Medicare Coverage for Mental Health and Substance Abuse

 

Medicare can pay for mental health, substance abuse screening and counseling, and telehealth services in your home.

David Minaya
June 20, 2024

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According to the National Council on Aging , up to 25% of seniors aged 65 and older live with a mental health condition. Furthermore, nearly 5%  of older adults are living with a serious mental illness, which may include:

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Depression (most common)
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Schizophrenia (less common)
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Bipolar disorder (least common)

According to the National Institute on Drug Abuse , nearly 1 million adults aged 65 and older live with a substance use disorder. Furthermore, alcohol is the most used drug among older adults, with about 65% reporting high-risk drinking, which Dietary Guidelines  defines as:

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More than two drinks per day for men
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More than one drink per day for women

Also, over 10% of seniors binge drink. Guidelines recommend you avoid binge drinking, which is defined as:

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5 or more drinks for males
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4 or more drinks for females

Medicare helps pay for mental health services. Starting January 1, 2024 , it also covers services for marriage and family therapists and mental health counselors. Medicare also covers depression and alcohol misuse screenings.

First, let’s identify the symptoms of mental health problems.

Symptoms of Mental Health Problems

You might have a mental health problem if you have any of the following symptoms :

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Feeling sad or down
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Withdrawal from friends and activities
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Problems with alcohol or drug use
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Suicidal thinking

Medicare Depression Screening

Medicare Part B covers one depression screening  per year to identify symptoms of depression. You pay nothing for this screening if your doctor accepts Medicare assignment. Furthermore, you must get this screening in your primary care setting (doctor’s office).

Medicare Alcohol Misuse Screening and Counseling

Medicare Part B covers alcohol misuse screening  for adults, including pregnant individuals, who use alcohol, but don’t meet the medical criteria for alcohol dependency . Medicare covers one alcohol misuse screening per year, and you pay nothing if your doctor accepts Medicare assignment.

Your primary care doctor can provide up to 4 brief, face-to-face alcohol misuse counseling sessions each year if you are competent and alert. Furthermore, counseling must be in a primary care setting (doctor’s office).

Medicare Telehealth Services

Through December 31, 2024, you can get Medicare telehealth services  at any location in the US, including your home. After this period, certain services require you to be in an office or medical facility in a US rural area. However, certain Medicare telehealth services will still be available without being in a rural healthcare setting, including:

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Services to treat a substance use disorder or a co-occurring mental health disorder (dual disorder), or for the diagnosis, evaluation or treatment of a mental health disorder, including in your home.
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Behavioral health services, including in your home.

Suicide and Crisis Lifeline

To talk with a trained crisis counselor, call or text 988 for free and confidential emotional support. US counselors are available 24 hours a day, 7 days a week. You can also connect with a counselor at 988lifeline.org .

Discover what parts of Medicare cover inpatient and outpatient mental health services and prescription drug coverage.

Call Senior Healthcare Direct at 1-833-463-3262 to speak with a licensed agent.

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