Does Medicare Cover Mental Health Care?

Updated on June 15, 2023

As the years’ progress, it is only natural that your body will start slowing down. This sometimes makes your body vulnerable to multiple diseases that require careful management. Consequently, it may lead to anxiety or even depression because of the constant thought of your body and its progress.

Several symptoms can show that you are experiencing this disorder. It includes frequent thoughts of ending your life, lack of overall energy, hopelessness, social withdrawal from friends and family, low concentration on activities. Additionally, finding little or no interest in things you previously enjoyed, insomnia or hypersomnia increased substance use and abuse, and weight loss are part of the symptoms any individual can experience.

Mental health includes psychological, emotional, and social well-being. It generally affects how we act, think, or feel and how we make decisions. Mental health care includes all the programs and services that help diagnose and treat mental health conditions. Medicare care now covers benefits that care for your mental health and include preventive screenings, psychological counseling, and outpatient treatment. Below are parts covered on Medicare.

Preventive coverage

One of the best ways of dealing with something that is not beneficial to you is prevention. Preventive care helps identify seniors who are mostly at risk of mental problems way before they get serious so that help and treatment are offered as soon as possible. The medical part that covers all this is part B, and it includes the screening of seniors who are at risk of some mental health problems.

Medicare covers four main benefits to prevent poor mental health; annual Depression screening, alcohol misuse screening, a welcome to Medicare visit, and a wellness visit

Annual depression screening

It is a type of screening that is offered to all Medicare subscribers and is free at least once every year as long as the doctor taking care of you accepts your assignment.

The annual depression screening works by giving you a brief questionnaire that you’ll complete with your doctor. It contains questions regarding your appetite, mood, energy level, sleep, and even suicidal thoughts. If your answers suggest that you suffer from depression, your doctor will discuss the results and refer you for further psychology assessment or treatment. 

Generally, many companies provide a list of psychological assessment tools used to measure and evaluate a person’s mental health and functioning. They can be used to diagnose mental disorders and develop treatment plans. Some common types of psychological assessment tools include interviews, self-report measures, behavioral observations, and neuropsychological tests.  

Alcohol misuse screening

Recent reports have shown that most people with mental health issues more often than not turn to alcohol for comfort, which later turns to alcohol and drug abuse. Medicare health coverage offers one alcohol abuse screen for every year. This service is offered to all Medicare subscribers that are not alcohol dependent. All those that are alcohol dependent may qualify for this service but otherwise qualify for counseling.

Alcohol misuse screening is a brief, confidential conversation with your healthcare provider to evaluate your risk of alcohol misuse or unhealthy drinking habits that don’t meet the medical requirements for alcohol dependency. If the assessment’s result suggests that you may be misusing alcohol, your doctor will recommend some treatment options. These can include counseling, medication, or a combination of both.  

With alcohol misuse screening under Medicare, you can ensure early identification of alcohol misuse, which helps prevent more serious health problems like cancer, heart disease, and liver disease.

Welcome to Medicare Visit

This is the first check-up visit offered to all new Medicare enrollees, including a check-up on your mental health to see if you are at risk of depression as a senior. It is important to note that this kind of check-up exam has to be taken within one year after enrolling in Medicare services to be eligible.

Wellness Visit

Medicare customers are subjected to an annual visit to their doctors who check their mental and physical health to learn more about Medicare visit During this time, you are allowed to highlight any mental issues that they may be going through. The doctor will then follow up on the issue, advise you accordingly, and even offer additional treatment based on their findings. 

However, choose a healthcare provider you can feel comfortable with and trust to get the most out of your wellness visit. Prepare a list of your current medications, and don’t hesitate to talk about your lifestyle, including your diet, smoking habits, and exercise.  

Outpatient mental health coverage

Medicare part B is the part that encompasses all mental health services if you are an outpatient. This can either be done in a therapist’s office or a clinic. Some of the services offered here include counseling services, group therapy for similar problems, individual therapy, and psychiatric evaluation. Diagnosis tests are taken to see if you are in your right mind and family counseling if you choose to and alcohol abuse counseling with a maximum of four sessions.

For you to enjoy all of these benefits, you may be forced to comply with additional eligibility requirements. However, it is essential to note that Medicare doesn’t cater to expenses on all sorts of therapy. The types of therapy that are not covered are counseling with a pastor or marriage counseling. This is because enrollees are only covered by activities performed by licensed medical practitioners and professionals who perform Medicare assignments.

It is also important to note that not all mental health cases are of the same intensity. Some need more attention than others from therapists and doctors. Medicare offers these intensive outpatient services without the patients being admitted into the hospital for inpatient services. This kind of service is called partial hospitalization. They are done through a mental health facility in the outpatient unit of a hospital. You are eligible for such a program if the doctor decides you could otherwise be admitted as an inpatient.

Inpatient mental health coverage

Medicare part A is the part that encompasses psychiatric and general hospital services. However, there is a clause in the rules that states that Medicare will only cover your inpatient services if you are in a psychiatric hospital for a maximum of 190 days in your lifetime. If you are admitted into a psychiatric hospital as an inpatient, part B of Medicare will cover for doctor expenses.

Prescription drug coverage

The part that covers services in this section is part D, ensuring you get treatment for your condition. Parts like A, B, and the original Medicare does not talk about drugs. The part that does is part B; however, it restricts the administration of drugs to those that cannot be self-administered like injections. If an enrollee wants further prescription coverage and is on a current original Medicare plan, they are forced to fill and enroll in a different drug plan in part D.

Seniors on the Medicare advantage plan can enjoy a prescription drug plan that combines all the benefits from Medicare parts A, B, and D under one plan. Antipsychotic drugs, anticonvulsant drugs, and antidepressant drugs that treat mental health are protected. They are under part D of Medicare. Seniors can quickly check if a specific prescription drug is covered in the Medicare Advantage or Medicare plan by merely checking the drug list. If the drug is not covered, you can request the doctor to switch the drug to a similar one for proper health care.

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The Editorial Team at Healthcare Business Today is made up of skilled healthcare writers and experts, led by our managing editor, Daniel Casciato, who has over 25 years of experience in healthcare writing. Since 1998, we have produced compelling and informative content for numerous publications, establishing ourselves as a trusted resource for health and wellness information. We offer readers access to fresh health, medicine, science, and technology developments and the latest in patient news, emphasizing how these developments affect our lives.