Does Medicare cover behavioral health?
Medicare covers behavioral health services under the mental health care coverage in Parts A and B. Medicare Part B mental health services include outpatient testing and treatment, while the program covers inpatient mental health services under Part A. You will be responsible for deductibles and coinsurance on your behavioral health treatment, but Medicare Supplement can relieve that burden.
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UPDATED: Apr 28, 2021
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- Medicare covers most behavioral health services
- Part B will cover outpatient treatment, while Part A covers inpatient
- You will have to pay your Medicare deductible and coinsurance amounts unless you have supplemental coverage
Does Medicare cover behavioral health? Medicare covers an array of mental health services, including behavioral health services. These are covered under Medicare Parts A and B and include screenings and treatment, both inpatient and outpatient. Although there are a deductible and a coinsurance cost, a Medicare Supplement plan can cover the out-of-pocket costs not paid for under the Medicare-approved amount. If you have a Medicare Advantage health insurance plan, you may have additional coverage and different deductibles and coinsurance.
If you’d like to shop for additional Medicare coverage for behavioral health such as an Advantage or supplemental plan, enter your ZIP code above for free quotes.
What type of Medicare coverage is available for behavioral and mental health?
Medicare covers a long list of services for mental illness and mental health needs. According to Medicare.gov, outpatient mental health services are covered under Part B. Some of the mental health benefits covered by Medicare during the benefit period include:
- Annual depression screening and mental health treatment from the yearly depression screening, focused on preventive care with your primary care provider
- Group and individual psychotherapy
- Family counseling services
- Psychiatric evaluation
- Medical management
- Tests to diagnose and also find out if treatment is working
- Partial hospitalization
Mental and behavioral health services are all considered to be part of the same coverage under Medicare. Medicare Advantage plans may include additional services from health care providers that are covered.
If you require inpatient treatment, hospital portions of the service will be covered under Medicare Part A. Again, the Part A deductible will apply.
Prescription drugs to treat mental illness are covered under a prescription drug plan with Medicare Part D medical insurance plan, which must be purchased separately.
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What is the cost of behavioral health services with Medicare?
Because the type of service will vary, the cost depends on what type of testing and treatment is recommended by your doctor. However, since it’s covered under Part B, mental health services will be subject to the deductible and you will pay 20 percent of the approved cost as your health care coinsurance to licensed professionals. If you are treated in a hospital, your Part A coverage will kick in after the deductible. Medicare Supplement insurance plans can cover up to 100 percent of the out-of-pocket costs not paid for by Medicare.
Part D plans vary in terms of how much they charge, but most plans cover Tier 1 drugs at no or very little cost.
Advantage plans vary in terms of what they cover and at what level. To find out what you will pay out-of-pocket to your doctor for your mental health care, contact your Medicare Advantage provider.
What is the bottom line?
Included in mental health coverage options, behavioral health services from a doctor is covered by both Medicare Part A and B, depending on the type of treatment. Out-of-pocket expenses will vary greatly, but a Medicare Supplement plan can reduce those costs to nothing.
To compare rates on supplemental Medicare coverage for behavioral health, enter your ZIP code below.