What types of mental health services does Medicare cover? I struggle with anxiety and depression, and my primary care provider recommended I see a therapist or psychiatrist.
Anxious Annie
Dear Annie,
Medicare actually covers both outpatient and inpatient mental health care services and programs to help beneficiaries with anxiety, depression and many other mental health needs. Here's what you should know.
Outpatient coverage
If you’re enrolled in original Medicare, your Part B coverage will pay 80% after you’ve met your annual $257 Part B deductible for a variety of counseling and mental health care services that are provided outside a hospital, such as in a doctor or therapist’s office, hospital outpatient department, or community health center. These services also can be received via telehealth.
You or your Medicare supplemental (Medigap) policy is responsible for the remaining 20% coinsurance.
Medicare also gives you the expanded option of getting treatment through a variety of health professionals such as psychiatrists, psychologists, clinical nurse specialists, clinical social workers, nurse practitioners, physician assistants, marriage and family therapists, and mental health counselors.
To get this coverage, you’ll need to choose a participating provider that accepts Medicare assignment, which means they accept Medicare’s approved amount as full payment for a service.
If you choose a nonparticipating provider that accepts Medicare but does not agree to Medicare’s payment rate, you may have to pay more. And if you choose an opt-out provider that does not accept Medicare payments at all, you will be responsible for the entire cost.
To locate a mental health care professional in your area that accepts Medicare, go to www.Medicare.gov/care-compare, click Doctors & clinicians and type in your location, followed by clinical psychologist or psychiatry in the Name & Keyword box. You also can get this information by calling Medicare at 800-633-4227.
