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Does Medicare Cover Mental Health?

Christian Worstell by Christian Worstell    |    Published Nov 04, 2019    |    Reviewed by John Krahnert

Medicare does cover some mental health services, for both inpatient and outpatient treatment.

If Original Medicare (Part A and Part B) covers your mental health care, you may face out-of-pocket costs such as deductibles, copays, coinsurance and more.

A Medicare Supplement (Medigap) plan can help cover your mental health Medicare costs.

A man speaks with his mental health care therapist
Medicare does cover some mental health counseling services.

How Does Medicare Cover Mental Health Care?

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 Medicare assignment, Part B will likely cover:

  • One depression screening per year

  • Psychotherapy

  • Family counseling

  • Psychiatric evaluation

  • Medication management

  • Diagnostic tests

  • Partial hospitalization

  • A one-time preventive visit

  • A yearly “Wellness” visit

How Much Does Mental Health Care Cost With Medicare?

If you are admitted to the hospital for mental health services, you will need to meet your Medicare Part A deductible ($1,364 per benefit period in 2019) before your Part A coverage kicks in.

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.

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 Plans Can Cover Mental Health Medicare Costs

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.

For example, each of the 10 standardized Medigap plans that are available in most states provide at least partial coverage for the Medicare Part B coinsurance or copayments you might face when you receive covered outpatient mental health treatments.

A licensed agent can help you decide on a Medicare option that works for you. Call today to speak with a licensed agent and compare the Medigap plans that are available where you live.

 

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Christian Worstell is a health care and policy writer for MedicareSupplement.com. He has written hundreds of articles helping people better understand their Medicare coverage options.

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