Rehab Centers in San Jose That Accept Medicare

Which parts of Medicare pay for addiction treatment in San Jose?

Medicare pays for addiction treatment in San Jose through three parts, and each part covers a different kind of care. Part A covers inpatient stays in a general or psychiatric hospital, including medically managed withdrawal when a hospital admission is needed.

Part B covers outpatient therapy, partial hospitalization, intensive outpatient care and opioid treatment program services, including methadone. Part D, or the drug coverage inside a Medicare Advantage plan, covers prescriptions such as buprenorphine and naltrexone. What you pay depends on each plan’s formulary, and Advantage plans may also limit you to a network or ask for authorization first.

Levels of care to look for in San Jose listings include withdrawal management, outpatient and intensive outpatient programs, opioid treatment and care for co-occurring mental health conditions. To compare, see detox in San Jose, outpatient rehab in San Jose and methadone clinics in San Jose.

Deductibles and coinsurance change every January, so get current figures from 1-800-MEDICARE or from your plan. Residential care outside a hospital and sober living generally fall outside Medicare coverage, though people who also qualify for Medi-Cal may be able to use it to fill that gap.

Does Medicare cover residential rehab in San Jose, and what are the alternatives?

Medicare generally does not pay for residential treatment outside a hospital, and it does not pay for sober living. Some San Jose residents on Medicare also qualify for Medi-Cal. Dual-eligible members can use Medi-Cal for care Medicare leaves out, and in Santa Clara County that care runs through county-contracted providers. Medi-Cal’s Medicare Savings Programs can also help with premiums and cost sharing. Medicare is not only for adults 65 and older: people under 65 who receive Social Security disability benefits or have end-stage renal disease are covered too.

Santa Clara County residents can reach the County of Santa Clara Behavioral Health Services Department through its Behavioral Health Services Call Center at (800) 704-0900. A phone representative asks a few questions and then places callers in alcohol and drug treatment. For options outside Medicare, see residential rehab in San Jose and state-funded rehab in San Jose.

What should people on Medicare ask a San Jose program before admission?

Ask intake staff whether the program is enrolled in Medicare, which services it bills to Medicare and what out-of-pocket costs to expect. Original Medicare works with any enrolled provider. Medicare Advantage plans sold in Santa Clara County use provider networks and may require prior authorization, so ask the plan whether a listed program is in network. Telehealth sessions are also worth asking about.

Getting there

About nine in ten San Jose programs listing Medicare sit within 25 miles of a river, nearly always the Guadalupe River. Mount Hamilton is the named summit closest to most of them, a median of 8 miles away. Downtown and central San Jose programs are on or near VTA light rail, while east-side and south San Jose sites mostly rely on bus routes.

Free help with coverage questions

California runs a free Medicare counseling program for residents, and 1-800-MEDICARE answers coverage questions by phone. In a crisis, calling 988 from the 408, 650 or 669 area codes connects to the county’s mobile response teams. For Medicare listings across California, see Medicare rehab in California. Coverage basics are on the Medicare insurance page, and every San Jose program is on the San Jose rehab page.