Written By Teresa Greenhill
According to the National Alliance on Mental Illness, depression affects more than 6.5 million Americans age 65 and older. Depression isn’t just about being sad or lonely; in fact, seniors who are suffering from depression may feel tired, irritable, worried, confused, and worthless rather than simply feeling sad. Major depression can hinder a person’s ability to sleep, eat, work, and enjoy life to its fullest. Additionally, genetics, stress, brain chemistry, and other factors can lead to depression. For older adults, depression can also co-occur with various medical issues, such as cancer, diabetes, and heart disease. Depression can worsen these illnesses, and the conditions (and the medications that are taken for them) can heighten the depression.
If you or someone you love is experiencing symptoms of depression, it’s important to seek out professional help for a proper diagnosis, counseling, and treatment options. Fortunately for many older adults, Medicare covers mental health services for depression and other disorders.
Mental Health and Medicare
Medicare Part A covers inpatient hospital care, while Part B covers outpatient care. Specifically, Part A covers inpatient mental health services that you receive in a psychiatric hospital for up to 190 days in your lifetime. You must pay your deductible first, then Medicare pays in full for the first 60 days, and after that, you pay a daily hospital coinsurance. However, if you receive inpatient mental health treatment in a general hospital, the 190-day limit does not apply.
Medicare Part B covers an annual depression screening from your primary care provider, as well as individual and group therapy, substance abuse treatment, diagnostic tests, psychiatric evaluations, medication management, and other outpatient mental health care services. Original Medicare pays 80 percent of the cost of these services, while the patient pays 20 percent, as long as a participating provider that “takes assignment” is used. A provider who takes assignment is one who accepts the Medicare-approved amount as payment. If you have supplemental insurance (Medigap), the policy can cover your 20 percent share of the cost.
To find a mental health provider that accepts Medicare, use the Physical Compare search engine on the Medicare.gov website. You can simply enter your location, along with other filters, to search for providers in your area.
Benefits of a Medicare Advantage plan
Medicare Advantage plans offer all the mental health services of Original Medicare, including counseling and therapy with psychiatrists, clinical psychologists, and other therapists. Certain Medicare Advantage plans can also cover treatment in intensive outpatient settings, physician-administered psychiatric medications, and community case management services. For example, Aetna helps patients get the right type of mental health care as soon as possible through their utilization and complex case management programs. They assist patients to find counseling and treatment from credentialed mental health professionals as well as provide coaching and support from their care management staff to help patients adhere to treatment plans. Of course, the benefits and costs of Medicare Advantage plans differ greatly depending on the insurance company you choose.
Getting In on Opening Enrollment
The Open Enrollment Period for Medicare is October 15 to December 7 each year. This is a great time to consider your mental health care needs and decide which Medicare plan is right for you. During this period, you can switch from Original Medicare to a Medicare Advantage plan, join a new Medicare Advantage plan, and sign up for prescription drug coverage (Part D).
If you are dealing with depression, contact Medicare or your primary care provider to find help. Depression can worsen (and be exacerbated by) a number of age-related health conditions. However, with the aid of counseling, medication, and other treatment options, you can relieve many of your symptoms and improve your quality of life immensely.