Medicare and taking care of your behavioral health
March 1, 2021 | View PDF
Did you know that Medicare can help cover costs associated with behavioral health care? Behavioral health care includes mental illness and addiction-related issues. According to the National Alliance on Mental Illness (NAMI), “a mental illness is a condition that affects a person’s thinking, feeling or mood.” Substance use disorders and addiction do not fall under this definition of mental health illness, but they are considered behavioral health conditions.
Examples of mental health illnesses include depression and anxiety. Examples of addiction-related issues include opioid use disorder and alcoholism.
It is important to note that behavioral health conditions are typically not the result of any single event or circumstance. Rather, they tend to be complicated conditions involving multiple factors.
Everyone agrees that 2020 was a difficult year. Unfortunately, Alaskans deal with the additional mental stresses of a long, dark winter. Even with the success of the COVID vaccines and gaining the light back, it is never too late to begin getting the help you need.
What does Medicare cover? That all depends on what services you require or have received. Your Medicare Part A (hospital coverage) covers inpatient mental health and addiction recovery services that you receive in either a psychiatric hospital or a general hospital or inpatient rehabilitation facility. Don’t forget that you will have to meet the 2021 Part A deductible of $1,484. Medicare has a lifetime benefit of 190 days in a psychiatric hospital.
Your Medicare Part B (medical coverage) will cover outpatient services. These can include individual or group therapy, addiction recovery services, or laboratory testing. It can also cover prescription medications that are administered by a health care professional, such as injectable medication.
If you need help finding doctors and facilities that accept Medicare, you can use the federal Care Compare Tool online at https://www.medicare.gov/care-compare/ or call 1-800-Medicare (1-800-633-4227).
Medicare Part D (prescription drug plans) can cover any medically necessary, outpatient prescription medications that treated substance abuse issues or mental illness. Part D plans cannot cover outpatient methadone or similarly administered medications to treat substance use disorders, but they can cover methadone for other conditions, such as pain.
This is hardly a comprehensive list of coverage details for behavioral health care with Medicare. What do you do if you want more information? Call the Alaska Medicare Information Office at 1-800-478-6065. A Certified Medicare Counselor can go over the details of your specific situation, so you have the knowledge to make the best care decision for yourself. Additionally, 1-800-Medicare (1-800-633-4227) is available 24 hours a day, seven days a week to assist you.
Here are some additional resources for finding the right behavioral health care.
National Alliance on Mental Illness (NAMI)
Call 800-950-NAMI (6264)
Substance Abuse and Mental Health Services Administration (SAMHSA)
Call 800-662-HELP (4357)
National Suicide Prevention Lifeline
Colton T. Percy is a Certified Medicare Counselor and the Volunteer Coordinator for the Alaska Medicare Information Office. If you have questions about Medicare or are interested in volunteering and helping your fellow Alaskans navigate Medicare, please call 1-800-478-6065.