| Tue, May 09, 2017 @ 09:00 AM

Medicare Increases Coverage for Mental Health Care

Posted by Medicare Made Clear

senior-man-sitting-outsideAccording to the National Institute of Mental Health, 15.8% of adults age 50 and older had a mental illness in 2012. Yet historically, Medicare has paid a smaller share of the cost for mental health visits than for other medical services.

As of January 1, 2014, Medicare Part B will pay 80 percent of the cost for visits with psychiatrists, psychologists and clinical social workers once the annual deductible is met. This is the same percentage Medicare pays for most medical services. You will have to cover the remaining 20%. By comparison, beneficiaries paid up to 50% of this cost in 2008.

About Mental Health

Mental health includes your emotional, psychological, and social well-being. It affects how you think, feel and act. It also helps determine how you handle stress, relate to others and make choices. Mental health problems can affect your thoughts, moods and how you function in life.

Mental health problems can be caused by many factors including:

  • Biological factors, such as genes or brain chemistry
  • Life experiences, such as trauma or abuse
  • Family history of mental health problems

Some mental health conditions such as minor depression, while painful, can be treated successfully. Medicare’s preventive services benefit covers depression screening once a year. Pay attention to any symptoms you may experience, and tell your doctor or health care provider if you have:

  • Little interest in things you used to enjoy
  • Sad, empty or hopeless feelings
  • A lack of energy
  • Trouble sleeping
  • Trouble concentrating
  • Weight loss or loss of appetite
  • Increased use of alcohol or other drugs
  • Thoughts of ending your life

Other Medicare Coverage for Mental Health

While Part B covers visits with a psychiatrist or other mental health professional, Medicare Part A will help pay for mental health care if you are a hospital inpatient. Coverage for care in a psychiatric hospital has a lifetime limit of 190 days, but there is no such limit for care received as an inpatient in a general hospital.

Medicare Part D prescription drug coverage helps pay for drugs you may need to treat a mental health condition. Each Part D plan has its own list of covered drugs, known as formulary. Check with your plan to see which drugs it covers.

If you get your Medicare benefits through a Medicare Advantage plan or other Medicare health plan, check your plan’s membership materials and call the plan for details about how to get your mental health benefits.

For more information, explore MedicareMadeClear.com or contact the Medicare helpline 24 hours a day, seven days a week at 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048.


Medicare & Your Mental Health Benefits: Learn more about Medicare’s mental health coverage and what you pay for services.

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