Medicare and depression treatments — what Medicare covers
Mental health is a critical part of overall health. Conversations on the topic of mental health were rare when the baby boomer generation was young. Today, the topic is far more accepted.
Mental health is a critical part of overall health. Conversations on the topic of mental health were rare when the baby boomer generation was young. Today, the topic is far more accepted now that
- Medical professionals publicly recognize and discuss the importance of mental health.
- Mental illness is more commonly recognized, addressed, and treated. It has become more accepted and people who suffer from it aren’t as defined by it or shunned because of it.
- The quality of an individual’s daily life has been linked to the effects of depression.
As the National Institute of Aging indicates, clinical depression is more than just feeling sad; it is a clinical disorder that requires medical treatment. You cannot push it away or snap out of it easily.
Among seniors, clinical depression may be caused by prolonged emotional disturbance or other medical conditions, such as heart disease or stroke. Even side effects from certain medications can lead to depression.
Clinical depression, like cancer or diabetes, can disrupt your life if it is ignored. It needs to be diagnosed and treated.
These are some common signs and symptoms of depression:
- Suicidal thoughts
- Feelings of sadness or hopelessness
- Loss of self-worth
- Isolation and withdrawal from social life
- Loss of interest in passions and hobbies
- Lack of energy
- Difficulty in concentrating
- Trouble sleeping
- Loss of appetite and weight
- Increased reliance on drugs and alcohol
Seniors who are signed up for Medicare will probably wonder: Does Medicare cover mental health?
The answer is yes. The following Medicare mental health benefits help treat depression.
Medicare Part A coverage
Medicare Part A covers inpatient requirements—any hospitalization needs that you may have due to mental health, will be covered by Part A Medicare coverage.
This includes visits to a regular hospital or a psychiatric hospital. Part A of Medicare only covers up to 190 days of hospitalized care over your lifetime.
Here’s a comprehensive list of mental health coverage offered in Part A during hospitalization:
- Hospital room
- Nursing care
- Laboratory testing
Medicare Part B coverage
Medicare Part B covers visits to the doctor or outpatient care. This includes visits to mental health institutes, clinics, and visits to therapists. You will also receive treatment for alcohol or drug abuse if necessary, which can lead to symptoms of mental health problems.
Part B also covers more intensive treatment such as partial hospitalization provided through a hospital’s outpatient program or at a mental health center. These treatments are usually more demanding than basic visits to the clinic but don’t require overnight stays in the hospital.
The mental health treatments and measures that are covered under Part B include:
- Annual depression screening
- Individual or group psychotherapy
- Family counseling
- Evaluations to track the progress of the treatment
- Psychiatric evaluations
- Management of medication
- Injections and other forms of medication that cannot be self-administered
Medicare Part D prescription drug coverage
Medicare Part D deals with prescription drug coverage, which includes medication pertaining specifically to mental health. However, each prescription drug plan has its own list of medicines and covered drugs.
Apart from a few exceptions, all Medicare Part D plans are required to cover antidepressants, anticonvulsants, and antipsychotic medications – which are crucial for certain mental health issues.
If you find that your Part D plan doesn’t cover a specific prescribed drug, you can file a coverage determination appeal and request an exception.
Types of costs you may have to personally pay under Original Medicare
Original Medicare’s mental health benefits are comprehensive but aren’t entirely free of cost. Apart from any annual premiums you might have to pay for their coverage, you are also expected to pick up copayments, coinsurance, and deductible charges for specific treatments.
These costs can vary year to year, so make sure that you are familiar with your plan.
Other Medicare options
If you need help covering these additional costs, you can opt for a Medicare Supplement or Medigap plan. Or, you can choose a more comprehensive coverage option through a Medicare Advantage plan, like Medicare plans in California. These Medicare Advantage plans must include everything covered by Original Medicare as mentioned above and offer additional coverage.
Here’s a quick rundown of the frequently asked questions regarding Medicare’s mental health benefits:
- Does Medicare cover mental health? Yes
- Does Medicare’s mental health coverage stretch to hospital stays and periodic visits? Yes
- Does Medicare cover psychotherapy? Yes
- Does Medicare cover psychiatry? Yes
- Does Medicare pay for counseling? Yes
- Does Medicare cover drugs and medication for mental health issues? Yes
- Does Medicare cover all costs? No
- Are there other Medicare options apart from Original Medicare you can opt for? Yes
Speak with an insurance company representative to learn about other Medicare options and what would be best for your needs.
You can find more information on these types of plans at medicare.gov.
H2819_23_375B1_C Accepted 10092023
Page last updated 10/12/2023