Share Your Story to Improve Substance Use Disorder Treatment in Medicare!
We want to hear from you! The Legal Action Center is collecting stories from people who use Medicare and who have not been able to get the substance use disorder (alcohol or drug addiction) treatment they need. If you are a friend, family member, or health care provider of someone who needs treatment, you can also answer these questions on their behalf. The stories will be used to encourage policymakers to make treatment better and easier to access.

Your name or other identifying information will not be shared with anyone. If you have questions about this form or would like to share your story in another way, please contact Deborah Steinberg at dsteinberg@lac.org.
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Describe the problem(s)
The first few questions will help us understand the problem(s) you faced when trying to get substance use/addiction treatment through Medicare and whether you were able to get the treatment you needed.
What service or treatment did you try to get?
What problem(s) did you face when you tried to get the service or treatment? Check all that apply.
Please provide any additional information about the problem.
Were you eventually able to get the treatment or services you needed?
Clear selection
Please provide any additional information about how you were able or unable to get the treatment or services you needed.
For example, if Medicare covered some of the treatment, what did they cover and what did you not get? If you got the treatment but it was not covered by Medicare, how was it paid for?
When did you experience the problem(s)?
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Background Information
These questions help us understand more about your Medicare. All of the questions are optional. You may skip questions you do not want to answer. You do not have to provide your name.
Home zip code
This information is used to identify your member of Congress. When we talk to Congressional offices, it is helpful to say that someone they represent is affected by this problem. If you do not know the zip code, you can also give your town and state.
Do you use Medicare for health insurance?
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Do you have any other insurance in addition to Medicare?
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What type of Medicare do you have?
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Additional Details/Follow Up
Last section! Tell us about yourself (or if you are answering for someone else, about the person who needs treatment). All your answers are anonymous.

We are asking these questions because we know recovery looks different for everyone. We also know age, race, gender, sexual orientation, and other social factors affect access to quality treatment, services, and recovery. Your answers will help us make sure we are reaching as many communities as possible.
Age
Race and/or ethnicity
Gender
Sexual Orientation
Type of substance use disorder
Your name
If you would like your name to be given with your story, please include it here. These stories will be shared with policy makers to make treatment better and improve access to care.
If you are filling out this form on behalf of the person who needs substance use/addiction treatment, what is your relationship to that person?
Clear selection
Can we contact you if we have questions about your experience? If so, please share your contact information (phone or email).
If you do share your contact information, it will be kept confidential.
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