Medicare covers treatment services for opioid use disorder in opioid treatment programs. Services include medications (such as methadone, buprenorphine, naltrexone, etc.). Medicare doesn't reimburse you for therapy or counseling. Annual wellness screenings and depression screenings are available at no cost with your plan.
For other services, you'll pay the Part B deductible and 20% of the Medicare-approved amount above the deductible. A person's mental health refers to their state of psychological, emotional and social well-being, and it is important to take care of it at all stages of life, from childhood to the end of adulthood. Fortunately, Medicare beneficiaries who have mental health problems can receive coverage for mental health services through Medicare. Mental health services are a system of care whose objective is to evaluate, diagnose, treat and advise, in an individual or group setting, anyone who needs help to alleviate illnesses, symptoms, conditions and mental or emotional disorders.
Find out what your Medicare coverage for mental health services includes and get the help you or a loved one needs. You're only covered for mental health services from a psychiatrist, clinical psychologist, or other licensed health professional who accepts the Medicare allowance. Understanding the mental health benefits that Medicare covers can help older adults get the treatment they need. However, Medicare will only cover types of counseling that directly address your specific mental health condition.
Medicare beneficiaries may know that they have some type of mental health coverage, but they may not understand what it means when it comes to services, copays, and prescriptions. With Medicare, you don't need to visit a general practitioner before seeking mental health counseling or therapy. If possible, start seeing a mental health professional who is taking Medicare before enrolling in the program. Once you reach your Part B deductible for the year, you'll have to pay 20 percent of the Medicare-approved amount for doctor office visits to diagnose and treat your mental health condition.
In severe cases of mental illness, the psychiatrist may determine that the patient must be admitted to a psychiatric hospital or general hospital for treatment, and Medicare Part A (hospital insurance) can help pay for mental health services for inpatients during a stay in a hospital or mental health facility. For those on Medicare, knowing what mental health services are covered can make seeking help more overwhelming. Kayrish recommends going to the State Health Insurance Assistance Program (SHIP), which aims to provide comprehensive and objective local insurance advice and assistance to people who qualify for Medicare, their families and their caregivers. Medicare covers this service in hospital outpatient centers and community mental health centers (CMHC).
The Centers for Medicare and Medicaid Services offers a tool called Medicare Care Compare that provides a list of Medicare mental health providers who accept Medicare. While Medicare covers mental health care, finding providers who accept Medicare as a form of payment for these services can be difficult. The good news is that the demand and need for mental health services during the pandemic led Medicare to approve telehealth services for mental health counseling, expanding the number of accessible professionals.