Approximately 1 in 5 older adults suffer from a mental disorder. Declining health issues bring on these kinds of challenges that require medical attention. It is important to know if the services that are necessary are covered by Medicare, especially mental health services. If someone is struggling with depression or suicidal thoughts, they should be able to seek help without fear of extreme bills following.
Medicare Preventive Coverage
Medicare provides free preventive coverage to their beneficiaries. These include mental health services as well. The free services covered are:
- Annual depression screening: Medicare beneficiaries can get one free evaluation for depression every year.
- Alcohol misuse screening: Medicare covers one alcohol misuse screening per year
- ‘Welcome to Medicare’ visit: When you first enroll into Medicare Part B, you can get this initial visit within the first 12 months. During this visit, your medical and social history is reviewed. There will also be a review of your risk for depression.
- ‘Wellness’ visit: During the annual visit, your doctor will evaluate your physical and mental health. During this time, you should bring up any mental health concerns. Your doctor will make recommendations, or refer you for additional treatment.
Mental Health Outpatient Services
Outpatient mental health care is covered by Medicare Part B. Medicare covers counseling services, including diagnostic assessments including:
- Psychiatric evaluation and diagnostic tests
- Individual therapy
- Medication management
- Certain prescription drugs
- Partial hospitalization
- Group therapy
- Family counseling (if the main purpose is to help with your treatment)
- Alcohol abuse counseling (up to four sessions)
You can receive these services from a psychiatrist, clinical psychologist, clinical social worker, clinical nurse specialist, nurse practitioner, or physician assistant. Visits are usually in a doctor’s office or health center.
Mental Health Inpatient Services
If your condition requires inpatient care, such as a stay at a hospital or psychiatric hospital services, Medicare Part A will cover it. The coverage will only last for up to 190 days in your lifetime. Medicare Part B will cover the doctor services you get during your hospital stay.
Although Medicare covers mental health services, there are some costs that fall on you. Medicare Part A 2020 costs for mental health are:
- The Medicare Part A deductible – $1,408
- No coinsurance for the first 60 days
- $352 coinsurance per day for days 61-90
- $704 coinsurance per “lifetime reserve day” after the 90th day. Lifetime reserve days are days that you remain inpatient after the 90-day hospital stay.
- All costs after your lifetime reserve days are used up
Part B 2020 costs are:
- Deductible is $198
- 20% of the Medicare-approved health-care services
- Possible additional copayment or coinsurance if you receive services as a hospital outpatient. The amount depends on the services provided, but is generally 20%.