Medicare Part B covers services for mental health, but it’s important to be aware of the guidelines regarding Medicare and mental health coverage. In order to know that your mental services are covered, it’s important to find a provider that accepts Medicare. While Medicare Part B does cover mental healthcare, there are co-pays for many services. Furthermore, some services are covered by parts of Medicare other than Part B.
Does Medicare Cover Mental Health
If you’re admitted to a hospital for a mental health concern, Medicare Part B will cover 80% of the cost of healthcare during your hospitalization. If you don’t have Medicare Supplement insurance, you’ll be responsible for the remaining 20% of the cost of your healthcare during your hospital stay.
Medicare Part B generally doesn’t cover a private room during inpatient mental health treatment. Medicare Part B doesn’t cover any additional amenities in your room, such as a television or telephone or personal care items during your hospital stay.
Medicare Part B covers mental healthcare whether you’re hospitalized in a psychiatric or general hospital. It’s important to note that not all private psychiatric hospitals accept Medicare, many psychiatric hospitals are privately run.
The cost of the hospital room you stay in is covered by Medicare Part A rather than Part B. Medicare Part B pays the costs for care you receive from doctors and nurses within the hospital.
Does Medicare Cover Mental Healthcare Programs
Some psychiatric and general hospitals offer day programs for mental health treatment. When you’re enrolled in these programs, you check yourself in for the day or part of the day and return home in the evenings. This plan often covers costs for these programs. However, it often doesn’t cover all services that are offered by them.
It doesn’t cover support groups that are part of a partial hospitalization program. However, it does cover group psychotherapy, which is lead by a psychologist or psychiatrist.
It doesn’t cover meals at a partial hospitalization program or transportation to it. If you receive any job or skills training in the partial hospitalization program, this isn’t covered by Medicare Part B unless it’s a direct part of your mental health treatment.
Additionally, partial hospitalizations are only covered if the hospital or community mental health center you receive these services from accepts Medicare. Many facilities that offer partial hospitalization programs don’t accept it.
Does Medicare Cover Outpatient Mental Healthcare?
Often times, Medicare Part B can cover expenses for outpatient mental healthcare. This includes mental health concerns related to substance abuse. However, not all psychologists and psychiatrists accept Medicare Part B.
Medicare Part B covers one depression screening each year & a wellness visit each year. You can use this visit to bring up mental health concerns to your doctor.
If you have a mental health concern come up at any point during the year, it covers a psychiatric evaluation. If diagnostic tests have to be performed after this evaluation, Medicare Part B typically covers the costs.
It also covers many treatment costs for mental health concerns. Medicare Part B covers counseling, and this includes outpatient group therapy sessions. If you require family counseling for your mental health treatment, this is also covered by Medicare Part B. It covers the cost of this care whether it’s provided by a psychologist, doctor/psychiatrist, clinical social worker, physician’s assistant, clinical nurse specialist, or nurse practitioner.
Medications As Part Of Outpatient Mental Healthcare
The cost of most medications for mental health concerns are not covered by Medicare Part B. Instead, they are covered by Medicare Part D. If you need to have the dosage or type of your medications adjusted, Medicare Part B can cover the cost of these appointments. It also covers the cost of evaluations to determine whether or not the medications you’re taking are effective. Still, there can be co-pays for these services.
If you have both Medicare Part A & Part B you’re eligible for a Medicare Supplement plan. Click here to compare rates or call us not to speak to a licensed agent!