Personal mental health is something every person needs to take seriously—seniors especially. It’s difficult to ask yourself, “am I depressed?” or “should I talk to someone about my mental health?” but these are important questions nonetheless. Unfortunately, these questions are often followed by another one: “does my insurance cover mental health services?”
The good news for most seniors is that original Medicare covers basic inpatient and outpatient mental health services. Some costs—like depression screenings and other preventive mental health services—are even totally covered by Medicare. Nevertheless, it’s still important to know what’s covered, what’s not, and how to fill the gaps in your insurance so you can get the mental health services you need.
What Does Medicare Cover?
Mental health coverage extends to both Medicare Part A and Part B, depending on where and how services are rendered. Here’s a breakdown of coverages across both parts.
Medicare Part A covers hospitalization for mental health-related concerns, in either a general hospital or a psychiatric hospital.
- 20% of Medicare-approved inpatient costs
- $0 coinsurance for days 1–60 of treatment
- $352 coinsurance per day for days 61–90 of treatment
- $704 coinsurance per day for days 91+ of treatment, through your lifetime reserve days
- 100% of the treatment costs beyond lifetime reserve days
Medicare Part B coverage extends to outpatient services rendered by mental health professionals, including psychologists, social workers, nurse practitioners, and more.
- 20% of Medicare-approved outpatient costs
- Any copayment or coinsurance for services rendered at a hospital outpatient clinic
What Doesn’t Medicare Cover?
While basic Medicare coverage does offer seniors options for mental health, there are some important gaps to take note of—issues that may push you to seek more coverage.
For starters, not every mental health professional accepts Medicare and Medicare Part B only covers services rendered by a healthcare provider who accepts assignment. Medicare Part B also only covers certain medications, which may leave you paying out-of-pocket for some prescriptions. Additionally, Medicare Part A won’t cover inpatient stays past 160 days.
How SeniorCare Benefits Can Help
If you’re someone who needs more coverage and resources for your mental health, it’s important to explore healthcare plans beyond what basic Medicare can provide. Medicare Part C and Part D, as well as Medigap, offer extended mental health coverage for those who need it.
- Medicare Part C adds coverage for prescription drugs to Part A and Part B benefits.
- Medicare Part D can cover antidepressants, antianxiety medication, and antipsychotics.
- Medigap can help cover deductibles and coinsurance costs for inpatient and outpatient.
SeniorCare Benefits helps seniors explore these extended options and the mental health coverages within them, to give seniors the peace of mind they need about getting the mental health help they deserve.
You shouldn’t have to seek mental health services based only on what Medicare will cover! Let us help you get the coverage you need so you can get the help you need. To learn more, please call us at 1-888-230-0269 to speak with one of our agents about your coverage needs.
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