Mental disorders affect over 47 million U.S. adults in 2017, according to the National Institute of Mental Health.
If you are a Medicare user, you might be wondering if under your package you are eligible for mental health services. The good news is that inpatient treatment, outpatient services, and partial hospitalization are included in Medicare mental health coverage.
Take a detailed look at what sort of mental health services the Medicare plan includes, what kinds of Medicare programs are better for mental health coverage, and when to pursue mental illness assistance.
Mental health benefits from Medicare are largely provided by Medicare Part A and B. Let's take a look at the specifics of what is covered by each part.
Part A of Medicare provides mental health treatment related to stays in the inpatient facility. For people with acute mental condition crises that may damage themselves or others, this form of care is particularly necessary.
You're compensated by Medicare Part A for the cost of the room. Also, Medicare Part A is useful for covering:
laboratory research and some drug medications
Quality treatment in nursing
Medicare Part B includes your outpatient treatment-related mental health services, including comprehensive outpatient treatment programs and regular depression screenings. For anyone who needs ongoing mental health care, this form of treatment is significant.
Part B of Medicare is good for:
diagnostic laboratory research
some pharmaceutical products
intensive outpatient treatment, also referred to as partial hospitalization, including opioid use disorder rehabilitation
appointments in general and specialist therapy
appointments for psychiatry
appointments for clinical social workers
Medicare Part B also provides one yearly depression screening, with extra coverage for other mental health specialists for follow-up visits or referrals.
While parts A and B cover most of your mental health needs, by enrolling in the following Medicare plans, you can get additional coverage:
Medicare Part C: automatically incorporates the services of Medicare Part A and Part B, including prescription medications and other coverage areas
Medicare Part D: can help cover some of your medicines for mental wellbeing, including antidepressants, anti-anxiety drugs, antipsychotics, mood stabilizers, etc.
Medigap: can help offset some inpatient or outpatient treatment-related costs, such as coinsurance and deductibles,
For inpatient mental health services at a general or psychiatric facility, you must have Medicare Part A to be covered. For most of the inpatient medical programs, Medicare would pay for them. Depending on your schedule and the duration of your stay, however, you can still owe some out-of-pocket expenses.
For Medicare Part A, below are the basic costs:
$252-458 premium, if you have one,
$352 a day coinsurance for care days 61-90
$704 coinsurance monthly for 91+ days of therapy during your lifetime reserve days
a deductible of $1,408
20% of all Medicare-approved expenses during your stay
$0 coinsurance for therapy days 1-60
You will owe 100% of the care costs beyond your lifetime reserve days.
It is important to remember that while there is no limit to how much inpatient treatment you will receive in a general hospital, Medicare Part A in a psychiatric hospital will cover only up to 190 days of inpatient care.
For outpatient mental health services, partial hospitalization, and annual depression screenings, you must have Medicare Part B to be covered.
Medicare, like inpatient care, will cover most of the outpatient medical services, but before Medicare pays, there are certain financial conditions that you must meet.
For Medicare Part B, below are the basic costs:
20% of all costs accepted by Medicare during your treatment
any copayment or coinsurance costs while you are providing treatment at an outpatient medical clinic
A premium of $144.60, if you have one
deductible of $198
For outpatient mental health services, there is no limit on the number or amount of sessions that Medicare can cover. However, since these programs are associated with out-of-pocket expenses, to decide how much you can seek care, you may have to review your own financial situation.
Here is a list of mental health care providers that Medicare approves if you are looking to start counseling or therapy appointments under your Medicare plan:
nurse practitioner or an associate physician
a psychiatrist or physician
a clinical psychologist, social worker, or specialist nurse
There are many kinds of professionals in mental health that you can consult for assistance. Speak to your doctor about which specialist could be best for you if you're not sure who to see.
We become more vulnerable to health issues as we age, which may put older adults at a higher risk of mental disorders such as depression.
Common depression symptoms in people over 65 years of age can include:
changes in appetite
changes in sleep
difficulty with attention or memory
lack of pleasure in interests and sports
changes in mood
feeling negative continuously
other symptoms, such as tiredness, headaches, or digestive problems
The idea of harming oneself or others
Consider reaching out to your doctor to determine the next steps if you have problems with the symptoms above. They will refer you to a mental health provider if appropriate, who can talk about your symptoms, give a diagnosis, and seek care.
You are covered for both inpatient and outpatient mental health treatment because you have Original Medicare or Medicare Advantage. This includes hospital stays, appointments for counseling, intensive outpatient treatment, yearly screenings for depression, and more.
There are some expenditures associated with these programs, so finding the right Medicare plan for your needs is crucial.
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