Medicare Coverage for Mental Health Services

When most people think of Medicare, they may only envision health care coverage for physical ailments. Unfortunately, many beneficiaries fail to realize that their Medicare coverage also includes an array of mental health services. 

The lack of knowledge surrounding Medicare mental health coverage is worrisome on two levels. For one, older adults can be at risk of developing a mental health issue due to issues such as dementia, deteriorating health, or the loss of a loved one. And second, a large number of older adults with mental health problems fail to receive the care they need due to a lack of access, affordability, or knowledge about the benefits they actually have available to them. 

Here is an overview of Medicare’s coverage of mental health services to help beneficiaries better understand their options for seeking treatment. 

What Medicare Covers

Medicare is split up into four separate parts — A, B, C and D — and each offers its own set of benefits related to mental health. 

Medicare Part A provides coverage for inpatient care at a psychiatric hospital or when receiving mental health services as an inpatient at a general hospital. Coverage includes the cost of your room, meals, nursing care, therapy and other treatment, tests, medications and other related services. 

Medicare Part B is where you’ll find the bulk of mental health coverage. Part B provides coverage for outpatient services and includes:

• Annual depression screenings
• Individual and group psychotherapy
• Individual and family counseling
• Lab and diagnostic tests
• Psychiatric evaluations
• Certain medications and medication management
• Partial hospitalization 

Many of Medicare’s Part B services can now be accessed via telehealth, which allows you to meet with doctors and other health care professionals without having to leave your own home. Part B also provides coverage of alcohol and substance abuse treatment for people who are struggling with dependency.

Medicare Part C (also known as Medicare Advantage) and Part D can provide coverage of prescription drugs designed to treat the symptoms of mental health conditions, including antidepressants and antipsychotic medications. 

Medicare Advantage plans can also provide coverage of fitness programs, adult care, and other things that can help fight off depression and other mental health problems.

When to Seek Help

Identifying and opening up about a mental health issue can be even more intimidating than navigating your Medicare benefits. Talk to your doctor if you have ever experienced:

• Suicidal thoughts
• Lack of energy
• Difficulty concentrating
• Trouble sleeping
• Feelings of hopelessness or a loss of self-worth
• Social withdrawal and isolation
• Extreme weight loss or loss of appetite
• Increased use of alcohol or drugs

Medicare Part B and all Medicare Advantage plans provide coverage of one depression screening every year, and you will pay nothing for the appointment as long as your doctor accepts Medicare. 

And all new Medicare beneficiaries are entitled to a “Welcome to Medicare” preventive care visit which includes a review of your possible risk factors for depression. In each subsequent year, your annual Medicare wellness visit includes a review of those risk factors and an evaluation of any changes in your lifestyle or mood. Both your Welcome to Medicare visit and the annual wellness visit are also fully covered.  

Take advantage of your Medicare mental health benefits so that you can continue living your best life.