Medicare
and Mental Health
Medicare pays for some mental health services. The following describes how and under what circumstances. 1. What and How Much Medicare Pays for Psycho-therapy Medicare will pay 80 % for the initial mental health visit and only pay 50% of its approved amount for future visits. The same payment rate aplies to all approved mental health providers such as psychiatrists, psychologists and social workers. Those individual therapists(such as psychiatrists, psychologists, and social workers) who take Medicare assignment agree to accept the Medicare-approved amount as payment in full for their services. Beneficiaries will have to pay a 50% co-insurance but no additional fees to the provider. If the premiums are affordable a Medicare supplemental insurance policy(Medigap) will help. It will pay for the remaining 50% and most retiree coverage will also pay all or part of the 50% co-insurance. 2. Which Therapists Can Take Payment From Medicare. Medicare will help to pay for outpatient mental health services from:
Medicare will only pay for the services of those therapists if they are Medicare certified and take assignment(they must accept Medicare's approved amount as payment in full). Medicare will pay for the services of medical doctors who do not take Medicare assignment but they can charge up to 15% above Medicare's approved amount, depending on State law. 3. Which Outpatient Mental Health Services Medicare Covers They include:
4. Where Outpatient Mental Health Services Can Take Place Medicare will pay for mental health serivces in an outpatient hospital, a doctor's or therapist's office, or a clinic so long as they are Medicare certified. These services can al;so take place in the home of a beneficiary. 5. How Medicare Pays for In-Patient Mental Health Services Medicare pays for in-patient services in either a psychiatric or a general hospital. Under Medicare Part A for each benefit period(in 2005) the beneficiary pays:
-After the 60 lifetime reserve days have been used Medicare will no
longer pay for any coverage until a new benefit period has begun. For more information go to www.medicarerights.org |