Does Medicare Cover Mental Health Care?





Mental health problems, just like physical health problems, can severely affect our daily lives, and require medical care. Does Medicare cover mental health care? Yes, Medicare covers mental health care services including diagnosing, treatment and prescription drugs, but the patient’s Medicare plan plays an important role in what services are covered.

Outpatient Mental Health Care Coverage

Outpatient mental health services that doesn’t require overnight stay at a health facility, such as psychotherapy, and diagnostic tests that are required to diagnose the patient’s mental health conditions are covered by Medicare Part B. However, the amount the patient pays depends on the purpose of the visit, because diagnosing and treatment have different co-insurances to be paid. The patient pays 20% of the Medicare approved amount, if it’s for diagnosing, but for treatments that doesn’t require overnight stay, the patient pays 45% of the Medicare-approved amount. The percentage of the coinsurance amount for mental health care is higher than the coinsurance amounts for other medical services, but there’s an ongoing plan to reduce it. The amount will be reduced progressively, it’ll be 45% in 2011, 40% in 2012, 35% in 2013, and finally in 2014 it’ll be 20%.

Inpatient Mental Health Care Coverage

Medicare Part A covers the inpatient mental health care, where the patient needs to be admitted to a hospital to get treatment. Medicare covers inpatient mental health services provided by general hospitals as well as psychiatric hospitals, but the beneficiaries for inpatient mental health care in a psychiatric hospital is limited to 190 days in a lifetime.

Coverage For Prescription Drugs

Medicare also covers prescription drugs the patient needs for mental health care, but some drugs may not be included in the plan. However, after a request by the patient that is supported by a statement from the person who prescribed the drug, Medicare may decide to change the plan and include the drug to be covered. So, to answer the question again in relation to coverage for prescription drugs, Does Medicare cover mental health care? It all depends on the final say but Medicare & whether the person who prescribed the drug sends in a request about it.



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