Mental Health Coverage and Medicare

It doesn’t matter if you’re just watching a movie, venting, or celebrating a special occasion. It’s a fact—gathering with friends helps you stay happier.

But what if you’re having a hard time connecting with friends? You’re going through a difficult time that you don’t know how to talk about.

Medicare is here to help. Talking with a mental health provider can offer the support you need. Mental health services also help diagnose and treat people with mental health disorders like depression and anxiety.

Take Advantage of Your Annual Free Depression Screening

Medicare Part B covers one depression screening per year in a primary care setting (like a doctor’s office). The office can provide follow-up treatment and/or referrals if needed. You pay nothing for this screening if your doctor “accepts assignment.” This means they agree to accept the Medicare-approved amount as full payment for covered services.

Outpatient Mental Health Services Under Medicare

Part B covers these outpatient mental health services.

• One-on-one counseling or group psychotherapy with licensed professionals
• Family counseling – if related to your treatment
• Testing to make sure you’re getting the right services, and if current treatment is helping you
• Psychiatric evaluation
• Medication management, including some injections
• Treatment of substance abuse
• Alcohol misuse screening and counseling
• Opioid use disorder treatment services
• Partial “hospitalization” in a hospital outpatient department or community mental health center. (This intensive outpatient program is an alternative to inpatient psychiatric care. Treatment does not include staying overnight.)

You usually pay 20% of the Medicare-approved amount for visits after meeting your Part B annual deductible. Medicare pays 80% and may pay 100% in some cases. Services at a hospital outpatient center may require an extra copay or coinsurance amount.

For more information, refer to the MLN Booklet published by the Centers for Medicare & Medicaid Services, www.cms.gov/files/document/mln1986542-medicare-mental-health.pdf opens a new window

If you have a Medicare Advantage plan, other mental health benefits may be available. Talk with your plan representative for more information.

Inpatient Mental Health Care Under Medicare

If you’re admitted to a hospital or a psychiatric hospital, Medicare Part A helps pay for the below.

• A semi-private room (a private room may be covered if medically necessary)
• Meals
• General nursing
• Drugs (including methadone for opioid use disorder)
• Other services and supplies as part of inpatient treatment

Part B covers mental health services from doctors and other health care professionals while you’re an inpatient. You typically pay 20% of the Medicare-approved amount after paying your annual Part B deductible.

The amount you pay during a hospital visit depends on how long you stay. For 2023, you pay a $1,600 deductible (per benefit period) when your stay is 60 days or less. (That’s up from $1,556 in 2022). For more than 60 days, you’ll pay different coinsurance amounts.

You can only get inpatient psychiatric care in a freestanding psychiatric hospital 190 days in a lifetime under Part A.

Time to Connect

When you’re ready to gather with friends—take it one moment at a time. You may feel awkward about reaching out. But it’s important to remember that good friends have your back. Connecting with them can provide huge benefits for your mental health.

Our licensed insurance agents are here for you too. While we can’t set up that movie date, we’re here to answer any questions. So you get the help you need.

MR655 11/2022