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Athena Care
Does Medicare Cover Mental Health Services & Therapy in Tennessee?

Does Medicare Cover Mental Health Services & Therapy in Tennessee?

Yes, Medicare insurance covers mental health services, inpatient and outpatient, depending on your specific plan’s benefits.

Parts A and B of Medicare assist in paying for mental health services. Medicare Part A covers inpatient services and treatments administered in a psychiatric or general hospital, while Medicare Part B covers doctor visits and services that are considered outpatient.

How to Verify Medicare Mental Health Benefits

Athena Care is in-network with many insurance plans and providers. The simplest and fastest way to find out if Medicare covers behavioral health therapy and services is to fill out our free and confidential online insurance verification form.

Allow our highly trained and knowledgeable care coordinators to manage the challenges of contacting your insurance company for information on your Medicare mental health coverage.

After completing the form, a care coordinator will review your insurance and thoroughly explain your options. Rest assured that any information exchanged or discussed will remain confidential.

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Which Mental Health Services Are Covered by Medicare Insurance?

Your Medicare mental health coverage may cover a variety of resources and services, including but not limited to the below:1

  • Counseling for Alcohol Abuse (up to four sessions)
  • Family Counseling
  • Medication management and several non-self-administered prescription drugs
  • One depression screening per year
  • Opioid use disorder treatment2
  • Psychiatric evaluation and diagnostic tests
  • Telehealth
  • Therapy

Which Mental Health Conditions Are Covered by Medicare Insurance?

Medicare mental health coverage in Tennessee may cover the following conditions:

  • Anxiety Disorders
  • Depression
  • Partial Hospitalization
  • Substance Use Disorders

How To Find Mental Health Providers that Accept Medicare Near Me in Tennessee?

With Athena Care, gaining access to mental health testing services and treatments has never been easier. A care coordinator can assist you at one of our various mental health clinics in Tennessee, open Monday through Friday, 7:00 a.m. to 6:00 p.m.

When choosing mental and behavioral health doctors in Tennessee, keep the following in mind:

  • Education, training, license, and years of experience
  • Specialties and services offered
  • Treatment methods and philosophies
  • Insurance companies they work with
  • Office hours
  • Pricing
  • Session length

Also, don’t be afraid to ask questions.

Here you’ll find a list of practitioners organized by city, along with information about their backgrounds and specialties.

What is Medicare Insurance?

Medicare is a government-run national health insurance program that began in 1965 under the Social Security Administration. Today, the Centers for Medicare and Medicaid Services administer its four parts (A-D).

As of 2016, Tennessee has some of the highest percentages of citizens receiving disability benefits, thus receiving Medicare.3

Medicare Eligibility

In order to be eligible for Medicare benefits, an individual must either be aged 65 or older, have a disability, or have End-Stage Renal Disease (ESRD).

Medicare Plans & Parts

  • Plan A: This plan provides coverage for inpatient and hospital stays, including up to 190 days in a lifetime at a Medicare-certified psychiatric facility.4
  • Plan B: Medicare Part B provides coverage for outpatient/medical coverage. This includes, but is not limited to, Medicare mental health coverage and select prescription drugs.5
  • Plan C: While the majority of people with Medicare have Original Medicare, others choose to obtain their Medicare and mental health treatment through a Medicare Advantage (MA) Plan, often known as a Medicare private health plan or Part C. Plan C is provided by many insurance providers, including Anthem, Blue Cross Blue Shield, Cigna, United Healthcare, and Aetna.
    • If you enroll in an MA Plan, you still have Medicare. As a result, you’ll most likely have to pay a monthly premium for Part B. Most MA plans include Plan D. If you have an MA Plan, you should receive the same benefits as if you had Original Medicare.
    • Keep in mind that MA plans may differ in their network of providers, coverage rules, premiums (in addition to the Part B premium), and cost-sharing for covered services.6
    • The most common types of MA Plans are:
      • Health Maintenance Organizations (HMOs)
      • Preferred Provider Organizations (PPOs)
      • Private Fee-For-Service (PFFS)
      • Special Needs Plans (SNPs)
  • Plan D: This is the Medicare prescription drug program, which covers the majority of outpatient prescription medications. Private firms offer Part D as a stand-alone plan for those enrolled in Original Medicare or as a set of benefits included with your Medicare Advantage Plan.7

Does Medicare Insurance Cover Online Therapy?

Yes, Medicare Part B covers telehealth services.8

Does Medicare Cover Prescription Medications?

Yes, Part D of Medicare is specifically for prescription drug coverage. If your specific medication isn’t included in the list of drugs covered, a comparable medicine should be available.9

Part B of Medicare also includes coverage for select prescriptions medications.

What Services & Treatments Are Not Covered by Medicare?

The following are some of the services and treatments that Medicare does not cover:10

  • Long-term care
  • The majority of dental care
  • Exams to prescribe glasses
  • Dentures
  • Cosmetic surgery
  • Acupuncture
  • Hearing aids and the tests required to fit them
  • Foot care

How Are Medicare & Medicaid (TennCare) Different?

Medicare is a federal insurance program that covers you regardless of your income if you are 65 or older or have a disability.

Medicaid is a state and federal assistance program that provides health insurance to low-income people of every age.

Tennessee’s Medicaid program is known as TennCare. It primarily serves low-income pregnant women, parents or guardians of minor children, children, and the elderly or disabled.11

Sources

  1. “Does Medicare Cover Mental Health Services like Therapy?” eHealthInsurance Services, Inc., 2022, https://www.ehealthmedicare.com/medicare-coverage-articles/medicare-coverage-therapy-mental-health-services/
  2. “Centers for Medicare & Medicaid Services.” CMS, 2022, https://www.medicare.gov/Pubs/pdf/10184-Medicare-and-Your-Mental-Health-Benefits.pdf
  3. “Medicare in Tennessee.” Healthinsurance.org, 2022, https://www.healthinsurance.org/medicare/tennessee/
  4. Medicare Part A Covered Services.” Medicare Interactive, 2022, https://www.medicareinteractive.org/get-answers/medicare-covered-services/medicare-coverage-overview/summary-of-part-a-covered-services?
  5. “Medicare Part B Covered Services.” Medicare Interactive, 2022, https://www.medicareinteractive.org/get-answers/medicare-covered-services/medicare-coverage-overview/summary-of-part-b-covered-services?
  6. “Medicare Advantage Plans.” Medicare.gov, 2022, https://www.medicare.gov/sign-up-change-plans/types-of-medicare-health-plans/medicare-advantage-plans
  7. “Part D Basics. Medicare Interactive, 2022, https://www.medicareinteractive.org/get-answers/medicare-prescription-drug-coverage-part-d/medicare-part-d-coverage/part-d-basics?
  8. “Telehealth.” Medicare.gov, 2022, https://www.medicare.gov/coverage/telehealth
  9. “What Medicare Part D Drug Plans Cover.” Medicare.gov, 2022, https://www.medicare.gov/drug-coverage-part-d/what-medicare-part-d-drug-plans-cover
  10. “What’s Not Covered by Part A & Part B?” Medicare.gov, 2022, https://www.medicare.gov/what-medicare-covers/whats-not-covered-by-part-a-part-b
  11. “TennCare Medicaid.” https://www.tn.gov/tenncare/members-applicants/eligibility/tenncare-medicaid.html

If you suspect that you or someone you love suffers from mental health disorders, contact Athena Care today.

One of our friendly associates will help you get the help you need. Take this first step to feel better and take control. 

(615) 320-1155