Medicare & Mental Health: Depression & Anxiety Coverage

Medical care coverage may help with the financial burden of treating anxiety and depression. You are not alone if you struggle with anxiety and depression. With 40 million persons aged 18 and older suffering from anxiety disorders, they are regarded as the most prevalent mental ailment in the United States. Even though anxiety disorders are highly curable, only 36.9% of persons with them seek help. Anxiety and depression often coexist, in fact, over half of the people with a diagnosis of depression also have an anxiety diagnosis. Thankfully, Medicare covers these diseases, giving people access to the required medications and services.

A mental illness called depression is characterized by protracted emotions of melancholy, despair, and disinterest in activities. On the other side, anxiety is a state characterized by excessive fretting, trembling, and terror. These diseases have the potential to lower a person’s quality of life significantly and, if addressed, may have grave repercussions, including physical health issues. The Medicare Part B benefit, which pays for medically required outpatient treatments, includes this kind of coverage. This indicates that Medicare will cover visits to mental health specialists such as clinical social workers, psychiatrists, and psychologists.

Anxiety and depression-related medically essential and preventive therapies are included under Part B (medical care). They consist of the following:

  1. Family counseling, if applicable: Medicare Part B may contribute to the cost of family counseling if the therapy’s purpose is to aid in your treatment. Also, if it is offered by a Medicare-approved hospice and accessible in that state, grief, and loss counseling may be covered by Medicare for qualifying hospice patients and their relatives.
  2. Psychiatric evaluation: Medicare covers 80% of the cost of a psychiatric examination that Medicare has authorized. You are responsible for the Part B deductible, coinsurance fees, and 20% of the Medicare-approved amount. Verify that Medicare will pay for the treatments if your psychologist accepts the assignment or is covered by your insurance provider’s network.
  3. Management of medications: Commonly prescribed drugs for depression and anxiety include antidepressants and anxiety relievers. Prescription medications, particularly those used to treat mental health issues, are covered by Medicare Part D.
  4. Transcranial Magnetic Stimulation (TMS): TMS is a non-invasive technique that stimulates brain nerve cells using magnetic fields. When other therapies haven’t worked to treat depression, it’s often utilized. As long as TMS is judged medically essential, Medicare will pay for it.
  5. Psychotherapy: Sometimes referred to as talk therapy, it is a kind of medical care that entails a patient conversing with a mental health expert to determine and cure the underlying reasons for their sadness or anxiety. Medicare covers individual and group treatment sessions.


Additional coverage includes:

  • A yearly depression examination in a primary care facility or office
  • Both individual and group counseling
  • Diagnostic procedures
  • Checking to see whether your services and treatment are making a difference in your condition
  • Self-administered medications that are usually not used, such as injections
  • Just once, welcome to your Medicare preventive appointment, which will also examine your risk factors
  • A brief hospital stay
  • A yearly check-up during which your doctor may assess any changes to your mental health

Both general hospitals and psychiatric hospitals are covered by Medicare Part A for inpatient mental health treatments, however, psychiatric hospitals are only covered for a lifetime maximum of 190 days per beneficiary. During each benefit period, which for hospital services starts on the day of admission and ends when a beneficiary has not received inpatient treatment for 60 days straight, traditional Medicare enrollees must pay a deductible and coinsurance. Those enrolled in Medicare Advantage plans have varying cost-sharing obligations.

The fact that not all mental health therapies are covered by Medicare should not be overlooked. For instance, Medicare doesn’t pay for most relationship therapy or marital counseling forms. Moreover, it excludes services like counseling and personal development therapy that are not considered medically required. A person must first get a recommendation from their primary care physician in order to use mental health therapies covered by Medicare. The doctor will decide if the patient’s mental health issue qualifies for coverage and will then send them to the proper mental health specialist.

Medicare facilitates seniors’ access to inexpensive mental health counseling and care. Your strategy may assist you in receiving private counseling and medical attention to manage your mental health in the best manner possible. Your whole well-being is impacted by your mental health, which is just as crucial as your physical health. Much like physical diseases, emotional issues, disorders need and merit prompt medical care.

In conclusion, anxiety and depression are widespread mental health issues that may significantly lower a person’s quality of life. Medicare covers the diagnosis and treatment of these illnesses, as well as psychotherapy, drugs, ECT, TMS, and IOPs. A recommendation from a primary care doctor is necessary to get mental health therapy, and not all mental health therapies are covered by Medicare. People with depression or anxiety must get treatment and take advantage of the mental health services available through Medicare to improve their well-being.