The New Year brought about a welcome change for Medicare patients seeking mental health services.
Effective Jan. 1., Medicare coverage of mental health treatment is now in line with that available for other types of medical care — covering 80 percent of most fees and leaving only 20 percent up to the patient.
The change has been in the works for several years, thanks to the Medicare Improvements for Patients and Providers Act, which amended the Social Security Act in 2008.
Previously, patients seeking treatment such as psychotherapy from a clinical psychologist, Ph.D. or social worker were responsible for half the bill.
Medicare has been boosting its coverage for such services incrementally since 2008, covering to 55 percent in 2010, 60 percent in 2012 and 65 percent last year, according to the bill. Coverage will now remain at 80 percent.
Up to now, many patients seeking mental health services had to rely on supplemental coverage such as Medigap insurance to fill in the void, said Eric Hausman, Medicare consultant for the county Department for the Aging.
“The people who will be impacted most will be the people who don’t have other insurance aside from Medicare,” he said. “That’s a good change for them in terms of what they are paying out of pocket.”
With increased access to affordable care, patients who have thought about seeking mental services in the past should seriously consider utilizing care, he said.
Another recent change makes accessing care even easier: Medicare patients are now eligible for one free annual depression screening, which is now covered in full by Medicare, thanks to the passage of the Affordable Care Act, Mr. Hausman said.
“It’s at no cost as long as the doctor or provider accepts Medicare. This is a good way for somebody to get screened to see if they might need mental health counseling,” he said.
Once diagnosed, patients can access the affordable therapy they need — or be put on prescribed medication that has also only recently become available to Medicare patients, he said.
Before 2013, Medicare Part D, which covers prescription medications, did not cover many common psychological drugs such as benzodiazepine and barbiturates, Mr. Hausman said.
“Drugs like Valium and Xanax that people might take for anxiety, originally those classes of drugs were excluded from Medicare part D drug plans when it first started in 2006,” he said. “They started to cover those in 2013.”
The combined changes show that mental health treatment has become “better accepted and more recognized” in the field of medicine, he said.
Mr. Hausman said the best way to find a mental health provider in the area who accepts Medicare is to visit the Medicare website and use the “physician compare” tool, filling in the Zip code and type of provider.
He cautions, however, that even if a Medicare provider is listed, it does not necessarily mean he or she is able or willing to take on new Medicare patients.
“The best thing they can do is call and ask,” Mr. Hausman advised.