Does Medicare Cover Depression Screenings?
December 15, 2022 | John Demko
With the current state of the world, it is no surprise that mental health concerns are on the rise. Awareness of depression symptoms and being proactive in seeking mental health care can make a significant difference in overall well-being. At Twin City Underwriters, we often get questions about whether Medicare covers mental health screenings and services. Continue reading to learn more.
Does Medicare Cover Depression Screenings?
Most health plans do cover depression screenings as preventive services. Medicare Part B covers an annual depression screening. This screening should be conducted by your primary care provider (PCP) or another trusted doctor.
Medicare will not cover the screening if it takes place in an emergency room, skilled nursing facility, or hospital. (If you are on a Medicare Advantage Plan (MA/MAPD), the screening will have no copay if performed by an in-network provider.)
The depression screening could be completed during regularly scheduled office visits (such as your Annual Wellness Visit, which Medicare also covers). You can also ask for a separate visit just for the screening.
What Happens During a Depression Screening?
During the screening, you will complete a questionnaire to assess risk factors and symptoms of depression. Symptoms include, but aren’t limited to, the following:
- Loss of interest/lack of energy
- Feeling of hopelessness
- Poor appetite
- Weight gain or loss
- Suicidal thoughts or actions
- Panic or fear
- Shortness of breath
- Nausea
- Trouble sleeping
You and your doctor would review the answers and discuss the next steps. Your doctor may refer you for further mental health services.
The Center for Medicare & Medicaid Services (CMS) offers a free booklet that may be a helpful resource: Medicare Mental Health Benefits
Medicare Coverage and Mental Health
Remember that Medicare only covers services when your healthcare provider states they are medically necessary. The services must be received according to Medicare’s and your plan’s guidelines and when clinicians provide services within your plan’s network.
If on a Medicare Supplement or Medicare Advantage plan, you can read the Explanation of Coverage to learn the specific details available. Also, remember that mental health benefits often require prior authorization with Medicare Advantage Plans.
Inpatient Vs. Outpatient Mental Health Care
Mental health services are provided in both inpatient and outpatient settings. Inpatient services could include lab tests, room and meals, nursing care, individual or group therapy, and some medications.
Outpatient care could include services such as:
- Lab tests
- Some medications (when given in a medical setting)
- Visits with a doctor or social worker
- Individual or group therapy
Mental health help is available! If you or someone you know is in crisis, call the National Suicide Prevention Lifeline at 1-800-273-8255. TTY: 1-800-799-4889. You can call and speak with a counselor 24 hours a day, 7 days a week. Call 911 if you are in an immediate medical crisis.
Mental health is part of our overall health and well-being, so it’s good that Medicare covers services and costs related to mental health. Reach out to Twin City Underwriters today to learn more about the health care and coverage available to you.
Do you have questions about Medicare, and which plan is right for you? Twin City Underwriters offers free informational Medicare workshops and one-on-one consultations with Medicare insurance brokers where you can ask questions and get personal answers. If you need Medicare help, we can help you select the right coverage for your needs. To attend a Medicare webinar or set up an appointment, call us toll-free at 1-800-507-6778 or send us a message.
