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Medicare and Mental Health

Conditions concerning mental health like depression or anxiety can happen to anyone at any time. it doesn't choose people nor time. Thus, it is better to talk to your doctor if you're experiencing one of  the following;

  • suicidal thoughts
  • sad, empty, or feeling of hopelessness
  • a lack of energy
  • trouble concentrating
  • sleeping problems
  • little to no interest in things you used to enjoy
  • weight loss or loss of appetite
  • increased use of alcohol or other drugs

How are these covered?

Medicare Part A (hospital insurance)

It helps pay for mental health services for an inpatient in a general or psychiatric hospital. It covers your room, meals, nursing care, therapy or other treatment for your condition, laboratory tests, medications, and other related services and supplies. 

If you're in a psychiatric hospital, Part A only pays for up to 190 days of inpatient psychiatric hospital services during your lifetime.

Medicare Part B ( Medical Insurance)

It helps cover mental health services provided by doctors and other health care professionals if you're admitted as a hospital inpatient.

It also helps cover outpatient mental health services that you generally get as a hospital outpatient, including visits with these types:
  • A psychiatrist 
  • Clinical psychologist
  • Clinical social worker
  • Certain other health care professionals
Part B helps pay for thee covered services:
  • One depression screening per year
  • individual and group psychotherapy
  • Family counseling
  • Certain lab and diagnostic tests
  • Psychiatric evaluations
  • Medication management
  • Certain prescription drugs, like some injectables
 For some instances, Part B may also help pay for partial hospitalization services - an intensive, structured program of outpatient psychiatric services provided to patients as an alternative to patient psychiatric care. 

Medicare Prescription Drug coverage (Part D) 

It helps cover drugs you may need to treat a mental health condition. They are required to cover all antidepressant, anticonvulsant, and antipsychotic medications.


 What do I pay?

For inpatient mental health services, you  will pay:
  • A one-time hospital deductible for each benefit period
  • day 1-60: no coinsurance amount for each benefit period
  • Days 61-90: a coinsurance amount per day each benefit period
  • Days 91 and beyond: a coinsurance amount for each "lifetime reserve day" after day 90 of each benefit period
For most mental health services provided by doctors or other health care professionals, you will pay 20% of the Medicare-approved amount after the Part B deductible is met. If you get your services in a hospital outpatient clinic, you may have to pay an additional copayment or coinsurance amount to the hospital.

For prescription drugs, the amount you will pay varies depending on the Medicare drug plan you have. If you have limited income and resources, you may qualify for Extra Help from Medicare to help pay the costs of Medicare prescription drug coverage. 

For detailed information, you may visit Medicare.gov/your-medicare-costs or call 1-800-MEDICARE.

Reference: Medicare.gov
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