Medicare and Mental Health

Medicare and Mental Health Image

According to the CDC, an estimated 20 percent of Americans over the age of 55 “experience some type of mental health concern.” The most common disorders affecting older people are anxiety, severe cognitive depression, and mood disorders such as depression. In fact, men over the age of 85 comprise the group with the highest suicide risk in America.

Around the world, mental health is a recognized public health issue, with seniors’ mental health declared a priority by the World Health Organization, the White House, and the Surgeon General. Unfortunately, when it comes to mental health, seniors are underdiagnosed and undertreated.

Medicare recognizes that mental health is part of your overall health. As a result, it covers a variety of mental and behavioral health services, including yearly screenings, counseling or therapy, inpatient and outpatient services, and drug coverage

Seniors’ Unique Mental Health Needs

Each phase in life comes with its own set of challenges and changes, stressors that may lead to mental, emotional, or behavioral health issues. Seniors and those nearing retirement age (or past it), undergo a wide array of life changes in a relatively short period.

Retirement, for instance, brings many changes. Many recent retirees transition from a structured, disciplined day – up at the same time, out the door at the same time, assigned work duties and responsibilities, home for the day, dinner, bed, repeat – to a wide-open schedule. Such immediate freedom may feel overwhelming at first. Furthermore, retirees may see their social networks shrink, as they no longer interact with the same group of coworkers on a daily basis; the disappearance of this emotional support system can affect any individual. Finally, retirement may also bring financial constraints and economic worries. Each of these issues alone can be stressful. Collectively, they can certainly be overwhelming.

Other challenges unique to seniors that may affect mental health include changes in body chemistry, relocation and other changes in living situations, loss of friends and family, even side effects of medications. Finally, according to the National Institute of Mental Health, depression often occurs alongside illnesses such as Parkinson’s disease, diabetes, and heart disease.

Defining Depression

When depression strikes, it often goes undiagnosed. This is especially true for older Americans, who typically feel that their depression symptoms are a natural part of life. Even if they recognize the symptoms as part of a deeper problem, seniors are more likely than other groups to not report these issues.

Warning signs of depression include:

  • Thoughts of suicide
  • Sadness lasting longer than two weeks
  • Appetite or weight changes (i.e., gaining or losing 5 percent of your body weight in less than a month)
  • Increased feelings of anger or irritability
  • Trouble concentrating
  • Loss of interest in activities you used to enjoy
  • Changes in sleep habits, either oversleeping or insomnia
  • Strong feelings of self-loathing or guilt
  • Loss of energy or feeling physically drained
  • Reckless behavior such as substance abuse or compulsive gambling

You don’t need to exhibit each symptom to qualify as depressed, although if several or many of these are familiar to you and have been for some time, you may be at a higher risk for depression. Schedule an appointment with your primary physician right away if you recognize these signs in yourself.

What Does Medicare Part B Cover?

Medicare Part B covers a variety of outpatient mental health services, including visits with a psychiatrist, clinical psychologist, or clinical social worker who accepts assignment. It also covers a number of screenings, diagnostic tests, and services, including:

  • Yearly depression screening with your primary care doctor
  • Individual and group psychotherapy
  • Testing to determine if you are receiving the services you need
  • Psychiatric evaluation

Your yearly depression screening comes with no out-of-pocket cost as long as your provider accepts assignment. Diagnosis and treatment cost Medicare Part B recipients a 20 percent co-pay, and the Part B deductible applies.

What Does Medicare Part A Cover?

If your mental health treatment requires inpatient hospital treatment, Medicare Part A covers your general hospital visit and up to 190 days in a psychiatric hospital over your lifetime. It does not cover private nursing or a private room (unless deemed medically necessary), a phone or TV in your room, or personal care items.

Your costs include a $1,288 deductible for each benefit period, with no limit to the number of benefit periods. Days 1 through 60 have $0 coinsurance per day, and you are responsible for 20 percent of Medicare-approved mental health services received in hospital.

What Does Medicare Part D Cover?

To help treat a mental or behavioral health condition, Medicare Part D drug plans cover a variety of medications prescribed for your mental health, including antidepressants, anticonvulsants, and antipsychotic medications. Beneficiary financial responsibility varies depending on which drug plan you choose.

Do not ignore your mental health. Schedule your yearly depression screening and talk openly with your doctor about any challenges or struggles you face. One’s “golden” years should not be in a state of unhappiness, sadness, or anger. With proper treatment, you can thrive and enjoy the happy, fulfilling life you deserve.

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