1208 Ella Street Anderson, SC 29621 1.800.376.0824 [email protected]

Medicare and Mental Health

Medicare and Mental Health

While not often talked about, mental health is one of the most important health issues related to Medicare enrollees and plays a significant role in overall happiness. Because mental health is such an important part of our lives, as people enter into Medicare, they wonder if their Medicare policy will cover the costs of any mental health services and how much they would have to pay for these services.

The good news is that original Medicare Parts A & B do cover portions of mental health expenses. Medicare Part A will cover any inpatient expenses like room costs, food in the hospital, and any related inpatient supplies or services.

Part B will cover the costs of visits with a psychiatrist or other mental health professionals. It will also pay for lab tests that are prescribed by your doctor. It will pay for certain visits with professionals like a social worker, clinical psychologist, clinical nurse specialists, or physician’s assistant. Just like with any other health professional, they must accept Medicare assignment for Medicare to cover the costs.

While original Medicare won’t cover the costs of any prescriptions that the mental professional suggests, having an additional Medicare Part D plan will cover these costs. These drugs aren’t covered under Parts A or B, so you will have to pay extra for the Part D coverage, which means you’ll have to determine if the fees for the coverage outweigh the costs of the medication.

One of the less common known things that Medicare covers is treatments for inappropriate use of alcohol or drugs. The program will cover the costs of inpatient and outpatient drug and alcohol rehabilitation costs.

What Isn’t Covered By Medicare

Because Medicare covers so much of mental health costs, some enrollees are surprised when they receive higher bills than they expected that they have to pay for out-of-pocket. To keep you from being shocked by your bill, there are a couple of things you should realize Medicare doesn’t pay for. Some of the common expenses that Medicare doesn’t pay for are private nursing services, a private room, or personal transportation to the hospital.

Mental Health And Seniors

Problems with mental health are much more widespread than many people realize, especially among older Americans. In fact, around 20% of people over the age of 55 have had or will have some mental health complications. An even more shocking statistic is that one in three of those seniors will not receive any professional help for the mental health problems. With proper treatment, many of the mental health problems that seniors have are minor and harmless, but if not treated they can become worse and potentially harmful for older adults.

In previous years, Medicare didn’t cover any mental health professional expenses. After a Medicare and Medicaid reform in 2008, the programs slowly began to cover larger portions of the costs until eventually they were paying for 100% of the total expenses. Before the programs were paying for the expenses, thousands of seniors were left trying to pay for medical bills that they couldn’t afford, or they were just delaying going to the doctor for mental problems that could cause serious complications later in life.

With Medicare paying for all or a significant portion of the expenses, no senior should ever go without the health care that they need. Many people tend to ignore their mental health, but you should always be aware of your mental capacity and emotional strength. If you think you are at risk for any mental health complications, schedule an appointment with your primary physician to receive a referral to a mental health professional.


MedicareWallet.com is an unbiased, online resource for individuals turning 65 or already on Medicare. Our utmost goal is to provide information in a way that is user-focused, informative and ethical. With a combined 40 years of experience in the Medicare market, we can answer any questions about Medicare and Medigap insurance. Feel free to reach out to us at 800.376.0824 or by email at [email protected]

Leave a reply

Recent Posts