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Minding Your Mental Health: Does Medicare Cover Therapy?

Depression is not a normal part of aging. However, older adults are at an increased risk for depression and anxiety. If an individual has other illnesses or limited functions, the risk for depression increases.

Fortunately, Medicare does provide some benefits to diagnose depression and monitor an individual's mental health.

But first, how do you know if what you're feeling is depression? It can be easily written off as just a case of "the blues." How do you know when it's something more?

Depression: Signs and Symptoms

Depression is not something that lasts a day or two. It can last for weeks or months at a time.

Other than a strong feeling of sadness, individuals might experience:

  • Insomnia or excessive sleeping
  • Appetite loss or overeating
  • Suicidal thoughts or attempts
  • Difficulty concentrating and making decisions
  • Persistent, general body aches and pains that do not diminish with other treatment
  • Irritability
  • Memory loss
  • Fatigue
  • Feelings of hopelessness, worthlessness, and guilt
  • Loss of interest in usually enjoyable activities

depressed man wondering if Medicare covers therapy

Medicare Part B: Understanding Your Benefits

Medicare beneficiaries are eligible to receive some help with the cost of mental health services through Medicare Part B.

Upon enrollment in Medicare, an individual receives a "Welcome to Medicare" preventive visit. This is a one-time occurrence. During this visit, providers discuss the individual's risk factors for depression.

After the initial welcome visit, you are also eligible for one depression screening a year and an annual "Wellness" visit. Risk factors and any current symptoms can be discussed with a primary care physician at these visits.

Individuals are also eligible for psychiatric evaluation, diagnostics tests, partial hospitalization, injectable medications, and medication management. In some states, individual and group therapy is also provided, and family counseling is offered to help the Medicare beneficiary with their treatment. If alcohol and drug use are involved with the depressive episode, Medicare Part B covers outpatient mental health services to treat the addiction.

Medicare Part B does not cover 100% of the cost for most of these services. Medicare will pay the entire cost for the initial "Welcome to Medicare" visit, the annual "Wellness" visits, and the yearly depression screenings, assuming your provider accepts Medicare assignment. For any other mental health services that are part of Medicare benefits, individuals will pay 20% of the cost for these services and the Part B deductible. If you have not met your annual deductible, it will also apply. A Medicare Supplement plan can alleviate some or all of these remaining costs.

If you have a Medicare Advantage plan, it will offer at least as many benefits as Part B. However, your costs will likely be different. Review your plan’s summary of benefits to find out what your copay will be for a therapy visit.

Mental health has not always been widely accepted as an integral part of overall health. Thankfully, more resources and help are available to those who need them. If you or someone you know is struggling with depression, get help. Our golden years are not meant to be spent in darkness.

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