Mental health is just as important as physical health, and for those enrolled in Medicare, understanding what services are covered can make a significant difference in accessing necessary care. Medicare provides coverage for a range of mental health services, including therapy, medication, and hospitalization, but it’s important to know the specifics of what’s included under each part of Medicare.
Medicare Part A: Inpatient Mental Health Coverage
Medicare Part A covers inpatient mental health services provided in a hospital, whether in a general hospital or a specialized psychiatric facility. This includes:
Hospital stays for mental health treatment
Semi-private rooms, meals, and nursing care
Medications administered during inpatient treatment
Necessary lab tests and therapy sessions
Costs: Beneficiaries will be responsible for the Part A deductible, and if a stay extends beyond 60 days, coinsurance costs may apply. Medicare covers up to 190 days in a lifetime for treatment in a psychiatric hospital.
Medicare Part B: Outpatient Mental Health Services
Medicare Part B covers outpatient mental health services, including:
Individual and group therapy sessions
Psychiatric evaluations and diagnostic testing
Medication management services
Telehealth mental health services
Depression screenings (covered once per year)
Alcohol and substance use disorder treatments
Costs: Beneficiaries typically pay 20% of the Medicare-approved amount for outpatient mental health services after meeting the Part B deductible.
Medicare Part D: Prescription Drug Coverage
Medicare Part D helps cover prescription medications, including those prescribed for mental health conditions such as:
Antidepressants
Anti-anxiety medications
Mood stabilizers
Antipsychotic drugs
Each Part D plan has its own formulary (list of covered medications), so it’s essential to check if specific prescriptions are included in a plan before enrolling.
Medicare Advantage (Part C) and Mental Health Coverage
Medicare Advantage plans (Part C) must provide at least the same mental health coverage as Original Medicare (Parts A & B) but may also offer additional benefits such as:
Lower copays for therapy sessions
Expanded telehealth services
Wellness programs and support groups
Coverage for alternative treatments
Because coverage varies by plan, beneficiaries should review their Medicare Advantage plan details for specifics on mental health benefits.
Does Medicare Cover Long-Term Mental Health Care?
While Medicare provides coverage for acute mental health treatment, it does not cover long-term care in nursing homes or assisted living facilities. However, it may cover short-term stays in a skilled nursing facility following hospitalization.
How to Find a Mental Health Provider That Accepts
Medicare
Beneficiaries can use the Medicare Provider Search Tool on Medicare.gov to find psychiatrists, psychologists, therapists, and other mental health professionals who accept Medicare. Many providers now offer telehealth options for easier access to care.
Medicare provides crucial mental health coverage, but understanding the costs, limitations, and available services is key to making informed healthcare decisions. If you or a loved one need mental health care, reviewing your Medicare plan and speaking with Silvercrest Insurance can help ensure you receive the support you need.