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Medicare and Mental Health

Mental health diseases have been on a rise for the past few decades. The stressful life we are living, lack of work-life balance, financial constraints, and hectic work schedule are responsible for the increasing incidence of depression, anxiety disorders, and several other mental health conditions.

The healthcare costs related to the management of these diseases can only add to your mental stress causing the symptoms to become worse.

If you or your family member is diagnosed with any psychological condition, read on to find out whether the treatments costs are covered by Medicare.

mental health

Does Medicare help cover mental health needs?

Original Medicare Part A and Part B cover the treatment costs of mental health diseases to some extent. Medicare part A basically coves the expenses related to hospitalization while part B covers the other costs primarily related to out-patient care and prescription drugs.

The in-patient mental health care such as the charges for the room, nursing, meals provided by the hospital and other related services offered during the hospital stay would be covered by part A Medicare.

This care can be received by the patient in a psychiatric hospital or a general hospital. Medicare coverage has a limit of 190 days for in-patient care when the patient is admitted to a psychiatric hospital.

Medicare also uses the benefit period for coverage during a hospital stay. The benefit period starts from the day the patient admitted as an in-patient. It ends when he or she has received the in-patient care continuously for 60 days from the date of admission.

Medicare Part A covers the costs of mental health care based on the following criteria. Please note that the coinsurance and deductible amounts may change every year.

  • You need to pay Medicare Part A deductibles. It should be noted that the full amount of the deductible applies for each benefit period.
  • You do not have to pay for any coinsurance for the first 60 days of the hospital stay.
  • You have to bear the expenses of the coinsurance from 61st to 90th day of the in-patient stay.
  • After the 90th day, you need to pay for the coinsurance as “lifetime reserve day”. The lifetime reserve days are the days when you remain in the hospital beyond the 90 days stay covered by Medicare.
  • Medicare pays for the covered costs for up to 60 days of in-patient care in your lifetime and charges you a daily coinsurance amount.

In addition to Medicare Part A, you may also have to bear some expenses associated with Medicare Part B.

Medicare Part B offers coverage for mental health services provided outside a hospital, such as visits to the health professionals including your doctor, clinical psychologist, and clinical social worker.

Medicare Part B also includes some costs related to annual depression screenings, some diagnostic tests, psychiatric evaluation, partial hospitalization, and medication management. It may also cover the costs of the individual or group psychotherapy by a licensed healthcare professional permitted by the state the therapy takes place in and family counseling.

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