Yes! Outpatient mental health care is covered under Medicare Part B. Your prescription medications are covered under Medicare Part D.
Mental Health Care Covered Under Medicare
Medicare covers one depression screening each year at your primary doctor’s office or another primary care clinic that is equipped to provide follow-up treatment. Your first screening will happen during your Welcome to Medicare preventive visit, and you can discuss your mental health with your doctor in your yearly wellness visit.
You are also covered for psychiatric evaluation, diagnostic tests, family counseling to help with your treatment, and testing to make sure you are receiving services that are helping you. Part B covers partial hospitalization, medication management, and specific prescription drugs that are not self-administered.
A Medicare Part D plan will cover the majority of prescription drugs you take for your mental health treatment. You sign up for these plans separately from Original Medicare, and they can be found alone or as part of a Medicare Advantage plan.
Medicare Restrictions to Mental Health Care
Medicare has restrictions on which type of provider it covers for your mental health treatment. You are covered if you receive mental health care from a psychiatrist or other doctor, clinical psychologist, clinical social worker, clinical nurse specialist, nurse practitioner, or physician assistant.
Medicare will only cover these mental health visits from providers who accept assignment. This arrangement means that the provider is paid directly by Medicare, accepts Medicare’s payment amount, and will not charge you more than the Part B deductible and coinsurance for covered services.
Part B will cover these services if they are provided at a doctor or other health care provider’s office, a hospital outpatient department, or a community mental health center.
Your Costs for Medicare Part B
You pay 20% of the Medicare-approved amount after you meet the Part B deductible for mental health visits to diagnose or treat your condition. If you receive these services at a hospital outpatient clinic or hospital outpatient department, you may be charged an additional coinsurance amount.
The yearly depression screening through your doctor or health care provider is free if your provider accepts assignment.
Keep in mind that your provider may recommend services that Medicare does not cover, or more often than Medicare will cover them. Ask clarifying questions to make sure you know how much you will be charged for services.
Reach out to Magellan Healthcare today to learn more about the Medicare coverage available to you.
