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A Guide to Mental Health Coverage in Medicare Part B

Outdoor Portrait Of Serious Hispanic Senior Man With Mental Health Concerns

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From August 2020 to February 2021, the percentage of adults with symptoms of anxiety or depressive disorders increased from 36.4% to 41.5%. According to research published in the CDC’s Morbidity and Mortality Weekly Report, the alarming rise of mental health problems is closely associated with the outbreak of the COVID-19 pandemic.

Developments in Medicare plans may be able to help. Despite the increase of premiums for Parts A and B, a number of benefits were added as well. We previously discussed the key differences between the two parts here on Bobby Brock Insurance. Today, we will discuss why Part B is best if you’re interested in preventative care and office visits, counseling, or therapy.

Preventative care

In order to identify patients who are at risk of mental health problems and provide them the necessary treatment, diagnostic tests and screenings are important.

Medicare Part B includes preventative services that assess your risk towards certain medical health conditions through an annual depression screening, alcohol misuse screening, and a free annual wellness visit to evaluate your physical and mental health.

Outpatient visits

Medicare Part B covers most outpatient mental health services, such as visits with psychiatrists and other professionals managing mental health. This includes clinical psychologists, clinical social workers, clinical nurse specialists, physician assistants, and nurse practitioners. As health services are now being offered online, it’s important to put people in touch with a wide range of professionals.

Even healthcare education has shifted to tele-arrangements, allowing practitioners flexibility to pursue specialization opportunities in in-demand fields like mental health. In a journal article on the Introduction to the Online Nursing Education Best Practices Guide, the researchers discuss how the rising nursing shortage can be assuaged by the number of online nursing education programs offered in the US.

Clinical nursing specialists, for one, benefit greatly from remote learning. As mentioned on Maryville University’s online post master’s NP certification page, nursing practitioners will need specialized training to diagnose, treat, and improve mental health conditions. These certification programs equip them with the latest knowledge and clinical skills that enable them to help patients of all ages cope with mental health disorders.

Licensed health professionals who accept the Medicare assignment can provide counseling services, individual therapy, group therapy, alcohol abuse counseling (up to four sessions), and family counseling (if it can improve the existing condition).

Inpatient care

If your condition requires an inpatient stay, Medicare Part B will cover all provider-based services with a 20% coinsurance. Part B also provides an alternative to inpatient psychiatric care: partial hospitalization.

Partial hospitalization is a structured program that is more intense than what you’d receive at a therapist’s office, but you won’t need to stay overnight for treatment. You would receive occupational therapy, individual patient training, and education on your condition.

Senior woman reading leaflet of a drug and elderly man holding p
Some doctors prescribe medication to treat certain mental health conditions.

Prescription drugs

Some doctors prescribe medication to treat certain mental health conditions. Medicare Part B has limited prescription drug coverage for specific prescriptions and medications that cannot be self-administered, such as drugs given through injections. For the most part, however, beneficiaries with the Original Medicare should enroll in a separate Part D prescription drug plan.

Antipsychotic, antidepressant and anticonvulsant drugs are in protected classes. Although all Part D plans are required to cover basic medications for mental health treatment, the American Psychiatric Association’s page on Medicare Part D highly recommends checking if your medication is included in your Prescription Drug Plan — which would have its own list of covered drugs.

The article was written by Rachel James
Exclusively for bobbybrockinsurance.com and the Medicare Gurus

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