Medicare and Mental Health Coverage – Your Therapy Questions Answered

If you need access to mental health services, you are sure to be wondering what mental health coverage is included with Medicare plans.

Well, mental health services and programs via Medicare can be provided in both outpatient and inpatient settings. Also, prescription drugs that are taken to help treat mental health conditions are available via Medicare Part D.

Let us explore the topic in more detail so you can gain answers to your questions. 

Do Medicare supplement plans include mental health coverage?

As you may know, the Original Medicare program consists of three different parts.

Part A covers inpatient stays at hospitals, nursing facility care, hospice care, and some care at home.

Part B covers certain doctors’ services, preventive services, outpatient care, and medical supplies.

Part D covers prescription drugs.

You also have the opportunity to get a Medicare supplement plan via a private insurance company, such as Plan N and Plan G.

Take a look at this helpful article to learn more about Medigap Plan N vs Plan G.

You should look at Medicare supplement plans to find out precisely what mental health coverage and other health coverage they include so you can make an informed decision as to which supplement plan, if any, is suitable for your needs.

Alternatively, you can stick with Original Medicare, but you will be able to access more services if you take out additional coverage with a private insurer.

The following information will tell you all you need to know about mental health coverage for Original Medicare.

What mental health coverage is included in Medicare Part B?

Outpatient mental health care services are available via Medicare Part B.

Those services include the types of mental health services that you can generally access outside of a hospital setting as well as services that hospitals provide in their outpatient departments.

Medicare Part B also covers visits with:

• A psychiatrist or another type of doctor that specializes in mental health conditions.
• A clinical psychologist.
• A clinical social worker.
• A clinical nurse specialist.
• A nurse practitioner
• A physician assistant.

What mental health coverage is included in Medicare Part A?

Inpatient mental health care is provided via Medicare Part A.

That means people with mental health issues can be covered for the mental health services that they get in a hospital setting.

You would be admitted as an inpatient to either a general hospital or a psychiatric hospital to access those services.

With Part A coverage, you would be able to get general nursing, a semi-private room, meals, prescription drugs as necessary, and other inpatient hospital services.

What mental health coverage is included in Medicare Part D?

Medicare Part D enables people to access prescription drugs, including drugs that are used to treat mental health conditions.

Most Medicare drug plans have a list of drugs that the plan covers, which is known as a formulary.

Almost all antidepressant, anticonvulsant, and antipsychotic drugs are available via a Medicare Part D plan, but you should always check the specifics before you take out Part D coverage as there can be some limited exceptions.

The Takeaway

You should look at each part of Original Medicare in detail to find out precisely what services and medications are available, but the above information should provide the most important answers to your mental health coverage questions.

You should also explore Medicare supplement plans to find out more about the mental health services and prescription medications that are included in those.

Armed with informative information, you can determine which Medicare plan options are best for your specific needs.