Often, individuals will opt out of mental health services because of money. They think that they cannot afford it. However, there are different ways you can afford the care you need. Medicare covers many of the costs for various mental health care services. This can be outpatient and inpatient at a general or psychiatric hospital. Medicare is a great option; however, it’s important to be aware that these benefits are subject to limitations—such as copayments, coinsurance, and lifetime maximums.

Medicare Coverage

Medicare provides coverage for both inpatient and outpatient mental health care. Additionally, Medicare prescription drug plans include coverage for medications used to treat mental health conditions. It’s important to review the formulary to ensure that the specific brands and dosages you require are covered.

• Medicare Part B

Under Medicare Part B, outpatient mental health care is covered and includes a range of services such as:

• Individual and group therapy
• Treatment for substance use disorders
• Diagnostic tests to ensure appropriate care
• Occupational therapy
• Activity therapies like art, dance, or music therapy
• Training and education related to your condition
• Family counseling as part of your treatment
• Laboratory tests
• Prescription drugs that necessitate administration by a medical professional, like injections
• An annual depression screening

Before beginning services, confirm with your healthcare provider whether they accept Medicare insurance. Providers who don’t accept Medicare might require you to bear the full cost of care. 

• Medicare Part A

Medicare Part A encompasses inpatient mental health care coverage, whether in a psychiatric hospital or a general hospital. 

Your healthcare provider determines the appropriate hospital setting. If care is provided in a psychiatric hospital setting, Medicare covers up to 190 days of inpatient care over your lifetime. If you’ve used up your lifetime days but require further mental health care, Medicare may cover care received in a general hospital.

• Medicare Part D

Medicare Part D covers most prescription drugs used to treat mental health conditions. 

Your Part D coverage might be through a Medicare Advantage Plan or a stand-alone Part D plan. All Part D plans are required to provide coverage for at least two drugs from most drug categories and all drugs within specific categories, including antidepressants and antipsychotic medications.

Providing Medicare Covered Therapy

Here at PPH, we have a number of different licensed professionals who offer Medicare covered therapy sessions. Contact us today to learn more about our services and treatment options!