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.



2 Responses to “Does Medicare Cover Mental Health Care?”

  1. Dave Helwig says:

    My mother passed away almost two years ago. As you can well assume it was a and still is a difficult time for all of us. It has been especially hard on my father.

    They were together over 50 years. Ever since her passing, my father has been terribly depressed. The problem we are all having is getting him to check back into life. Every day he sits in the same chair in front of the tv. He will sit there all day and night never get out of his pajamas. He sleeps 14 hours a day. My brothers and I try to get him involved in life and nothing seems to be working. He frequently talks about wanting to hurry up and die so he can be with Mom. He is 75 years old. Since mother’s death, he acts like he’s 100.

    We need professional help. He only has Medicare. Can we get him help?

    Dave Helwig

  2. […] send a note with her to the appointment? Here's a link that does say that Medicare covers therapy: Does Medicare Cover Mental Health Care? Good luck and give your Mom a BIG kiss for me. It is soooo cool that you are so concerned with her […]