Does Medicare Cover Therapy- And What You Need to Know
- Melanie Richardson
- May 24, 2022
- 5 min read
Find Out If Medicare Covers Mental Health
If you're over 65 or about to turn 65, and live in the U.S. you've most definitely heard about Medicare. For those not familiar, Medicare is a government-run health insurance program that provides coverage for seniors(65+) and people with disabilities.
Medicare has many advantages and with certain plans and benefits can really improve your life by providing services you need without having to pay as much as on traditional insurance plans.
One of the many benefits of Medicare is that it can cover mental health counseling, also known as therapy. However, not all Medicare plans cover therapy, so it's important to check your plan details to make sure you're eligible.
In this blog post, we will discuss the steps you need to take to make sure you have access to mental health counseling through Medicare, and why you should be taking advantage of the opportunity.
Insurance and Mental Health Services
There are many government programs that offer mental health benefits. For example, If you are a part of the military, there are mental health services available to you. There are also many private insurance companies that will offer you some form of mental health services.
The type and amount of services that are available to you will all depend on the insurance company that you choose, as well as the type of policy that you have.
Medicare Plans Quick Breakdown
There are four types of Medicare plans: Original Medicare (Part A and Part B), Medicare Advantage (Part C), Medicare Part D, and Medicaid.
Original Medicare (Part A) is described as hospital insurance. It covers inpatient care in hospitals, skilled nursing facilities, hospice care, and home health care services.
Original Medicare (Part B) is known as medical insurance. It covers outpatient care, preventive services, durable medical equipment, and some mental health services.
Medicare Advantage plans are an alternative to Original Medicare. They are offered by private insurance companies and must follow the rules set by Medicare. These plans typically offer more coverage than Original Medicare, but they may also have different rules, cost sharing, and networks.
Medicare Part D is a prescription drug plan that covers the costs of prescription drugs.
Medicaid is a state and federal program that provides health coverage for low-income adults, children, pregnant women, people with disabilities, and the elderly.
Does Medicare Cover Mental Health?
Now that we've gone over the basics of what each type of Medicare plan, let's focus on what specifically they cover when it comes to mental health services.
Original Medicare (Part A and B) does cover some mental health services. Part A covers inpatient mental health services in a hospital if you have a medical condition that requires treatment.
Part B covers outpatient mental health services, which include doctor's visits, counseling, and therapy.
Medicare Advantage plans must cover all the services that Original Medicare covers. This means that if a Medicare Advantage plan covers outpatient mental health care, it must cover all the services that Part B covers.
Medicare Part D plans may cover prescription drugs that are used to treat mental health conditions.
Medicaid programs must provide coverage for mental health services, but the type and amount of coverage will vary from state to state.
Medicare Part B
According to the Medicare website Part B
"helps pay for these outpatient mental health services:
One depression screening per year. The screening must be done in a primary care doctor’s office or primary care clinic that can provide follow-up treatment and referrals.
Individual and group psychotherapy with doctors (or with certain other licensed professionals, as the state where you get the services allows).
Family counseling, if the main purpose is to help with your treatment.
Testing to find out if you’re getting the services you need and if your current treatment is helping you.
Psychiatric evaluation.
Medication management.
Certain prescription drugs that aren’t usually “self-administered” (drugs you would normally take on your own), like some injections.
Diagnostic tests.
Partial hospitalization.
A one-time “Welcome to Medicare” preventive visit. This visit includes a review of your possible risk factors for depression.
A yearly “Wellness” visit. Talk to your doctor or other health care provider about changes in your mental health since your last visit.
Part B also covers outpatient mental health services for treatment of substance abuse."
Where is Part B Accepted?
Medicare covers services and visits with these types of professionals:
Psychiatrists or other doctors
Clinical psychologists
Clinical social workers
Clinical nurse specialists
Nurse practitioners
Physician assistants
Medicare Part B Deductible
With Part B coverage your one depression screening a year is covered completely and you pay nothing extra if your healthcare provider or doctor accepts assignments.
Once you meet your Part B deductible then your start to pay 20% of the Medicare-Approved amount for visits to diagnose or treat your condition.
How Do You Know if You Have Medicare Mental Health Benefits?
If you have signed up for Medicare you may have already been signed up for part B, if not you will need to do that to avoid any Medicare penalties and to receive your full benefits.
The best way to find out if you have Medicare mental health benefits is to contact your insurance company or Medicare plan directly.
You can also contact your state's Medicaid office to see if you are eligible for coverage.
Why is Mental Health Care Important?
Mental health care is important because it can help you manage your mental health condition.
Mental health care can help you improve your relationships, sleep better, and think more clearly. It can also help you cope with stress, anxiety, and depression.
It's especially important to take care of your mental health as you get older because mental health problems can lead to other health problems, such as heart disease and stroke. Mental health care can help you stay healthy and prevent any other health problems associated.
Mental health care is important for everyone. If you or someone you know is struggling with a mental health condition, don't hesitate to reach out for help.
There are many resources available to help you get the treatment you need, including contacting Psychological Preventive Health for an in-person or telehealth session.
Mental Health Services with Psychological Preventative Health
At Psychological Preventative Health, whatever your needs may be, we are here to offer support. We offer outpatient mental health care to many patients with insurance, including Medicare.
Most of our therapists are located in Utah and Idaho, but we can accept patients from all over with our Telehealth option. We can accommodate individual, couple, family, and trauma therapy cases.
Medicare & Outpatient Mental Health Services PPH Therapy
We are happy to announce that Psychological Preventative Health accepts assignments and are happy to host you for your one depression screening per year along with any other services you may need.
Medicare Covers Mental Health Conclusion
In conclusion, if you are struggling with your mental health it is important to seek help. There are many resources available to help you get the treatment you need especially if you are using Medicare. As we went over Medicare covers inpatient and outpatient mental health care if your doctor accepts Medicare assignment.
This includes a free yearly depression screening and Medicare coverage over 80% of the approved amount for visits to diagnose or treat your condition.
If you have any questions regarding your mental health and Medicare coverage, please don't hesitate to reach out to us. We would be more than happy to help you get the care and treatment you need.
Please leave any questions or comments below! We would love to hear from you and assist in any way possible.
We hope this answered your question... does Medicare cover mental health!
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