Brenda Lyle – Hometown News

Q: Does Medicare cover mental health treatment?

A: Mental health issues have exploded during the pandemic, particularly for seniors. Many are reluctant to admit their struggle. Others are concerned about paying for treatment on a fixed income. The good news? Mental health counseling IS covered under Medicare.

According to Medicare.gov, Medicare Part B (Medical Insurance) helps pay for these outpatient mental health services:

  • One depression screening per year. Must be done in a primary care doctor’s office or clinic that can provide follow-up treatment and referrals.
  • Individual and group psychotherapy with doctors or other licensed professionals allowed by the state.
  • Family counseling — if its purpose is to help with your treatment.
  • Psychiatric evaluation.
  • Medication management.
  • Certain prescription drugs that are not usually “self-administered.”
  • Diagnostic tests plus testing to assess the efficacy of services and treatment.
  • Partial hospitalization
  • “Welcome to Medicare” – a one-time preventive visit, including review of your depression risk factors.
  • Annual “Wellness” visit. A chance to update your doctor on your mental health.
  • “Tele-health” appointments– by telephone or computer, from your home.

Medicare Part B limits coverage for mental health services and visits to these types of health professionals:

  • Psychiatrist or other doctors
  • Clinical psychologist
  • Clinical social worker
  • Clinical nurse specialist
  • Nurse practitioner
  • Physician assistant

Importantly, Medicare only covers the visits by a health care provider who accepts assignment. Then…

  • You pay nothing for annual depression screening.
  • You pay just 20% of the Medicare-approved amount for visits to diagnose or treat your condition. Part B deductible applies.

Generally, the cost for mental health counseling is similar to a trip to your regular doctor. If you have an “Advantage Plan” or “Medicare Replacement,” check with your insurance provider for a list of mental health professionals that will accept your insurance.

Don’t delay. Your mental health is too important. For mental health resources in Central Florida, you can always call One Senior Place at 321-751-6771.

One Senior Place is a marketplace for resources and provider of information, advice, care and on-site services for seniors and their families. Questions for this column are answered by professionals in nursing, social work, care management and in-home care. Send questions to AskOSP@OneSeniorPlace.com, call 321-751-6771 or visit One Senior Place, The Experts in Aging.

Brenda Lyle is a Certified Care Manager and Certified Dementia Practitioner with One Senior Place, Greater Orlando.