 2023


Medication for Gambling Addiction

Jun 27, 2023


The Seven Types of Gamblers: Are You One of Them?

Jun 25, 2023

Elliott Rapaport

10 Questions to Ask If You Think Your Loved One Has a Gambling Problem

Jun 24, 2023

Cara Anderson

Signs of a Sports Betting Problem

Jun 21, 2023


Las Vegas - often called the gambling capital of the world

Exploring the History of Gambling in the US

Jun 17, 2023

Elliott Rapaport

Gambling Treatment in Arizona

Jun 15, 2023


Voluntary Self Exclusion to Stop Online Gambling

Jun 15, 2023

Cara Anderson

Does Blue Cross Blue Shield Cover Gambling Treatment?

Jun 13, 2023


The Growing Issue of Loot Box Addiction: What Parents Need to Know

Jun 11, 2023

Cara Anderson

Gambling Addiction Hotline

Jun 5, 2023


How to Stop Gambling

Jun 1, 2023


Can Gambling Addiction Be Cured?

May 31, 2023


problem gambler worried about addiction

Why Is Gambling So Addictive?

May 30, 2023

Elliott Rapaport

Medication that can cause gambling

Abilify and Compulsive Gambling

May 26, 2023

Cara Anderson

A man who has regained control of his life by stopping gambling and online sports betting

How to Stop Gambling: Strategies for Regaining Control

May 21, 2023

Cara Anderson

This man stopped gambling by recognizing his online sports betting problem

How to Stop Gambling and Save Money

May 18, 2023

Cara Anderson

People celebrating being free of a gambling addiction

How to Help Someone with a Gambling Addiction

May 16, 2023

Elliott Rapaport

What is a Microbet and how does it contribute to online sports betting addiction

Microbets and Online Gambling Addiction

May 13, 2023

Elliott Rapaport

The Growing Phenomenon of Cryptocurrency Addiction: What Traders Need to Know About Crypto Addiction

Cryptocurrency Addiction

May 9, 2023

Tobias Jackson

Esports player competing in an esports match and having fans gamble on their play

The Rise of Esports Gambling

May 6, 2023

Cara Anderson

The stock market graph of a day trader who has a day trading addiction

How Day Trading Can Create a Dangerous Addiction

May 4, 2023

Elliott Rapaport

Younger individuals gathered around a computer talking about a gambling addiction meme

How Addictive Memes Have Fueled Problem Gamblers

May 2, 2023

Elliott Rapaport

Man in the middle of taking a Do I have a Gambling Problem Quiz

Clinical Screening Tools and Quizzes to Answer the Question: "Do I have a Gambling Problem?"

May 1, 2023

Tobias Jackson

This man has a Sports Betting Problem and is sitting in front of a tv watching his online sports bets lose.

Sports Betting Problems and What to Be Aware Of

Apr 30, 2023

Elliott Rapaport

Insurance paperwork that Birches clients do not need to go through as Birches Health handles all administrative and payment matters for them!

Insurance Coverage for Gambling Addiction in 2023

Apr 29, 2023

Elliott Rapaport

Man reading outside as he has stopped online sports betting

How to Stop Sports Betting

Apr 28, 2023

Cara Anderson

Couple hugging as the man has a gambling addiction and the woman, his loved one, is able to support him through it.

Helping a Loved One with a Gambling Addiction

Apr 27, 2023

Cara Anderson

Man actualizing self care and manifesting his recovery journey from problem gambling and gambling addiction

Self Care for Problem Gamblers

Apr 26, 2023

Cara Anderson

NCAA student athletes in college at university gathering to celebrate a great practice

Can NCAA Athletes Bet on Sports?

Apr 25, 2023

Elliott Rapaport

Bad effects of glamorization of gambling in the media in films, tv shows, and podcasts

Glamorized Gambling and What To Be Aware Of

Apr 24, 2023

Elliott Rapaport

College students (youths and young adults) all gathered around a tv watching the athletic contest during March Madness

What is March Madness and Should You Be Worried?

Apr 22, 2023

Elliott Rapaport

Basketball arena where spectators are gathering to watch a National Basketball Assocation (NBA) game and may be betting on sports and wagering on events and the outcome of the game

What is Sports Betting and Event Wagering?

Apr 21, 2023

Elliott Rapaport

Therapist offering a problem gambler gambling addiction counseling and treatment

What is Problem Gambling?

Apr 20, 2023

Elliott Rapaport