A growing concern for many Medicare beneficiaries pertains to what kind of mental healthcare services are available when they start their Medicare journey. Many people do not think that Medicare will cover any mental health services, this is incorrect. Medicare covers mental health services to help Medicare beneficiaries deal with depression and anxiety. Part A and Part B both have mental health coverage, how they are treated and paid for depends on whether the services fall under Part A or Part B.
Mental health coverage under Part A includes any mental healthcare you receive while admitted in a facility. This mainly includes inpatient hospital stays. If you are carrying just Original Medicare (Part A and Part B), you will have a Medicare standard Part A deductible before Medicare Part A steps in and pays. Please note: the Part A deductible resets after a Medicare defined benefit period. The defined benefit period is 60 continuous days of un-hospitalized care.
Outpatient mental health coverage is going to fall under Part B of Original Medicare; this is often thought as “counseling” and psychotherapy. Part B is going to include doctor’s visits, group and/or individual therapy etc. Partial hospitalization is also included underneath Part B of Original Medicare. Partial Hospitalization is done through hospitals on an outpatient basis to patients during the day with the individual not being admitted into the hospital. If you are just carrying Original Medicare (Part A and Part B), you will have a small Part B deductible and a 20% co-insurance for all covered services. This is a standard rate that is set by Medicare.
A Medicare supplement may help fill in the payment gaps for the mental healthcare co-insurances or deductibles, if they are Medicare approved services. Medicare Advantage plans also cover mental health services, but you will have different costs for different services depending on the plan. It is important to understand how your Medicare Advantage plan works; including the co-pays, co-insurances, and the provider network you must adhere to.
Medications that are prescribed to a Medicare Beneficiary to help treat mental health conditions can be cost shared through a stand-alone Part D plan or a Medicare Advantage plan that includes drug coverage. You may have co-pays in addition to your plan premium for you drug coverage. It is important you review your medications and plans thoroughly to understand what they are going to cover.
If mental health services are important to you when you are on Medicare, consult a licensed insurance professional to understand what you have available to you and how to utilize it.