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MEDICARE SECTION
DOES MEDICARE COVER: Outpatient Mental Health?
The shift in society's attitudes around mental health has improved in the 20th and 21st centuries. Society has become more accepting of mental health problems and more supportive of people with issues. Society is more aware of common mental disorders such as depression and anxiety, and people are more willing to talk to health professionals and seek treatment. The main reason for this shift in attitudes is mainly due to television shows, podcasts, social media, and open conversations. Believe it or not, mental illnesses are among the most common health conditions in the United States.
Here is how Medicare covers outpatient mental health:
Medicare Part B covers outpatient mental health care, including the following services:
- Individual and group therapy
- Substance use disorder treatment
- Tests to make sure you are getting the right care
- Occupational therapy
- Activity therapies, such as art, dance, or music therapy
- Training and education (such as training on how to inject a needed medication or education about your condition)
- Family counseling to help with your treatment
- Laboratory tests
- Prescription drugs that you cannot administer yourself, such as injections that a doctor must give you
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An annual depression screening
Things to be aware of:
Be sure to ask any provider you see if they take your Medicare insurance/Medicare Advantage insurance before you begin receiving services. If they don’t, you will likely be responsible for the full cost of the care.
Psychiatrists are more likely than any other type of physician to opt out of Medicare, meaning Medicare will not cover any of the cost of the care from those doctors. Additionally, not all non-medical providers (like psychologists or clinical social workers) are Medicare-certified. If you need a list of providers near you who accept Medicare, you can go to www.medicare.gov/care-compare.
Medicare Part A covers inpatient mental health care that you receive in either a psychiatric hospital (a hospital that only treats mental health patients) or a general hospital. Your provider should determine which hospital setting you need.
If you receive care in a psychiatric hospital, Medicare covers up to 190 days of inpatient care in your lifetime. If you have used your lifetime days but need additional mental health care, Medicare may cover your care at a general hospital.
Medicare Part D covers most prescription drugs used to treat mental health conditions. You may have Part D coverage through a Medicare Advantage Plan or through a stand-alone Part D plan. All Part D plans must cover at least two drugs from most drug categories and must cover all drugs available in certain categories, including antidepressants and antipsychotic medications.
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