Medicare offers mental health coverage for the elderly.
Medicare has offered help for physical health problems for decades, but until recently, psychiatric care did not get the same level of coverage as physical health care did. Now, the importance of mental health is becoming clearer, especially for elders who face changing roles, physical needs, and living circumstances.
Significance
Medicare mental health insurance provides help that improves the quality of life for many elderly and disabled people on its rolls. According to the Administration on Aging, 20 percent of the mental health issues of those older than 55 are beyond the scope of mental changes that normally take place with age. The World Health Organization addresses treatment, saying that mental help can improve health, quality of life, autonomy, and the needs of the caregivers, as well as lessening problems with disability.
History
At the time Medicare was founded, Medicare had a different attitude about mental health than physical medical problems. Many older Americans avoided seeking psychiatric assistance, partly due to the cost. In 2006, the push for parity in mental health coverage began in earnest. As of September 2009, the reimbursement for mental health services was at 50 percent, while Medicare paid 80 percent of the cost for physical illnesses. Medicare reimbursements continue to increase in 2010.
Benefits
Medicare helps pay for visits with mental health workers such as psychiatrists, clinical psychologists and social workers, and clinical nurse's assistants. If you want a prescription drug benefit to cover medications for mental conditions, you must buy a Medicare plan and learn the rules of that plan. Hospitalizations are a part of Medicare coverage as well, within specifically designated circumstances.
Considerations
Original Medicare, without a supplement plan, has certain limitations. Gaps in coverage include: transportation to mental health services, private care nursing or private rooms during hospitalizations, and drug benefits. Ask the mental health service provider whether she accepts Medicare assignment. This means that she accepts Medicare's allowed cost as the total, and figures your co-pay based on the proper percentage of that total. Otherwise, you may pay a higher price because the cost is not discounted.
Future
As of May 2010, the government plans to pay a higher percentage of Medicare-approved fees each year between 2011 and 2014. In 2010 and 2011, you will pay 45 percent for outpatient procedures. You will pay 40 percent in 2012, and 35 percent in 2013. Parity with physical care will be achieved in 2014 when you will pay only 20 percent of the cost for outpatient procedures.
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