Medicare Coverage for Mental Health Treatment

Medicare helps seniors pay for a whole host of mental health treatment services, including both inpatient and outpatient treatment services to help diagnose and treat mental health conditions. Depending on the type of care needed, beneficiaries may incur some out of pocket costs, including deductibles, and are subject to some limitations on the length of treatment you can receive at in patient centers.


Medicare Part A will cover inpatient mental health services at either a psychiatric hospital or a general hospital, depending on the type of care determined by the primary care doctor. Medicare will cover up to 190-days of treatment at a psychiatric hospital during a person’s lifetime and may cover additional inpatient care at a general hospital if necessary.


When receiving inpatient care with Medicare Part A, beneficiaries will need to pay an out of pocket deductible before they enter the facility. As of 2018, that cost is estimated to be $1,340. After paying the deductible, Medicare Part A will pay the first 60-days of inpatient treatment in full. The next 30-days require the patient pay a daily co-insurance of $355 and the remaining 90-days require a daily co-insurance of $670.


Medicare Part B is responsible for covering outpatient mental health treatment. Services covered by the plan include a yearly preventative depression screening that is totally covered. Other inpatient mental health services covered by Medicare Part B include individual and group therapy, substance abuse treatment, occupational therapy, family counseling to help with treatment, and prescription drugs patients cannot administer themselves.


Medicare Part B will pay up to 80 percent of approved inpatient treatments, with patients paying the remaining 20 percent as co-insurance to meet the plan’s deductible. Medicare Part B will also cover partial hospitalizations for mental health treatment (care that is more intensive than other forms of mental health care) for those who meet coverage requirements.


For those with a Medicare Advantage Plan, the insurance must cover the same inpatient and outpatient mental health services as Original Medicare plans, though there may be different rules and restrictions. Patients with Medicare Advantage plans with questions about the level and type of care they are entitled to are encouraged to contact their carrier’s representatives. Just as with any other type of healthcare, patients should take advantage of all the offerings entitled to them by Medicare to ensure their receive the best health care possible.


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