[x_blockquote cite=”Beau (Baton Rouge, LA)” type=”left”]Dear Marci,
I am new to Medicare. I have been receiving treatment for depression and anxiety for several years, and have gotten treatment in both inpatient and outpatient settings. Will these services be covered under Medicare? How much will they cost?[/x_blockquote]
Medicare covers medically necessary mental health care—services and programs that are intended to help diagnose and treat mental health conditions.
If you have Original Medicare, Part A covers inpatient mental health services that you receive in either a psychiatric hospital (a hospital that only treats mental health patients) or a general hospital. Your provider should determine which hospital setting you need. If you receive care in a psychiatric hospital, Medicare covers up to 190 days of inpatient care in your lifetime. If you have used your lifetime days but need additional mental health care, Medicare may cover your additional inpatient care at a general hospital.
Be aware that you will have the same out-of-pocket costs with Original Medicare whether you receive care in a general or psychiatric hospital:
Medicare Part B covers outpatient mental health care, including the following services:
Original Medicare covers these outpatient mental health services (with the exception of the annual depression screening) at 80% of the Medicare-approved amount. This means that as long as you receive services from a provider who accepts assignment (meaning they accept Medicare’s approved amount as full payment for a service), you will pay a 20% coinsurance after you meet your Part B deductible.
Medicare Part B also covers partial hospitalization for mental health treatment for people who meet coverage requirements. Partial hospitalization programs provide care that is more intensive than other forms of mental health care, but less intensive than inpatient care.
If you have a Medicare Advantage Plan, your plan must cover the same inpatient and outpatient mental health services as Original Medicare, but they may impose different rules, restrictions, and costs. If you need information about a plan’s costs and coverage rules, or if you are experiencing problems, contact your Medicare Advantage Plan.
Sign up to receive Medicare news, policy developments, and other useful updates from the Medicare Rights.