Original Medicare helps cover some inpatient and outpatient mental health services. Find out what each part of Medicare helps cover, the rules and rights you have as a recipient, and what you may pay out of pocket for care.
Understanding Your Medicare Benefits
Medicare Part A (Hospital Insurance) covers mental health services that you receive as an inpatient at a general hospital or psychiatric hospital. However, certain limits and rules for coverage apply.
Medicare Part B (Medical Insurance) covers outpatient mental health services that are provided at a therapist’s office, clinic or doctor’s office. As long as your mental health care provider accepts assignment, Part B will likely cover:
- One depression screening per year
- Family counseling
- Psychiatric evaluation
- Medication management
- Diagnostic tests
- Partial hospitalization
- A one-time preventive visit
- A yearly “Wellness” visit
If you are admitted to the hospital for mental health services, you can expect to meet your Medicare Part A deductible ($1,364 per benefit period in 2019). You may also pay hospital coinsurance if you experience a lengthy stay (more than 60 days). Your Part B deductible and coinsurance (see below) may apply for care received from your provider(s).
If your mental health care provider participates in Medicare and accepts assignment, Medicare Part B will generally cover 80 percent of the Medicare-approved amount of medical services received in an outpatient setting, and you’ll pay the remaining 20 percent (after your 2019 $185 annual Part B deductible is met).
NOTE: If you receive mental health services in a hospital outpatient clinic or department, you may have to pay an additional copayment of coinsurance amount to the hospital. Speak with your health care provider for specific details regarding what you’ll likely pay out of pocket for coverage.
Medicare Supplement Insurance
If you’re worried about the cost of your Medicare out-of-pocket expenses, consider a Medicare Supplement Insurance plan. Also known as Medigap, these private insurance policies help pay for some of the out-of-pocket costs left by Medicare, including deductibles, coinsurance and copayments. Speak with a licensed agent at --ms-tfn-- for your free Medigap quote.
For more information about Medicare or Medigap, read through some of our helpful guides below.
- What Does Original Medicare Cover?
- 10 Medicare Mistakes You Could Be Making
- Medigap or Medicare Advantage