Mental Health Basics for Medicare Part B

Benefit Qualifiers

Feelings of anxiety, depression or hopelessness, can happen to anyone at any time. Other qualifiers are emptiness, loss of self-worth, worried about being a burden, withdrawn socially, isolation, lack of interest in friends or activities, lack of energy, concentration issues, trouble sleeping, weight loss, loss of appetite, increased use of alcohol or drugs, thoughts of suicide, fixation on death.

Covered Clinicians

Licensed Clinical Social Workers

Clinical nurse specialist

Nurse Practitioner

Physician Assistant

Psychiatrist or other doctor

Access to Service

In patient

Out patient

In-home setting

Covered Services

Individual, family, group therapy

Psychiatric evaluation

Medication management

Diagnostic tests

Costs Associated with Services

Original Medicare Part B - generally, a 20% co-pay applies after the Part B deductible is satisfied.

Medicare Advantage & Medicare health plans – benefits vary according to individual plan memberships.

Medicare Supplement Insurance – generally will pay for uncovered, original Medicare expenses like copayments and deductibles. Benefits vary according to plan.

“Welcome to Medicare” visit – No out of pocket cost if done within the 1st 12 months of having Part B.

Annual “Wellness” visit – No out of pocket cost if done every 12 months.