Medicare covers various pain management services under Parts B (therapies) and D (medications). Part A covers hospital pain management, while Medicare Advantage usually covers the same treatments as Original Medicare.

The term “pain management” can include many different things. Some people may need short-term pain management after surgery or an injury. Others may need to manage long-term chronic pain for conditions like arthritis, fibromyalgia, or other pain syndromes.

Pain management can be expensive, so you may wonder if Medicare covers it. Medicare does cover many of the therapies and services you’ll need for pain management.

Read on to learn which parts of Medicare cover different therapies and services, what costs you can expect, and more about how pain can be managed.

Medicare provides coverage for many treatments and services that are needed to manage pain. Here is an overview of the parts that cover it and what treatments are included.

Medicare part A

You may receive pain management if you’re an inpatient at a hospital or long-term care facility for the following reasons:

  • car accident or major injury
  • surgery
  • treatment for a serious illness (cancer, for example)
  • end-of-life (hospice) care

While you’re admitted to the hospital, you may need several different services or therapies to manage your pain, including:

  • epidural or other spinal injections
  • medications (both narcotic and non-narcotic)
  • occupational therapy
  • physical therapy

In addition, Medicare may cover up to 4 weeks of hospitalization specifically for pain management, after which, if you need more support, you can continue as an outpatient under Part B.

Medicare Part B

Medicare Part B, your medical insurance, will cover the following outpatient services related to pain that lasts for longer than three months:

  • Medication management: Prior approval may be needed before you can fill narcotic pain medications. You may also be given a limited quantity.
  • Behavioral health integration services: Sometimes, people with chronic pain can also have problems with anxiety and depression. Medicare covers behavioral health services to help manage these conditions.
  • Physical therapy: For acute and chronic pain issues, your doctor may prescribe physical therapy to help manage your pain.
  • Occupational therapy: This type of therapy helps you return to your typical daily activities, which you may not be able to do while in pain.
  • Chiropractic spinal manipulation: Part B covers limited manual manipulation of the spine if medically necessary to correct a subluxation.
  • Alcohol misuse screenings and counseling: Sometimes, chronic pain can lead to substance misuse. Medicare covers screenings and counseling for this as well.

Medicare Part D

Medicare Part D (prescription drug coverage) will help you pay for your medications and programs to manage them. Medication therapy management programs are covered and can offer help navigating complex health needs.

What medications do doctors prescribe for pain management?

Common medications that may be used in pain management include, but are not limited to:

  • narcotic pain medicines like Percocet, Vicodin, or oxycodone
  • gabapentin (a nerve pain medicine)
  • celecoxib (an anti-inflammatory medication)

These medications are available in generic and brand-name forms.

Does Medicare pay for oxycodone?

Medicare Part D may pay for opioid pain medications such as hydrocodone (Vicodin), oxycodone (OxyContin), morphine, codeine, and fentanyl, which can help relieve your symptoms.

That said, the covered medications will depend on your particular plan. Costs and coverage amounts for different drugs will vary from plan to plan. The costs will depend on your individual plan’s formulary, which uses a tier system to group drugs into high, middle, and lower costs.

Getting your prescriptions from a participating healthcare professional and pharmacy is important. To ensure full benefits for Part C, you must use in-network providers.

Opioid safety notice

Opioids are highly effective pain medications. However, it’s important to know that they do have the potential for addiction and misuse.

There are a few steps you can take for safer opioid use:

  • Tell your doctor if you have a history of substance misuse. They can carefully monitor your medication regimen during your recovery period.
  • Follow the directions listed on your prescription. Taking too much or taking a dose incorrectly, such as crushing pills before taking them, may lead to serious side effects, including difficulty breathing or overdose.
  • Speak with your doctor about what substances to avoid while taking opioids. Mixing opioids with alcohol, antihistamines (such as diphenhydramine), benzodiazepines (such as Xanax or Valium), muscle relaxants (such as Soma or Flexeril), or sleep aids (such as Ambien or Lunesta) can increase your risk of dangerously slowed breathing.
  • Store your medications in a secure place and out of reach of children. If you have unused opioid pills, take them to a community drug take-back program for disposal.

To be eligible for coverage, you must be enrolled in either an Original Medicare plan or a Medicare Part C (Medicare Advantage) plan. A doctor must deem your hospital stay or clinic visit medically necessary, and the provider must participate in Medicare.

In addition, before any services and procedures are covered, a Medicare-enrolled doctor must certify that they are medically necessary to treat your condition.

Medicare Part A costs

Medicare Part A is your hospital insurance. While you are admitted to the hospital, you will be responsible for the following costs under Part A:

  • $1,632 deductible for each benefit period before coverage kicks in
  • $0 coinsurance for each benefit period for the first 60 days
  • $408 coinsurance per day of each benefit period for days 61 to 90
  • $816 coinsurance per each “lifetime reserve day” after day 90 for each benefit period (up to 60 days over your lifetime)
  • 100% costs beyond your lifetime reserve days

Medicare Part B costs

Under Medicare Part B, you are responsible for paying:

  • A $240 annual deductible, which must be met each year before any medically necessary services will be covered
  • Your monthly premium, which is $174.70 for most people in 2024

Medicare Part C costs

Costs under a Medicare Part C plan will differ and depend on your chosen plan and how much coverage you’ve chosen. The coverage you have under a Part C plan must be at least equal to what Original Medicare covers.

Medicare Part D costs

The cost of Part D also depends on your plan and the specific tier of the covered drug in the Part D formulary.

In addition to pain medicines and physical therapy, there are other methods for managing chronic pain. Many people find relief with the following therapies:

  • acupuncture, which is actually now being covered under Medicare for people who have issues with lower back pain
  • CBD or other essential oils
  • cold or heat therapy

Most of these aren’t covered by Medicare, but check with your particular plan to see if a therapy is covered.

Most Medicare plans cover pain management therapies and services if a healthcare professional certifies them as medically necessary.

Medicare Advantage coverage may vary from plan to plan, so be sure to check with your insurance provider about what is covered under your particular plan. In addition to narcotic pain medications, there are many other options to explore to manage pain.