May 11, 2022 Health & Wellness
Medicare and Mental Health Services
May is National Mental Health Month, so we thought it was the perfect time to highlight what mental health services are available for Medicare beneficiaries.
The Importance of Mental Health
First, let’s talk about why mental health is so important. It impacts our thoughts, feelings, and actions. People with positive mental health can better cope with stressors in their life, where people living with mental health disorders might have a harder time accomplishing both long term goals and daily tasks.
Mental health problems are common, but luckily help is available. It is certainly possible to live a full and fulfilling life with a mental health diagnosis if you seek treatment!
Warning Signs & Symptoms
If you are experiencing any of the following symptoms, you should contact your doctor for an evaluation. This is not a complete list of possible symptoms, so like we always say, if something doesn’t feel right, please contact a healthcare provider.
- Changes in sleeping or eating habits
- Trouble concentrating or being more forgetful than normal
- Having low or no energy
- Feeling numb, apathetic, or empty
- Using substances more than usual
- Losing interest in things you used to enjoy
- Social withdrawal or isolation
- Feeling on edge, scared, or unable to stop worrying
- Being angry or upset or feeling like you’re blowing things out of proportion
- Mood swings that lead to problems in interpersonal situations
- Feeling like taking care of daily tasks (even things like showering or brushing your teeth) is too difficult
- Thinking of harming yourself or others
It’s also important to look for these warning signs in those you love. If you notice a loved one exhibiting any of these symptoms, here are some tips for talking to someone about their mental health.
Medicare Mental Health Services
There are many possible ways to treat and recover from mental health and substance use disorders. Medicare pays for mental health services through Part A and Part B. A brief explanation of the Medicare coverage for mental health services is below, but for in depth details, you can visit Medicare.gov. You might want to double check coverage with your plan first.
Alcohol Misuse Screenings and Counseling
One alcohol misuse screening is covered per year if you’re an adult who uses alcohol but don’t meet medical criteria for an alcohol dependency. If your provider determines you are misusing alcohol, you can have up to four counseling sessions each year. You will pay nothing for this service if your qualified provider accepts assignment. This is an agreement where Medicare pays the provider or supplier directly, and they accept the payment amount Medicare approves, and will not bill you for anything more than that (besides a Medicare deductible and coinsurance).
Behavioral Health Integration Services
If your provider offers the Psychiatric Collaborative Care Model, Medicare may pay to help manage behavioral and mental health conditions like depression and anxiety. The Psychiatric Collaborative Care Model may include using care planning, ongoing assessment of conditions, medications, counseling, and other recommended treatments. You would pay a monthly fee, and the Part B deductible and coinsurance also apply.
Counseling to Prevent Tobacco Use & Tobacco-Caused Disease
Medicare Part B will cover up to eight smoking and tobacco-use cessation counseling sessions within a 12-month period for those who smoke or use tobacco. These are counseling sessions to help you stop using tobacco. You’ll pay nothing for these sessions if your qualified provider accepts assignment.
One depression screening per year is covered by Medicare Part B. You won’t pay anything for the screening as long as your doctor accepts assignment and the screening happens in a primary care setting where you can receive follow-up treatment or be referred.
Opioid Use Disorder Treatment Services
Medicare Part B will cover counseling, therapy, and periodic assessments either in-person or virtually. Services that can help treat an opioid use disorder may include medications, counseling, drug testing, individual and/or group therapy, intake activities, and periodic assessments. Besides the Part B deductible applying, you wouldn’t pay for these services as long as you get them from an opioid treatment provider that is enrolled in Medicare. You can find a program near you here.
Mental Health Care Services
Mental health care services can be administered in an inpatient (general hospital or psychiatric hospital), outpatient (health care provider’s office outside of the hospital), or partial hospitalization setting (more intensive than outpatient services, but you don’t stay overnight). Coverage and your costs related to these services will vary depending on the setting.
An Important Note About Mental Health
If you or someone else are in immediate danger, call 911. Do not wait. The National Suicide Prevention Lifeline is also available 24/7 at 1-800-273-TALK(8255).