Does Medicare Cover Mental Health Care? 

Taking care of your body as you grow older is important, but it’s important to pay attention to our mental health as well. Common mental health concerns that tend to show up with age include depression and anxiety. These conditions can either become chronic or may be situational. If you’re experiencing any changes in your mental health, talk to a medical  professional right away. 

Whatever the cause or level of severity, mental health concerns can not only impact your quality of life in what are supposed to be your best years, but they can also have an impact on your physical health as well. As a result, seniors are encouraged to seek help to address mental health challenges as soon as they begin to exhibit symptoms.

How do Medicare benefits cover mental health care?

Medicare coverage is available for mental health care in a number of different ways. When someone initially has a mental health concern, they typically will seek a consultation with a family physician. This visit is covered by Medicare Part B, the outpatient benefit. Medicare Part B also provides one depression screening per year at no cost. Medicare recipients do not need to have met the annual deductible in order to take advantage of this screening. Additionally, Medicare Part B covers one wellness visit per year with a family physician to check in and discuss prevention tips to stay healthy.

If therapy sessions are prescribed to treat mental health concerns, Medicare Part B will also supply coverage for these treatments. Individual, group and family counseling are covered by Medicare benefits. The cost to Medicare recipients under Part B is usually 20% of the total cost of each session. Medicare benefits cover the remaining 80%, but you will need to meet your plan’s deductible first. 

Additionally, services must be provided by a Medicare-participating clinical psychologist or approved therapist. Seeking independent treatment for mental health care may result in Medicare recipients bearing the full cost of care.

Medicare coverage of mental health medications

If medications are prescribed as a part of a treatment plan, these would be covered by Medicare Part D. The medications must be included in your plan’s formulary and purchased from a retail pharmacy. Medications that need to be injected by a medical professional may be covered by Medicare Part B as injections are considered outpatient treatment.

Medicare benefits and inpatient mental health care

Inpatient mental health services are covered by Medicare Part A. This part of Medicare coverage provides benefits for 60 days at full coverage for each benefit period. Beyond 60 days, Medicare recipients will pay a per-day fee for treatment in a hospital. If you receive mental health services in a skilled nursing facility (SNF), Medicare coverage supplies benefits for 20 days with an additional 80 days of inpatient coverage available at a discounted per-day rate.
Medicare and substance abuse care

Substance abuse is classified as a mental and behavioral health concern. Addiction and mental health challenges often go hand-in-hand, and it’s vital for seniors to seek treatment if they are experiencing the effects of addiction as a result of substance abuse. Medicare coverage provides benefits for substance abuse through both Part A and Part B for inpatient and outpatient care, respectively. Medications prescribed to treat substance abuse may also be covered by Medicare Part D.