Medicare Annual Wellness Visit

Mental health can be an issue regardless of a person's age. In fact, it’s estimated that more than 25% of the adult population struggles with their mental health. And issues relating to mental health can have an enormous impact on your ability to navigate and enjoy life (especially in your golden years). So if you rely on Medicare coverage, you might wonder “Does Medicare cover mental health counseling?” And the good news is that Medicare does cover a wide variety of mental health services. This guide will help you understand what you can expect from Medicare coverage for mental health and answers common questions about this coverage. Medicare and Mental Health As we mentioned, Medicare does cover mental health care. There are two kinds of mental health treatment: outpatient and inpatient. With outpatient care, you see a doctor or therapist from time to time. Inpatient care involves living in a facility or institution. Keep in mind that Original Medicare will have specific coverage levels with copayments or coinsurance.Medicare Advantage plans have to offer at least as much coverage as Original Medicare and often may offer more coverage, and potentially lower cost shares. . Does Medicare Cover Counseling?Counseling is a common outpatient treatment for a variety of mental health conditions. Is mental health therapy covered by Medicare? Yes, it is!Outpatient care is covered under Medicare Part B. The coverage will only apply if the therapist accepts an assignment from Medicare. You’ll pay your Part B deductible (if it hasn’t already been paid) and then 20% of the Medicare-approved amount for the counseling services.There are specific types of treatment that are not covered. These may include:Transportation to and from mental health appointmentsActivities for recreation to divert attention from other issuesSupport groups for socialization (group psychotherapy is covered)Job skills training or testing not related to your mental health treatmentMealsIf you have a Medicare Advantage plan, you will get at least as much coverage as Original Medicare. There may also be additional benefits. You’ll want to check with your specific plan.If you need counseling for mental health, don’t be afraid to get the care you need!How Many Therapy Sessions Does Medicare Cover?There is no specific limit to the outpatient therapy sessions covered by Medicare, provided they are necessary and there is a reasonable expectation that the treatment will help you improve. If you require inpatient mental health care in a hospital or institution, there is a lifetime limit to the number of days Original Medicare will cover.Your Medicare Advantage plan may have different guidelines, although they shouldn’t be more restrictive than Original Medicare. Be sure you talk to your insurance provider directly to ensure your therapist is in the network and to find out how therapy sessions are covered.Does Medicare Cover Depression?Depression is one of the most common mental health diagnoses. Unfortunately, the number of American adults struggling with depression or anxiety significantly increased during the COVID-19 pandemic.With Medicare, you can get one depression screening per year at no cost to you as long as your provider accepts an assignment from Medicare. If you need therapy or counseling, you’ll pay your Part B deductible (if it hasn’t already been paid) and then 20% of the Medicare-approved cost per session. Learn more about the latest updates to Medicare deductibles and premiums.Medicare Advantage plans will offer similar arrangements but may have additional benefits as well. You’ll want to talk to your insurer before you set up your depression screening and therapy appointments. The most important part of getting coverage through Medicare Advantage is to use the provider network that is part of the plan.Does Medicare Cover Mental Health Hospitalization?Is psychiatric treatment covered by Medicare if you need to be hospitalized? Inpatient care is covered by Medicare under Part A.Similar to other inpatient hospitalization, you’ll pay a $0 deductible for each day up to 60 within a benefit period. Days 61-90 will have a $389 per day charge in 2022. Beyond 90 days per benefit period, you’ll need to use your lifetime reserve days, which you only have 60 of in your lifetime. This article can provide additional information about Medicare costs.Overall, mental health hospitalization is limited to 190 days over your lifetime. After that, Original Medicare will not provide coverage and you’ll need to pay 100% of your costs.In addition to the inpatient hospitalization costs, you’ll also pay 20% of the Medicare-approved amount for therapy or other mental health services you get while you’re in the hospital. These are covered by Medicare Part B. Prescription drugs may be covered under Medicare Part D or Part A.If you have a Medicare Advantage plan, you may have similar limits or they may be more generous. You’ll need to check with your specific plan for details.Medicare Mental Health Reimbursement RatesHow much does mental healthcare cost with Medicare? With Original Medicare, you’ll pay the normal copayments or coinsurance for either inpatient or outpatient care. For example, a therapy session will cost you 20% of the Medicare-approved amount, as long as your deductible has been paid and your therapist accepts the assignment.With Medicare Advantage, you may have different deductibles, copayments, or coinsurance. You’ll need to talk to your insurance company to find out the details. It’s a good idea to do this before you commit to treatment so that you can ensure you know what to expect.  Contact Us to Learn More About Medicare and Mental Health CoverageIf you have any additional questions about Medicare and mental health coverage, or you’d like to talk to a licensed agent to choose the right Medicare plan for your needs, we're here to help. Contact us today!

