Mental Health - Dream Health Quotes

Ensure that your needs for mental health are met.

The benefits of Medicare are not universal. In order to make it easier for you to evaluate coverage choices and choose the plans that are best for you, DreamHealth has simplified the procedure. No commitment is necessary to sign up.

Medicare Coverage for Psychotherapy

Does Medicare pay for therapy for mental health?

As far as Medicare mental health coverage is concerned, you can anticipate that both Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) will cover a large portion of mental health therapy and hospitalization as long as both the outpatient treatment and the inpatient care are delivered by Medicare-approved providers.

Medicare Part A Coverage for Mental Health Costs

Your hospital stay for inpatient mental health treatment will be covered by Medicare Part A, which will also pay for your accommodation, meals, nursing care, and other ancillary services and supplies. Both regular hospitals and psychiatric hospitals offer these services. A mental institution can only provide inpatient care for a total of 190 days in a lifetime. Medicare Part A costs and expenses for mental health care are listed below:

Each benefit period (which runs from the day of admission to 60 days after the end of care) will require payment of the $1,600 Medicare Part A deductible (2023 rate).
For hospitalized days 1 through 60, you will pay NO coinsurance.
For days 61 through 90, your coinsurance rate is $400 per day (2023 rate).
After 90 days, you will be required to pay $800 in coinsurance each “lifetime reserve day” (2023 rate). When you stay in the hospital longer than the Medicare-covered 90 days, these additional days are known as lifetime reserve days. For up to 60 of these days throughout the course of your lifetime, Medicare will cover your covered expenses and will charge you a daily coinsurance fee.
After your lifetime reserve days are used up, you are responsible for all expenditures.

IMPORTANT: The cost of the Medicare deductible and coinsurance may change annually.

Medicare Part B Covers Mental Health Costs

You can be required to cover some Medicare Part B charges in addition to Part A costs. Even if you’re a hospital inpatient, this may involve medical care. Part B provides coverage for mental health services provided outside of hospitals, including consultations with medical professionals, clinical psychologists, and clinical social workers. Services like these may be covered by Part B:

Annual depression screenings (one free if conducted by a medical professional assigned by Medicare)
Tests that your doctor prescribed
Psychiatric assessment
Medication administration
Approved family counseling and psychotherapy sessions
In place of inpatient mental health care, partial hospitalization is a systematic regimen of outpatient psychiatric services.
A one-time “Welcome to Medicare” preventive appointment, which would assess any potential risk factors for depression in you
A yearly “Wellness” appointment to discuss changes in your mental health with your doctor or other healthcare practitioner so they can track your progress over time

Medicare Part B Costs and Expenses for Mental Health Care:

The Medicare Part B deductible is $233 (2022 rate), which you will be responsible for.
20% of the cost of healthcare provider services that have been approved by Medicare will be your responsibility.
If you receive your services as a hospital outpatient, you might be required to pay an additional copayment or coinsurance. The amount you pay varies on the service received but is typically 20% of the Medicare-approved fee.

Important: The Medicare deductible and coinsurance rates may change annually.

Approved Healthcare Facilities and Providers for Part B Coverage

Part B includes visits with these kinds of health providers and services related to mental health:

Psychiatrist or qualified physician
Licensed psychologist
Social worker in clinical practice
A clinical nurse specialist
Licensed practical nurse
Medical assistant

Important: Only visits delivered by healthcare providers who accept assignment are covered by Medicare.

Part B provides outpatient mental health care, including those often offered outside of a hospital. Examples of such services include:

A clinic run by a physician or other healthcare professional
A clinic’s outpatient division
A center for communal mental health

Mental Health Therapy and Medicare Advantage

If you’re enrolled in a Medicare Advantage plan, also known as Medicare Part C, you still get the same coverage as stated above, and your plan may also offer extra benefits like prescription drug coverage. Medicare Advantage plans are provided by private, Medicare-approved insurance companies, and they’re required to offer at least the same coverage as Medicare Part A and Part B (aside from hospice care, which Medicare does cover).

Does Medicare Part D cover medications used in the treatment of mental illness?

Nearly all medications classed as antidepressants, antipsychotics, and anticonvulsants must be covered by Medicare Part D plans. Make careful to find out which medications are covered by the plan if you’re thinking about going this route.

In addition to Original Medicare and Medicare Supplement Insurance plans, Medicare Part D is a voluntary component of the program.

DreamHealth can assist.

When it comes to Medicare and mental health coverage, we can assist you in better understanding your options. Start now to make sure you are receiving all the benefits you require and are due. There is no requirement to enroll, and the service is free.