What Mental Health Services Does Medicare Cover?
Key takeaways:
Medicare is a federal health insurance program for people 65 or older, younger people with disabilities, and those with end-stage renal disease.
Medicare Part A and Part B (original Medicare) cover inpatient and outpatient mental health services. You need to purchase a Medicare prescription drug plan (Part D) for prescription drug coverage.
A supplemental Medicare plan can help cover out-of-pocket mental health care costs not covered by original Medicare.
We have all paid a price from the pandemic and continue to.
Medicare does have a mental health benefit. Original Medicare consists of Medicare Part A (hospital insurance) and Part B (medical insurance). You will have access to inpatient and outpatient mental health services under Medicare Part A and Part B. Both may have deductibles and coinsurance.
Medicare Part A provides for inpatient services. These are for hospitals and psychiatric facilities.
You get coverage for the following:
Medications
Labs
Meals
Nursing care
Room
Medical supplies
Medicare Part B covers individual and group psychotherapy. You will also receive outpatient mental health services, which include:
Free annual depression screening (Must take place in a doctor’s office or primary care clinic)
Free annual wellness and “Welcome to Medicare” visits, which help identify risk factors for depression and other mental illnesses
Labs
Medication management
Partial hospitalization (No overnight stay required)
Testing and psychiatric evaluation
Treatment for substance abuse
This table shows mental health coverage for different parts of Medicare:
Source: US.gov
To qualify for mental health services, Medicare requires that the healthcare provider be one of the following:
Certified nurse-midwife
Clinical nurse specialist
Clinical social worker
Independently practicing psychologist
Medical doctor
Nurse practitioner
Physician assistant
Before you make an appointment with a mental health provider, ask if they accept the assignment. This means Medicare can pay them for medical services. You will usually only pay the deductible and coinsurance. Your healthcare provider will submit the claim to Medicare to receive the remaining amount of money owed for services. You do not need a letter for authorization.
If the doctor or mental health provider does not accept assignment, you will have to pay for the total cost of your services.
Your healthcare provider usually performs services outside of a hospital. This includes their office, community mental health center, and a hospital's outpatient department.
Medicare Part B provides benefits for mental health disorders like depression or anxiety. Here are examples of procedures and approaches: