Medicare and Mental Health – What’s Covered?

Mental health can be a heavy burden for those of us who haven’t been able to seek the help we need. Fortunately, there are more resources available now than in the past. Thanks to Medicare’s improvements and technology that has made resources more accessible, you can receive the necessary support for a variety of conditions.

According to the CDC, at least 20% of older adults feel that they have a mental health condition that needs to be resolved. Anxiety, severe cognitive impairment and mood disorders (such as depression) are prevalent conditions that affect many older adults and can have a significant impact on their wellbeing. The most common mental health condition is depression. Unfortunately, it can cause existing chronic conditions to worsen if left untreated, which is one reason why getting the proper support for this mental ailment is especially important.

Below are a few ways to gain mental health support when you need it:

  • Reach out to friends and family when you need to express your feelings and when you are feeling upset.
  • Seek out trusted guidance from mental health professionals.
  • Let people know when you need help with everyday activities like housework, transportation, or paying bills.

What Does Medicare Cover?

The great news is that Medicare offers coverage for those facing mental health conditions. It covers anything considered medically necessary, which includes mental health treatments.

Medicare Part A (hospital insurance) covers individuals who need to be admitted and classified as inpatient. If you are on Original Medicare only, once you reach your $1,408 Part A deductible, you will not be responsible for any additional days you may be in the hospital. If you are on a Medicare Supplement plan and are admitted to the hospital, you will only be responsible for your Supplement premium, Part B deductible and possibly some small copays depending on the Supplement you are enrolled in. Remember, Medicare covers what they consider medically necessary, so if you exceed 60 days in the hospital, you may be required to pay for your visit out of pocket.

Mental health screenings are included as part of Medicare’s mental health treatment coverage. If you are on Original Medicare only or a Supplement plan, after your Part B deductible has been met, you may use your coverage toward any mental health needs you may have, as long as your doctor accepts Medicare.

If you’re on a Medicare Advantage plan and you are admitted to the hospital, you will be responsible to pay copays or coinsurance depending on your specific plan. It’s important to check your plan’s Summary of Benefits statement to review the details of your coverage. Before receiving treatment, be sure to check that the facility or doctor is in-network. Our team is happy to walk you through your plan’s details, including in-network resources.

Mental Health Providers covered by Medicare Advantage plans:

  • Psychiatrist or Doctor
  • Clinical Psychologist
  • Clinical Social Worker
  • Clinical Nurse Specialist
  • Nurse Practitioner
  • Any other Medicare-qualified mental health care professional deemed by law

Medicare Advantage plans also include depression screenings and high-intensity behavioral counseling as preventive care screenings pertaining to mental health. These preventive care services do not require copays.

If you have questions about how your Medicare coverage may apply to a particular mental health need, contact our team of Client Advisors at client@retiremediq.com or 1-877-222-1942.

If you are not a RetireMEDiQ client and have questions about retirement or Medicare, please contact us at 1-866-600-5638 or advice@retiremediq.com.

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