  Many people who have Medicare rely on it as their only health coverage. However, some Medicare beneficiaries have other insurance alongside their Medicare coverage. Using Medicare with another type of insurance brings up a lot of questions, from “What insurance is primary or secondary?” to “Can I keep my employer's health insurance with Medicare?” This guide will answer many common questions about using Medicare alongside other insurance coverage. This will help you get a better understanding of how to maximize your benefits.   How Medicare Coordinates With Other Insurance Coverage If you have two different health insurance plans, it’s important to know which insurance plan will be the primary payment source. The other plan will provide backup for the costs that the first plan doesn’t cover. Understanding how Medicare works with other insurance plans can help you decide when to bring your Medicare health insurance card and when to bring your other plan information instead.  What Insurance is Primary or Secondary?When you have more than one payer — that is, more than one health insurance plan — there are rules that determine which plan is the first payer. That plan is considered primary, and then the other plan is secondary.When you have a health need, the primary plan provides coverage to the limits of its benefits and the secondary plan only pays if there are costs not covered by the primary plan.However, that doesn’t mean the secondary plan will pay all remaining costs. For example, you may have out-of-pocket costs like coinsurance or a copayment, or the services might not be part of what the secondary plan covers.When Medicare is working with other insurance plans, Medicare is usually the secondary payer. If you have an employer group plan from your job or your spouse’s job, that plan pays first. Here are some examples of Medicare working with other insurance, along with who pays first. If you have Medicare and:A group plan through your current job: The group plan pays first.A group plan through your spouse’s job and the company has more than 20 employees: The group plan pays first.A group plan from a previous employer that you have retired from: Medicare pays first.VA coverage: You use your VA benefits at VA providers and Medicare at other providers. Learn more about how Medicare works with VA benefits. Active-Duty TRICARE: TRICARE pays first.Non-Active-Duty TRICARE: Medicare pays first unless you use a military hospital or federal care provider.Medicaid: If you are dual-eligible for Medicare and Medicaid, Medicare pays first. How Does Medicare Work With Employer Health Insurance?The most common situation that people 65 and older are in when they have two insurance plans is this: they qualify for Medicare but they also have employer-provided health insurance. People aren’t necessarily retiring at age 65 anymore, which is why this happens. But don’t worry, your employer group plan will pay for your health benefits. If you go beyond those benefits, you can see if Medicare can provide additional coverage. Do I Have to Enroll in Medicare if I Have Employer Coverage?It’s a good idea to enroll in Medicare Part A (hospital coverage) as soon as you’re eligible. It’s premium-free for most Americans. However, if you have a qualifying group plan through an employer, you can delay your enrollment in Medicare Part B without paying the late-enrollment penalty. Another option is to drop your employer-based coverage and use Medicare instead. You’ll have to compare the coverage options and determine which is best for you. Can I Keep my Employer Health Insurance With Medicare?Some people worry that if they become eligible for Medicare they cannot keep their employer's health insurance. That’s not true! You don’t have to use government health insurance right away if you have other coverage. In fact, if you’re worried about the Medicare coinsurance costs, it might be best to keep your employer health insurance plan as the primary payer. That way, you can pay a set copayment or coinsurance amount, which can be more manageable than paying 20% of the Medicare-approved amount of care.Learn More About Medicare PlansAs you can see, you can have both Medicare and another health insurance plan. It’s just important to know which plan is the primary payer so you can ensure your bills are processed in a timely manner.Do you have more questions about Medicare plans and how they work in your specific situation? We’re here to help. Our licensed agents can address your concerns and help you compare plans to get the right coverage for your needs. Contact us today!

  If you have a question about your Medicare plan, who do you contact? How do you get a hold of someone who works at the Centers for Medicare and Medicaid??  These questions can be very important if there is a concern about your Medicare coverage. Fortunately, there are many easy ways to get in touch with the people you need to speak to, depending on the concern. This guide will look at the various ways to contact Medicare. Let’s get started! How Do You Contact Medicare by Phone? The easiest way to contact someone about Original Medicare is over the phone. You can call the Medicare phone number at 1-800-MEDICARE, which is 1-800-633-4227, to get answers to any Medicare-related questions. For TTY, call 1-877-486-2048. When you call, there will be a phone tree where you type a specific number to describe what you are calling about. This will help you talk to the right person in the right department.  The Medicare contact page also has a drop-down menu where you can get specific phone numbers based on the state you live in. However, the best place to start is still to contact Medicare by phone at 1-800-MEDICARE.  Keep in mind that if you have a Medicare Advantage plan, it’s generally best to contact that insurance provider directly using the phone number on the back of your insurance card. Who is the Best Person to Talk to About Medicare?If you have questions about Medicare, there are several people you can talk to. You can start by calling 1-800-MEDICARE, which is probably the easiest way to get help. You can also use live online chat by going to Medicare.gov.Another option to get your Medicare questions answered is to contact your local Social Security office. Call the national Social Security phone number at 1-800-772-1213. They can help you make an appointment with your local office if necessary. To get help choosing an insurance plan, you can talk to a licensed insurance agent. Each state also has a State Health Insurance Assistance Program (SHIP) that can offer free counseling and advice about your Medicare benefits. The specific needs you have about Medicare can help you decide who is the best person to talk to about Medicare.  How Do I Talk to a Person at Medicare?The best way to talk to a person at Medicare is to use the contact number for Medicare, 1-800-MEDICARE. That number allows you to select options through the phone tree so that the person you connect with is the right person for your needs.If you have a Medicare Advantage plan, you will want to call the number for that insurance provider to get efficient help with your concerns. Another way to contact Medicare is to go online. There are live chat agents available to talk to you one-on-one at Medicare.gov. They can answer questions and help you understand your coverage. If you need to speak with someone else for advanced service, they will give you that information.If you’d like in-person help, you can visit your local social security office or get help from your state’s SHIP program.When Should I Call Medicare?Are there specific times that the Medicare helplines are open? The good news is that you can call almost anytime. The Medicare phone number and Medicare.gov chat are open 24/7 except for certain federal holidays. You may also be able to log in to your Medicare plan via the Medicare website.If you have a Medicare Advantage plan, you can call the insurance provider for help. They may have 24-hour service, or they may have more limited hours. Most insurance providers also have a website that gives you 24/7 access to your account.Learn More About MedicareGetting the Medicare plan that’s right for your needs is essential so that there are no surprises when you need medical care. However, it can be challenging to understand and compare options.If you want to call Medicare directly, you now have the information you need. You can also contact us to get help with questions about Medicare. We’re here to make things easier. Reach out today!