Mental health care is for those who need need either out-patient care such as in office counseling and therapy sessions, or for those who need to be admitted to an in-patient facility for more intensive mental health care. Many people find that these services are necessary over a lifetime to help with loss, divorce, and other personal issues, as well as some people have mental health diagnoses that require more significant care. As people turn 65, they wonder how will mental health care be covered by Medicare. Let us explain.
Does Medicare Cover Mental Health Care?
Medicare does cover mental health care for both out-patient and in-patient services. Below are the costs you are responsible for, and the limitations placed by Original Medicare on mental health services.
Out-Patient Mental Health Care
Out-patient Mental Health Care for counseling and therapy is covered by Medicare Part B. Here are the basics of what is covered and your costs:
- For all services besides screenings you are responsible for your Part B deductible: $257
- Individual, group, and family counseling you pay 20% for doctor’s visits
- For out-patient facility care you can pay an additional copay usually 20-40%
- Diagnostic Tests: 20%
- One depression screening per year: $0
In-Patient Mental Health Care
In-patient Mental Health Care that requires you to be hospitalized is covered by Medicare Part A. Here are the basics of what is covered, your costs, and the limitations of coverage:
- For all mental health services in a hospital you must pay your Part A deductible: $1,676.
- Hospital coinsurance days 1-60: $0
- Hospital coinsurance days 61-90: $419 per day
- Hospital coinsurance days 91-150 (lifetime reserve days): $838 per day
- Over a lifetime you can only receive 190 days of mental health hospitalization
- Beyond Lifetime care and/or lifetime reserve days: 100%
- Doctors’ costs for mental services in the hospital: 20%
Does Medigap Cover Mental Health Care?
Medigap plans can cover some or all of the costs of mental health care, dependent on the Medigap plan you choose. For instance, while many Medigap plans will cover part of your costs, only Medigap plan C and F will cover all mental health service costs by a Medicare approved provider. Medigap C and F will cover your Part A and B deductibles, copays, and coinsurance.
If you were to have one of these plans, you should not have any out of pocket expenses besides your monthly premium -unless you were to go beyond your lifetime care days (then you would pay 100% out of pocket for all services).
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Does Medicare Advantage Cover Mental Health Care?
Medicare Advantage does cover mental health care. While Medicare Advantage plans “replace” Original Medicare with a smaller, local network, they must cover what Medicare covers; however, the costs for each service may vary. You will want to check with each plan to see how much Medicare Advantage will cost you for mental health services.
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To learn more call one of our licensed agents at 800-930-7956.