How Medicare Supports Members with Anxiety and Depression

You probably already know that many seniors face health challenges like heart disease and diabetes. But did you know that anxiety and depression are pretty common among older adults too?

According to one report, a quarter of Medicare members are living with a mental illness—everything from anxiety to bipolar disorder. And only 40-50 percent of them are getting treatment.

That’s unfortunate, because Medicare covers mental health services, much like it covers physical health services. In fact, you can get free annual screenings as a Medicare member.

Sometimes, treatment can’t wait.

If you or someone you know is struggling or in crisis, contact the Suicide & Crisis Lifeline at 988 (voice call or text), or start a web chat at 988lifeline.org.

This free, confidential service is available 24 hours a day, 7 days a week.

For immediate medical help, call 911.

What Is Anxiety?

We all get anxious from time to time. For you, that might be on the night before a medical procedure or when you have to drive across town at rush hour.

Clinical anxiety is different. It happens when your fear or dread is way bigger than the actual problem. And it affects your ability to function. Anxiety disorders include phobias, panic disorders, and generalized anxiety disorder.

What Is Depression?

We all experience moments of sadness. They can be caused by serious things, like losing a loved one, or minor things, like watching our favorite team lose a big game.

Again, clinical depression is different. Here, your sadness sticks around for weeks and may even cause physical symptoms. Types of depression include clinical depression (major depressive disorder), seasonal affective disorder, and, for new mothers, postpartum depression.

Coverage for Depression Screening

Both Original Medicare and Medicare Advantage cover an annual depression screening. These screenings happen as follows:

• During your first 12 months on Medicare, you should have a “Welcome to Medicare” visit with your primary care provider. During this visit, your provider will review your potential risk factors for substance use disorder and depression, and refer you for treatment, if needed.

• In future years, during your annual “wellness” visit, your provider will have you fill out a health risk assessment and will help you develop a personalized prevention plan. (Note: This visit can’t take place within the first 12 months since you joined Medicare or had your “Welcome to Medicare” visit.)

In both cases, there’s no cost to you (unless your provider orders additional services).

Mental health screenings rely on what you tell your provider, not on scans or blood tests. This probably goes without saying, but it’s important to be open and honest about how you’re feeling. Your provider can’t help you if they don’t know all the facts. And, remember, it’s not at all uncommon for older adults to experience anxiety or depression. This is especially true for those who have disabilities or are also enrolled in Medicaid.

What If I’m Diagnosed?

Medicare doesn’t just cover mental health screenings. It also covers treatment. That’s a good thing, because effective treatment is available. Options include talk therapy, medication and sometimes a combination of the two.

If you’re on Original Medicare, here’s what that coverage looks like:

• Part A (hospital insurance) covers inpatient treatment in a general or psychiatric hospital.

• Part B (medical insurance) covers treatment in settings like a doctor’s office, outpatient clinic, or community mental health center.

• Part D (prescription drug coverage) covers prescription drugs. (Part A covers drugs you receive while you’re in the hospital.)

If you’re on Medicare Advantage (Medicare Part C), you’re covered for everything Parts A and B cover, and probably for what Part D covers. About 90% of MA plans cover prescription drugs. (These are sometimes called MA-PD plans.)

At ArchWell Health, we strive to keep you healthy: body, mind and spirit. Our providers offer mental health screenings and referrals. And our social workers can connect you with support groups and other resources. Don’t hesitate to ask for help if you need it.