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Navigating Mental Health Services with Medicare

Navigating Mental Health Services with Medicare

Mental health refers to an individual’s psychological, emotional, and social well-being. It’s critical to maintain it at all stages of life, from birth to old age. Thankfully, Medicare patients suffering from mental illnesses are eligible for mental health therapy under Medicare. Mental health services are a type of treatment that aims to examine, evaluate, manage, and advise anybody who needs assistance with the following in a personal or group setting. 

  • Mental
  • Emotional sickness
  • Symptoms
  • Ailments
  • Disorders

We’ve featured a few of the benefits medicare provides in order to better assist you and your loved ones. Medicare covers a variety of mental health services, such as psychological therapy, preventative screenings, and outpatient treatment programs. Here’s a summary of navigating mental health services with medicare.


Medicare pays for a restricted amount of Part B services through telehealth by a physician or practitioner. This involves specific mental health treatment. 

  • Individual Psychotherapy
  • Pharmacologic Treatment
  • Behavior Evaluation and Counseling
  • Psychiatric Diagnostic Interview Examinations
  • Depression Screening Annually
  • Psychoanalysis
  • Psychotherapy for Families

In addition to a variety of unique mental health and substance abuse services including the following: 

  • smoking cessation programs
  • alcohol and/or substance addiction organized evaluation
  • intervention services
  • yearly alcohol abuse screening

Prescription Drugs

Review the plan’s drug list, this will list out everything covered in your plan. When required, your plan will provide you with information. 

Part D of Medicare includes prescription medication coverage that you may require for the treatment of your illness. Original Medicare Part A does not cover pharmaceuticals but, Medicare Part B does. They advise users to not self-administer, such as injections. 

Individuals with original medicare, on the other hand, must register in a different Medicare Part D prescription drug plan for other medical coverage. Drug coverage is available to Medicare Advantage members through a Medicare Advantage Prescription Drug plan. Which combines Medicare Part A, Part B, and Part D benefits into a single plan. 

Next, If your plan does not accept the prescriptions you are taking speak with your doctor. Switch to a similar drug that’s supported by the plan or seek a formulary exception. Even if they cover the same prescriptions, copayments and coinsurance fees for Medicare Part D prescription drug plans might differ.

In-Patient Care 

If your health necessitates an inpatient stay, Medicare Part A covers both general and mental hospital treatments. If you remain in a mental hospital, rather than a normal hospital, Medicare coverage for inpatient treatments is limited. Medicare Part A will only pay mental facility care for up to 190 days throughout your life. Lastly, Medicare Part B will still cover your services while hospitalized as an in-patient.

Home Health Services 

Homebound patients have access to part-time or periodic medicare services even when restricted to their home. Patients who satisfy these requirements are eligible for in-home care, even if they have no physical constraints. 

An individual is considered “homebound” when their condition is displayed by an unwillingness to leave home. Or if you believe leaving the house alone would be unsafe. According to the Medicare Benefit Policy Manual, home health psych nursing options are only appropriate if evidence shows that the individual is a threat to himself or herself or others.


Medicare Part B covers one annual depression screening, which must be performed at a primary care physician’s office or primary care facility that can provide follow-up care and referrals. Secondly, Medicare participants are entitled to a one-time “Welcome to Medicare” preventative checkup, which includes an assessment of possible risk factors for depression.

In addition, they provide alcohol abuse screening. Some individuals who have mental health issues may have substance abuse issues. Medicare covers one annual substance abuse screening. Furthermore, all Medicare participants who are not alcohol dependent can be eligible. Patients who’ve had a history of substance abuse are eligible for therapy.

Finally, Medicare provides a specialty wellness appointment. With this appointment, your specialist will examine your physical and mental health at this annual checkup. Later, you’ll have the option to discuss any mental health problems with your specialist. Your specialist may make suggestions or send recommendations for extra care related to risk factors.

Get Help 

Contact Harm Reduction Center in South Florida if you are battling with an addiction or having difficulty ending the usage of substances. We employ a variety of treatment alternatives, including medication-assisted treatment, at the Harm Reduction Center to aid with withdrawal symptoms, cravings, and the recovery process.

Each treatment plan is customized by our board-certified medical specialists based on client needs. Our goal is to empower and encourage you during rehabilitation. While also assisting in the smooth transition of our patients into the “real world.” Contact us right away if you are ready to break free from your addiction.