Does Medicare Cover Mental Health Services?

Medicare does help cover mental health care services for both outpatient and inpatient mental health care.

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When does Medicare pay for mental health care?

Medicare Part A helps cover mental health care if you’re admitted to a hospital as an inpatient. Examples of mental health services that are generally covered by Medicare Part A include:

  • Your room
  • Nursing care
  • Meals
  • Lab tests
  • Therapy or treatment for your mental health condition
  • Some medications

How much do mental health services cost with Medicare?

Before Medicare Part A will pay its share for covered mental health services, you must meet your Part A deductible ($1,364 per benefit period in 2019).

Once your deductible is met, you typically pay the following costs in 2019:

  • $0 coinsurance per day of each benefit period for days 1-60 as an inpatient
  • $341 coinsurance per day of each benefit period for days 61-90 as an inpatient
  • $682 coinsurance per each “lifetime reserve day” after day 90 as an inpatient
  • All costs beyond your lifetime reserve days

Note: A benefit period begins the first day you’re admitted as an inpatient and ends once you’ve been discharged from the hospital for 60 consecutive days.

Medicare Part B covers some mental health care services

Medicare Part B helps cover mental health services from a doctor outside of a hospital, such as:

  • Visits with a psychiatrist
  • Visits with a clinical psychologist or social worker
  • Lab tests ordered by a doctor

Typically, you pay 20 percent of the Medicare-approved amount for qualified mental health services, and Medicare pays 80 percent, once your Part B deductible is met. In 2019, the Medicare Part B deductible is $185 per year.

Note: Ask your doctor or psychiatrist if they accept Medicare assignment before obtaining mental health care services or treatment. Going to a doctor or provider who does not accept Medicare assignment could cause you to pay more out of pocket for your care.

Does Medicare cover prescription drugs?

Original Medicare (Part A and Part B) does not typically cover prescription drugs, including prescription drugs needed to treat or manage mental health conditions.

If you have Original Medicare and need coverage for prescription drugs, you may enroll in a Medicare prescription drug plan (Medicare Part D), or you may be able to switch to a Medicare Advantage plan that provides prescription drug coverage.

Medicare Advantage plans can cover mental health care and more

Medicare Advantage (Medicare Part C) is an alternative to Original Medicare that provides the same hospital and medical benefits as Medicare Part A and Part B.

Many Medicare Advantage plans may offer some additional benefits such as vision, dental and hearing coverage.

To learn more about Medicare Advantage plans and to find a plan in your area that can help cover your mental health care needs, call today to speak with a licensed insurance agent.

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