If you’re an older adult struggling with mental health issues, first of all, you’re not alone. Mental health counseling is a vital and beneficial form of healthcare, and Medicare can help cover the costs.
As such, you may be wondering how much Medicare pays for mental health counseling. Original Medicare — Part A and Part B — does cover some mental health services. However, it’s important to understand the limits of coverage to ensure you can get the plan you need.
Keep reading to learn more about your mental health coverage under Medicare.
Does Medicare Cover Mental Health Services?
Yes! Original Medicare does cover some mental health services. Part A (hospital insurance) covers inpatient care for mental health conditions, and Part B (medical insurance) covers outpatient care, such as visits to a psychiatrist, psychologist, or clinical social worker.
What Mental Health Services Does Medicare Cover?
Depending on Part A or B of Medicare, they will cover different things. Part A covers up to 190 days in a mental health hospital. On the other hand, Part B covers outpatient mental health counseling services, such as:
- Psychotherapy services
- Psychiatric evaluations
- One depression screening test per year
- Group therapy
- Family therapy
- A limited number of alcohol abuse counseling sessions
Some therapeutic approaches not covered by Medicare involved marriage counseling or pastor/religious-based counseling.
How Much Does Medicare Pay for Mental Health Counseling?
Medicare Part B pays 80% of approved amounts for most types of covered outpatient mental health care after you’ve met your deductible. In 2023, the deductible for outpatient mental health services is $226.
Generally speaking, that means you’ll be responsible for just 20% of out-of-pocket costs for mental health services.
It’s important to keep in mind that many providers don’t accept Original Medicare, so you may need a supplemental insurance plan to cover the full cost of mental health care.
Some Medigap plans offer additional coverage for mental health counseling, and some Medicare Advantage plans include it as part of their basic benefits package.
Does Medicare Cover Mental Health Treatment Like Hospitalizations?
Part A covers mental health hospitalizations, including inpatient stays for care and treatment of a mental health condition. Part A will cover room and board, nursing care, medications, lab tests, and other related treatments.
Part A does not cover outpatient mental health care, so you’ll need Part B for that coverage.
You can expect that Medicare will cover up to 190 days of inpatient hospital care during your lifetime as long as you meet the eligibility requirements.
Will Medicare Cover Mental Health Medications?
It’s necessary to note that Part A and Part B of Medicare do not cover mental health medications. However, many Medicare Advantage plans (Part C) and Part D plans offer some limited coverage for prescription drugs.
If you need medication to treat a mental health condition, such as depression or anxiety, Medicare Part D may help cover the costs.
You can ask for a list of covered medications when you enroll in a Part D prescription drug plan. Depending on your income, you will pay your plan’s premium each month, as well as any applicable deductibles, copays, and coinsurance.
Get Mental Health Coverage from Medicare With Senior Insurance Solutions
It’s important to understand the limits of Medicare coverage when it comes to mental health services. While Original Medicare covers some mental health care, such as psychotherapy and psychiatric evaluations, it does not cover all types of treatment or medication costs associated with a mental health condition.
At Senior Insurance Solutions, I can help you find the right insurance so that you receive comprehensive coverage for your specific situation. I am a licensed Medicare agent who can help individuals all across the nation get healthcare coverage. Contact me today, and I’ll guide you through the process of getting the best possible healthcare solution for yourself at a price you can afford.
