Medicare Mental Health Coverage Options: Tips for Seniors
By Teresa Greenhill
For many people, the Holiday Season is a joyful time where friends and families make a point to get together to spend quality time with one another. Sadly, that’s not the case for many. The holidays can be an especially challenging time for seniors who live alone or far from friends and family. Limited transportation options and changes in the weather can make it increasingly harder to get out, and harder for visitors to come by, exacerbating the problem leading to long periods of isolation and loneliness.
Friends and neighbors can help by checking in regularly with elderly neighbors or relatives. Dropping by with a meal or just to say hello can make a world of difference to someone who is unable to get out anymore on their own. Calling, dropping a note or card, or even inviting them out for a bite means so much to those who live in isolation and might otherwise not see anyone for days or weeks at a time.
During the holiday season, it can be extremely depressing to see others decorating their houses and rushing off to do their holiday shopping, knowing that they don’t have anywhere to go and nobody to celebrate with. Extending an invitation to a family dinner can make all the difference to a lonely neighbor, friend, or family member.
Sadly, not everyone will receive an invitation. For many seniors, nobody will take the time to call or visit. Not for the holidays. And not throughout the year. And studies have shown that loneliness and isolation can take a tremendous toll on one’s physical and emotional health.
Physical problems like chronic pain and illness sometimes prevent older adults from spending time with loved ones or enjoying activities they’ve always taken for granted. Isolation and feelings of alienation may result, leading to depression. If treatment becomes necessary, knowing where to turn can be difficult, particularly for seniors who struggle with disorientation or dementia. If you’re enrolled in Medicare, it’s important to know what you’re covered for and where to turn for help.
If you have basic Medicare coverage, you may be eligible for therapy (group or individual) as well as family counseling. Medicare usually covers psychiatric evaluations and other diagnostic tests, while Part B coverage provides outpatient services for some mental health services. However, seniors at risk for depression may require supplemental coverage, which offers a more extensive level of benefits. Medicare Part C provides coverage as an HMO or PPO, and generally gives seniors access to a broader list of mental health care providers. Medicare Part D is supplementary coverage that provides access to prescription medication, which can be important for some forms of treatment.
Medicare Advantage plans cover many mental health treatments, including therapy and counseling with professionals, from psychologists and psychiatrists to social workers. Keep these services in mind when reviewing your Advantage plan, especially if you expect to need help for depression later on. Anthem Medicare Advantage plans and others also cover prescription drugs which can help reduce the symptoms of depression.
Primary care referral and treatment
Primary care physicians are important points of contact for seniors who aren’t sure where to look for help. Older patients may be accustomed to discussing health issues with a physician, someone they feel comfortable confiding in. A primary care doctor can help with depression in other ways as well, including recommending a balanced diet, exercise and social engagement (for older adults who don’t like the idea of taking antidepressants, exercise can have a powerfully positive impact on mood and outlook).
A primary care physician can help you find a mental health professional who participates in Medicare, meaning Medicare covers 80 percent of the cost of treatment. If you end up with a non-participating practitioner, bear in mind that they aren’t required to accept Medicare, but can take Medicare reimbursement. Nonparticipating practitioners can charge a 15 percent premium, for which the patient is responsible.
Finding the right mental health provider
A physician can help you find a mental health professional who accepts Medicare, but it’s up to you to find the right provider for your condition. For example, depression may require inpatient residential treatment or, depending on the severity of the condition, psychiatric hospitalization followed by outpatient care, including ongoing counseling. If you need help getting started, check out this searchable online referral resource, or this listing of therapists and counselors who accept Medicare.
Counseling, therapy and other “traditional” forms of treatment are sometimes augmented by non-traditional, alternative treatments, like acupuncture or meditation. Though acupuncture, for example, has gained credence and increasing acceptance among mental health care providers, it is not yet covered by Medicare. Understanding the parameters of your Medicare coverage will help you understand which treatments are viable and affordable for you based on your Medicare plan.
It’s important to trust your physician as a reliable and trustworthy primary point of contact for finding the treatment you need for depression. Don’t be afraid to ask questions and express concerns or reservations about treatments with which you’re uncomfortable. Your physician may be able to help you find mental health care providers with whom you’ll feel at ease discussing uncomfortable subjects.
Teresa is the co-creator of MentalHealthForSeniors.com, which is dedicated to providing seniors with information on physical and mental fitness so that they can be active and happy in their golden years.