Medicare and Mental Health – What’s Covered?

Mental health can be a heavy burden for those who haven’t been able to seek the help they need. Fortunately, thanks to Medicare’s improvements and technology, resources are more accessible than ever before. As a Medicare beneficiary, you can receive the necessary support for a variety of conditions.

Mental Health and Older Adults

According to the Centers for Disease Control and Prevention (CDC), at least 20 percent of older adults feel they have a mental health condition that needs to be resolved. Anxiety, severe cognitive impairment, and mood disorders (such as depression) are 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. This 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 treatment.

Medicare Part A (hospital insurance) covers individuals who need to be admitted and classified as inpatient.

If you have Original Medicare only, once you reach your $1,484 Part A deductible, you won’t be responsible for any additional days that you stay in the hospital.

If you have 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 your Supplement plan.

Medicare Advantage plans cover inpatient mental health care. You’ll have a copay for your stay which varies by plan.

Remember, Medicare covers what it considers 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

Mental health screenings are included as part of Medicare’s mental health treatment coverage.

If you have 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 have (as long as your doctor accepts Medicare).

If you have a Medicare Advantage plan and you’re admitted to the hospital, you’ll 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, check that the facility or doctor is in-network.

Our advisors in Medicare are happy to walk you through your plan’s details, including in-network resources.

Mental Health Providers

Mental health providers covered by Medicare Advantage plans and Original Medicare include:

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

Depression Screenings

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

Advisors in Medicare Here for You

If you have questions about how your Medicare coverage may apply to your mental health needs, contact our team of client advisors at client@retiremed.com or 877.222.1942.

If you aren’t yet a RetireMED client and have questions about retirement or Medicare, please contact our advisors in Medicare at 855.465.2773 or advice@retiremed.com.