Original Medicare and Medicare Advantage both cover mental health services, which includes grief counseling. Grief counseling is typically an outpatient service and Medicare Part B contributes to the cost.
After a loss, a person can experience extreme sadness or sorrow. These feelings are called feelings of grief and a person may find it helpful to seek professional help from a psychiatrist, psychologist or grief therapist.
Medicare covers both inpatient and outpatient mental healthcare services including depression screenings, psychotherapy and medication management.
This article explains how Medicare covers grief counseling, therapy, and other services. This article also addresses additional support for mental disorders and where to get assistance.
This article may contain a few terms that might be useful in selecting the right insurance plan.
- Deductible: The annual amount a person must pay out of pocket in order to be eligible for insurance funding.
- Coinsurance: A percentage of the treatment cost that a person must pay themselves. This is 20% for Medicare Part B.
- A copayment is an amount paid by the insured for certain treatment. This usually applies to prescription drugs for Medicare.
Medicare coverage and grief counseling
For those who require mental health services, both original Medicare and Medicare Advantage provide coverage.
Part B typically covers grief counseling as an outpatient service. Medicare will cover the cost of therapy as long as it is medically necessary.
To be eligible for Medicare coverage of grief counseling, certain types of doctors must offer the service.
- Clinical social workers
- nurse practitioners
- nurse specialists
- physicians
- physician assistants
- psychiatrists
- psychologists
- social workers
Medicare’s Part-B outpatient mental health services for Medicare patients include:
- one annual depression screening
- Individual and group psychotherapy
- Family counseling
- Psychological evaluation
- A medical professional can prescribe medication management and prescription drugs.
- Diagnostic tests
Medicare coverage through part
Medicare’s different sections cover different aspects of mental health services.
Part A
Medicare Part A covers inpatient mental health services at a general hospital or a specialized psychiatric hospital.
Medicare covers up to 190 days inpatient psychiatric hospital care over the course of a person’s life.
Medicare will not pay for a private room during an inpatient stay unless it is medically necessary. The Medicare does not cover personal items, in room phones, in-room TVs or private-duty nursing.
Part B
Medicare Part B covers 80% if a person requires outpatient mental health services, partial hospitalization, or both.
These services include grief counseling and individual and group psychotherapy, medication management and psychiatric evaluations.
In some cases, intensive counseling may be beneficial for an individual. Medicare Part B, which covers partial hospitalization as an alternative to inpatient mental health care, is available. Medicare will pay eligible costs as long as the service is provided by a hospital outpatient department or community mental health center.
Part C
Private insurance companies provide Medicare Part C plans, also known as Medicare Advantage.
These plans provide the same coverage for mental health services as Medicare Parts A and B.
In 2021, 89% of Medicare Advantage plans will cover prescription drugs.
Part D
If a person has original Medicare, Part D covers the prescription medication needed as part of their mental health treatment.
These medications include antidepressants, antipsychotics, and anticonvulsants.
To ensure that the medication their doctor has prescribed is included in their Part D policy’s formulary, it is important to check.
Grief counseling
Many people feel grief when they experience loss.
Bereavement refers to grief that is related to the loss of a loved one, such as a spouse, family member or partner.
Grief can involve feelings of deep sadness, guilt, regret, and anger, but grief or bereavement counseling can help a person through the grieving process and adapt to a significant loss.
Counseling typically includes a variety of services that can be tailored to each individual. Individual counseling may be preferred by some people, while others prefer group sessions.
Some places also offer support programs, home visits and check-ins for people who are grieving.
An individual may find their therapist prescribes medications for depression and anxiety as part of the grief counseling process.
Prices
While Medicare covers the majority of mental health care costs, there are still some expenses that an individual must cover.
For someone with original Medicare, 2021 expenses include:
- Premiums up to $471 per Month for Part A (if applicable).
- Part A deductible: $1,484 per benefit duration
- After 60 days, Part A inpatient Copayment $371 or More per Day
- Part B premium $148.50 per month or more
- Part B deductible: $203 per annum
- Part B coinsurance 20% of the Medicare-approved sum
Medigap
People can enroll in a Medicare supplement plan, also known as Medigap.
These plans are offered by private insurance companies and help to cover certain out-of-pocket expenses from Medicare Parts A and B.
Medigap plans may also cover certain emergency medical expenses that are required by a person while traveling outside the United States.
If they are enrolled in Medicare Advantage, they cannot purchase a Medigap policy.
A Medigap plan has a monthly premium. This is the only cost. To save money, a person might want to compare different plans.
Summary
Medicare Parts A and B cover most grief counseling services. Individual therapy and group therapy are options for those in need.
Medicare Advantage plans offer the same benefits, and often include prescription drug coverage. Original Medicare beneficiaries can also add a Part D plan that covers prescribed drugs.
Medigap plans may be able to cover out-of-pocket costs that Original Medicare doesn’t pay.
Talking to your doctor is a good way to get grief counseling.
