Mental health is a crucial part of overall health yet it often doesn’t receive the same level of attention and resources as physical health. However, Medicare, the U.S. health insurance program for people aged 65 and older, as well as for some younger individuals with disabilities, offers coverage that can significantly reduce these barriers.
While the program provides coverage for several mental health services, its recent inclusion of marriage and family therapists and mental health counselors from January 2024, shows its commitment in making more mental health services accessible to people who need them.
Key Takeaways:
- Medicare offers mental health coverage for inpatient and outpatient care, medication, and screenings spread across four main parts, A, B, C, and D.
- Coverage for mental health services varies based on your Medicare plan.
Table of Contents
If you’re considering Medicare mental health coverage or you’re a Medicare beneficiary and wondering, “Does Medicare cover psychotherapy?” Here’s a comprehensive look at how the program covers mental health services.
Medicare Part A
Medicare Part A covers mental health care services you receive in a hospital that require you to be admitted as an inpatient. This coverage includes inpatient therapy, lab testing, and standard nursing care.
For mental health services, there are specific coverage limits. For instance, there’s a lifetime limit of 190 days for inpatient care in a psychiatric hospital.
Medicare Part B
Part B covers outpatient mental health services, including visits with a psychiatrist, clinical psychologist, physician assistant, nurse practitioner, or clinical social worker. Coverage also includes outpatient services usually provided outside a hospital, like yearly depression screenings and visits to a clinic.
Medicare Part B additionally covers partial hospitalization, which is a structured program of outpatient psychiatric services as an alternative to inpatient mental health care as well as follow-ups and referrals from other mental health professionals.
As of January 2024, Medicare also provides coverage for structured intensive outpatient programs (IOPs) with a minimum of nine hours a week of mental health therapy.
Medicare Part C
Medicare Part C or Medicare Advantage Plans are offered by private companies approved by Medicare. These plans must provide all of the benefits covered under Parts A and B, but can also offer additional mental health services. The specifics can vary from one Medicare Advantage Plan to another, so it’s important to review your plan for more details.
Medicare Part D
Medicare Part D covers prescription drugs that are necessary for treating a mental health condition. The medications include antidepressants, mood stabilizers, and antipsychotics. This plan comes in addition to the Original Medicare or as part of the Medicare C with drug coverage. That said, coverage specifics, such as which drugs are covered and how much you pay, can vary based on your Part D plan.
Additional Information You Need to Know About Medicare Mental Health Coverage
Eligibility and Enrollment
Medicare is available to individuals who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant).
There are specific enrollment periods for Medicare. For instance, the general enrollment period for Part B is January 1 — March 31. It’s important to enroll when you’re first eligible to avoid late-enrollment penalties.
Supplemental Policies
To help cover additional costs that Medicare does not cover, you can purchase Medicare Supplement Insurance (Medigap) policies from private companies. These policies can help pay for copayments, coinsurance, and deductibles.
Additional Support Services
Beyond the standard coverage, Medicare also provides access to preventive services to help maintain mental health. These include screenings for depression and alcohol misuse, and counseling to stop smoking.
Telehealth Services
Medicare has expanded coverage for telehealth services, which includes certain mental health services. This expansion allows beneficiaries to access healthcare providers from home, making it easier for those with mobility issues or those living in rural areas to receive care.
Challenges and Considerations
Despite the broad coverage, navigating Medicare can be complex. Ensure you understand specific rules governing different parts of Medicare. Additionally, consider your mental health needs first when choosing between Original Medicare and Medicare Advantage plans.
Contact B.E.S.T for Effective Therapy and Counseling Services
If you need professional therapy and counseling services, consider Behavioral Enhancement Services and Treatment, B.E.S.T. Our mental health specialists have years of experience treating various mental health challenges and can help you overcome your challenges so you can enjoy a better quality of life. Take the first step and schedule an appointment with us to get started.
