Eliminating Cost-Sharing for Opioid Addiction Treatment in Medicare and Private Plans.
This law aims to remove financial barriers to accessing opioid use disorder treatment, including medications, behavioral therapy, and recovery support services. Medicare beneficiaries in selected states and individuals with private insurance (starting 2025) will face zero out-of-pocket costs for these critical services. These changes are designed to increase access to life-saving treatment and support during the opioid crisis.
Key points
Zero Cost for Medicare: In 15 selected states, all cost-sharing (copayments, deductibles) will be eliminated for opioid addiction medications, overdose reversal drugs, behavioral therapies, and recovery support services for Medicare beneficiaries.
Private Insurance Coverage: Starting in 2025, private health plans must cover opioid use disorder treatment and cannot impose any cost-sharing requirements on patients.
Enhanced Medicaid Funding: Federal funding for states under the Medicaid program will increase to facilitate broader access to medication-assisted treatment and recovery support services.
Expired
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