Does Medicare cover mental health care?

Does Medicare cover mental health care?

Mental Health Care Coverage with Original Medicare (Part A)

Original Medicare Part A, which offers hospital insurance, will pay for inpatient mental health care at a general hospital or anything under a lifetime limit of 190 days at a psychiatric hospital. This coverage includes services and supplies such as nursing, rooms, and meals. 

You will still be partly responsible for some cost of the mental health care services provided even if you are covered under Medicare Part A. Costs associated with Medicare covered hospital stays are calculated through benefit periods. Benefit periods are 60-day time spans in which you received inpatient care at a hospital and usually begins the first day that you are admitted as an inpatient. You will have to pay the full deductible amount for each benefit period. "Lifetime reserve days" will begin to be counted after you have been admitted for 90 days as an inpatient at a hospital. Medicare will cover the costs of these lifetime reserve days but you will be charged a daily co-insurance until 60 of these days are used in your lifetime. 

Listed below are costs that you may pay under Medicare Part A coverage for mental health care. The amount you will pay for your deductible and coinsurance may be different year to year. 

  • $1,230 - Deductible for Medicare Part A in 2018
  • $0 - Coinsurance for the first 60 days of inpatient care
  • $365 - Coinsurance each day in 2018 for days 61-90
  • $640 - Coinsurance per lifetime reserve day in 2018 (beginning after 90 days of inpatient care)

Note: This is only an estimate of what you may be responsible for paying under Medicare Part A for mental health care. You may still be responsible for Medicare Part B costs such as doctor services, even with Medicare Part A coverage.

Mental Health Care Coverage with Original Medicare (Part B)

Original Medicare Part B, which offers medical insurance, will pay for outpatient (typically outside a hospital) mental health services such as seeing a mental healthcare provider like a doctor, clinical psychologist, or clinical social worker. 

The following are services that may be included under Medicare Part B coverage: 

  • Yearly screenings for depression.
  • Psychiatric evaluation.
  • Specific provider authorized diagnostic tests.
  • Partial hospitalization which is an alternative program, in place of inpatient mental health care, that offers structured outpatient psychiatric services.
  • State-permissible individual and group psychotherapy run by licensed mental health providers.
  • Management of medication.
  • Family counseling if necessary, for treatment.

Below you'll find possible costs that you may pay under Medicare Part B coverage for mental health care. The amount you will pay for your deductible and coinsurance may be different year to year.

  • $183 - Deductible for Medicare Part B in 2018.
  • 20% of the costs associated with Medicare-approved mental healthcare provider services.
  • 20 - 40% of Medicare-approved amount for service as copayment or coinsurance as an hospital outpatient.

Mental Healthcare Coverage with Medicare Advantage 

Medicare Advantage plans will provide the same coverage as Original Medicare Part A and Part B. Depending on your plan, you may qualify for additional benefits including prescription drug services. You will need to pay for your Medicare Part B premium and any possible additional Medicare Advantage plan premium.

Need Help Finding a Medicare Plan?

For help finding a Medicare plan, try our <link>Medicare Plan Finder<link>. If you have any questions, please contact Medicare at any time at 1-800-MEDICARE (1-800-633-4227; TTY users 1-877-486-2048).

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Does Medicare cover mental health care?