Medicare Beneficiaries: Understand Your Mental Health Coverage

Mental health care is important at any age, and even those who have never suffered mental health complications can develop certain symptoms in retirement. In particular, seniors can be prone to loneliness and depression. And in some cases, it can be difficult to tell the difference between a mood condition or the usual age-related memory and cognitive complications. It’s important to understand what Medicare does cover with regard to mental health, so that you can seek the appropriate services when needed.

Medicare does cover the following mental health benefits, as preventive care:

• A “Welcome to Medicare” visit, which screens you for depression and other conditions
• Annual depression screening
• Alcohol misuse screening
• Annual wellness visits with your primary care doctor, during which he will screen you for various mental health symptoms

Other than preventive care, which is important, what does Medicare offer with regard to treatment? Medicare Part B does cover counseling as an outpatient service, along with certain other services like:

• Group or individual therapy
• Family counseling
• Psychiatric evaluation and testing for a variety of mental health conditions
• Alcohol abuse counseling

In some cases, more intensive treatment may be needed for mental health conditions. In the event that you might otherwise be hospitalized as an inpatient, your doctor can help you enroll in a more intensive treatment program called a “partial hospitalization” program. The treatment will be more structured and rigorous, but you won’t have to stay in a hospital.

And yes, occasionally inpatient treatment might be required for a mental health condition. In this case Medicare Part A does cover hospitilization, although certain limits do apply. Medicare Part A imposes a coverage limit of 190 days of hospitilization of your lifetime.

Finally, drugs that are sometimes required for a mental health condition might be covered under your plan’s formulary. But because plans differ so greatly with regard to their lists of covered drugs, this is an issue to explore more carefully each year during enrollment. If mental health is a priority for you, remember to consult with us carefully before you enroll in a Medicare Advantage plan or supplementary prescription drug (Part D) plan. We can help you sort through your options and choose a plan that addresses your concerns.