Medicare Advantage and Mental Health Benefits
Does Original Medicare Have the Coverage You Need?
Taking care of your emotional health is just as important as taking care of your physical body. Mental health issues like depression and anxiety can affect people of all ages. If you have Medicare, you might wonder what’s covered in relation to counseling, therapy and treatment for behavioral health conditions.
Of course, the best Medicare plan for mental health depends on your own specific needs. Medicare Advantage plans (Part C) can often supply more health insurance options than Original Medicare (Parts A and B) alone.
Original Medicare vs. Medicare Advantage
Original Medicare is made up of Parts A and B. Part A covers hospital care, and Part B covers medical visits and outpatient care.*
For Medicare prescription drug coverage, you must purchase a Part D plan.
Original Medicare mental health coverage can include:
- Individual and family therapy with licensed providers
- Telehealth visits (after meeting a Part B deductible)
- Screenings for depression, alcohol and substance use
- Counseling to help quit smoking
- Opioid treatment services
- Partial hospitalization for mental health
Original Medicare mental health benefits do not include:
- Marriage counseling
- Grief counseling
- Religious counseling
- Medications (unless you have Part D)
Medicare Advantage (Part C) plans are offered by private insurance companies. These plans include everything Original Medicare covers and more, such as prescription drugs, support groups and extra services for mental health.
Medicare Advantage plans provide Original Medicare mental health benefits, plus:
- Broader networks of mental health providers
- Counseling and therapy
- Inpatient substance abuse treatment
- Support groups and specialized therapies
- Prescription drugs for mental health needs
Some Medicare Advantage plans do not require you to pay a deductible before getting mental health care, and coverage can be tailored to your needs.
Both Original Medicare and Medicare Advantage offer an annual free depression screening. Plus, your mental health will be discussed at your initial Welcome to Medicare visit and an annual wellness visit with a primary doctor.
Prominence Medicare Advantage plans give members access to 24/7 Teledoc™ visits with board-certified doctors and licensed therapists by phone or video. The sessions are confidential and available for $0 copay.
Medicare Advantage mental health providers and costs
The cost of Medicare mental health coverage varies depending on the plan you select. With Original Medicare, you’ll typically pay 20% of the Medicare-approved amount for outpatient therapy once you hit your deductible.
Medicare Advantage mental health benefit costs vary by plan but many have lower copays and no lifetime coverage limits. With many plans, you must use in-network providers but there are exceptions. Remember, many Medicare Advantage plans offer mental health coverage with no deductible.
Mental health matters, and both Original Medicare and Medicare Advantage offer important benefits. If you or a loved one needs mental health benefits, it’s worth comparing plans to find one that best fits your needs.
Enroll now
Call 866-747-8855 to join a Prominence Medicare Advantage plan during an enrollment period. The provider network presently offers members access to quality medical services in Florida, Nevada and Texas.
* All benefits not available on all plans
Enroll in a Prominence Health Plan Medicare Advantage plan.
The comprehensive provider network offers members excellent access to quality medical services.
