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Medicare and Mental Health: Know your benefits

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According to the World Health Organization, 15% of those older than 60 suffer from some sort of mental disorder with dementia and depression being the most common mental and neurological disorders. Speaking with your doctor about these issues or being treated is very important, but it can become expensive if you don’t have the right coverage. If you have Medicare or are wanting to enroll, it’s important to know what benefits you’ll receive so you have some peace of mind. 

Medicare Part A coverage

If you’re enrolled in Medicare Part A, which you’ll be required to enroll in if you receive Social Security benefits, then this will cover your inpatient costs if you happen to be admitted into a psychiatric or general hospital:

  • Room and meals
  • Nursing care 
  • Therapy 
  • Tests 
  • Prescriptions
  • Other treatments and inpatient services

However, if you’re admitted into a psychiatric hospital, then Part A will only cover up to 190 days for inpatient services that you receive in a lifetime. 

Medicare Part B coverage

You are not required to have Medicare Part B, but if you do have it or choose to enroll, then it’s important to know that whatever mental health visits you receive from your doctor or other services that can usually be done outside of the hospital, will be covered. Costs that will be covered include:

  • One depression screening each year
  • Psychotherapy
  • Family counseling, but only if it’s meant as a treatment for you
  • Specific lab and diagnostic tests
  • Evaluations
  • Management for your medications
  • Specific prescriptions
  • Partial hospitalization

Part B will also cover certain costs associated with opioid use and alcohol misuse, such as screenings and counseling.

Medicare Part D coverage

Medicare Part D will help cover the costs for any medications you have. There is a basic formulary list of drugs that are required to be covered by Part D which include antidepressants, antipsychotic medications, and anticonvulsive treatments.

Out-of-pocket costs

While there are a variety of benefits offered by Medicare, there will still be some out-of-pocket costs you should be aware of. If you’re eligible for Medicare Part A and receive Social Security benefits, then you’ll pay no monthly premium. However, Part A will not cover private duty nursing, or personal items for your room if admitted into the hospital. There will also be a deductible of $1,408 for each benefit period.

There will be a monthly premium for both Medicare Parts B and D, as well as a Part B deductible. With Parts A and B, you’ll also be paying 20% of the Medicare-approved amount for visits. There may also be coinsurance or copayments that will need to be made for Parts A and B.

Questions about coverage?

At Bobby Brock Insurance, we offer Medicare help for free! If you have any other questions regarding Medicare benefits, our well-trained and experienced agents are here to give you the answers you need. Our agents work for you, not the insurance company, so give us a call today at 877-877-5505.

Justin Brock

Justin Brock

The CEO and President of Bobby Brock Insurance. A nationally syndicated Medicare advisor, best-selling author of Medicare Breakdown: The Alphabet Soup of Medicare, and pacesetter for over 20,000 senior market insurance agents. Featured in many insurance-related publications for his Medicare and Health insurance... Read More »

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