older man at home discovering mental health therapy through medicare

Will Medicare Cover Mental Health
& Will Your Therapists Accept It?

Healing Minds Accepts Medicare in Reno

Healing Minds accepts Medicare in order to better serve our community. With that in mind, we wanted to share some information about what Medicare covers and how we can help. 

Read on to learn what Medicare covers—and what it doesn’t. 

 

Who Is Eligible For Medicare?

Medicare is health insurance for people 65 or older. You’re first eligible to sign up for Medicare 3 months before you turn 65. You may be eligible to get Medicare earlier if you have a disability, End-Stage Renal Disease (ESRD), or ALS (also called Lou Gehrig’s disease). Medicare also covers people who are younger than 65 when they have disabilities. People with end-stage renal disease or Lou Gehrig’s disease can enroll in Medicare before they turn 65 years old. People who qualify for Social Security Disability Income (SSDI) for any reason are eligible for Medicare 24 months after they start receiving SSDI. You can inquire about your Medicare eligibility at your local Social Security office.

What was the original purpose of Medicare?

The Medicare program was signed into law in 1965 to provide health coverage and increased financial security for older Americans who were not well served in an insurance market characterized by employment-linked group coverage. Most people in America enroll in Medicare when it becomes available to them at retirement age. Before Medicare was passed, 54 percent of elders aged 65 and over had health insurance. Now, 98.4 percent of elders in America have health insurance through Medicare.

What Are the Different Parts of Medicare?

There are four parts of Medicare: Part A, Part B, Part C, and Part D.

Medicare Part A covers inpatient treatment and Medicare Part B covers outpatient treatment. These two components of Medicare are often called “Original Medicare.”

You can also sign up for a Medicare Advantage Plan, also called Medicare Part C, when you want additional or different coverage. These plans are offered through private insurance companies.

Medicare Part D covers prescription drugs. It is administered by private insurance companies and is an optional part of Medicare that was created by the 2003 Medicare Modernization Act.

To Summarize:

  • Medicare Part A provides inpatient/hospital coverage.
  • Medicare Part B provides outpatient/medical coverage.
  • Medicare Part C offers an alternate way to receive your Medicare benefits
  • Medicare Part D provides prescription drug coverage.

Does Medicare Cover Inpatient Mental Health?

Medicare Part A covers inpatient mental health care including the following services:

  • Lab tests
  • MedicationsNursing care
  • Room fees and meals
  • Other related services and supplies
  • Therapy and other mental health treatment

 

There is no limit to the number of benefit periods you can receive for inpatient care. This includes inpatient medical care and inpatient mental health care received in the psychiatric unit of a general hospital.

Does Medicare Cover Counseling?

Medicare Part B covers mental health services you get as an outpatient, such as through a clinic or therapist’s office. Medicare covers counseling services, including diagnostic assessments including, but not necessarily limited to:

  • Diagnostic testing
  • Psychiatric evaluation
  • Medication management
  • Electroconvulsive therapy (ECT)
  • Partial hospitalization programs
  • Substance use disorder treatment
  • Group and individual psychotherapy
  • Activity therapies like art, dance, and music therapy
  • Family counseling to address a mental health condition
  • Drugs that usually aren’t self-administered (like injections)
  • An annual depression screening with a primary care physician
  • An annual alcohol misuse screening with a primary care physician

Does Medicare Cover Mental Health Services?

Medicare Part B covers mental health services you get as an outpatient, such as through a clinic or therapist’s office. Medicare covers counseling services, including diagnostic assessments including, but not necessarily limited to:

  • Nurse practitioners
  • Physician assistants
  • Clinical psychologists
  • Clinical social workers
  • Clinical nurse specialists

However, while Medicare covers all of these provider types in general, professionals in any of these categories can choose to opt out of Medicare reimbursement. If you want to see a professional who has opted out, you’ll need to use a supplemental plan or pay out of pocket for their services.

If you would like to pay for therapy using Medicare, check with the provider first to confirm that they have not opted out of accepting Medicare and are a participating or non-participating provider.

Does Medicare Cover Marriage Counseling?

Medicare generally only covers marriage or couples counseling in a very limited number of cases. Medicare only began reimbursing marriage and family therapists (MFTs) in 2019, and it currently only reimburses them for services provided to people with a primary substance use disorder diagnosis. Additionally, Medicare only covers services linked to a primary psychiatric diagnosis listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM).

Medicare will not cover any kind of marriage or family therapy from any kind of provider if it isn’t required to treat a mental health condition. In other words, if you want to see a therapist to address communication or other relationship issues that aren’t directly related to a mental health diagnosis, Medicare likely will not cover it.

Does Medicare Cover Online Counseling or Telehealth Therapy?

Medicare didn’t used to cover online therapy but during the height of the pandemic in 2020, Medicare removed many long-standing restrictions on its coverage of Telemedicine.

With remote services in high demand, legislators sought ways to remove barriers to Telehealth. Legislation that allowed the Centers for Medicare & Medicaid Services to revise regulations that previously limited Telehealth services to certain locations (i.e. rural locations or medical facilities) with the use of synchronous video technology.

Under the new rules, patients can receive services at home using their phones. The Department of Health and Human Services Office for Civil Rights declared it will waive penalties for HIPAA violations against health care providers providing Telehealth services in good faith. The Drug Enforcement Agency and the Substance Abuse and Mental Health Services Administration also made changes to policies, making it easier for physicians to prescribe medication.

Therapists Accepting Medicare in Reno

Healing Minds is now accepting all Medicare patients in order to help to serve the needs of our community. We accept Medicare and most major forms of insurance. Finally, healing for every kind of mind.

We believe that everyone can benefit from therapy, and should have access to professionals with other specializations to get the full scope of care they need. Healing Minds is a team of therapists in Reno, NV who have come together under this model.

We’ve taken a lot of care and effort to create a safe environment where you can think, discuss, connect, feel and be—a place where you can feel comfortable creating change.

If you or a loved one is facing an emotional crisis, help is here. If you have any questions or you would like more information, you can contact your insurance provider directly to find out more about your specific options. You can also speak with a mental health professional to learn more about your options.

Schedule an Appointment

At Healing Minds, we have therapists that can help you deal with difficult times and mental health issues. Working with a therapist can make the difference you need to step towards a full, whole life once again.

If you or a senior you know is struggling with stress or anger management issues, please reach out to schedule a therapy appointment with a trained practitioner.  We offer in person or Telehealth therapy from the comfort of your own home. Reach out today if you have any questions about your Medicare coverage with our office.