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How to Navigate Medicare and Mental Health at a Behavioral Hospital

Each year, nearly 20% of the US population experiences a mental illness. On top of that, approximately 4% of the population (11.2 million people) faces a serious mental illness that significantly impacts their work, school, or social life. There’s a mental health crisis in America and it’s only now starting to receive attention. Many people are afraid to seek treatment because they are afraid of exorbitant medical expenses. However, it might surprise you to know just how much Medicare can cover your costs. Port St. Lucie Hospital accepts Medicare, Medicare is one of the primary forms of payment. We’ve come up with a step-by-step guide to help patients navigate Medicare and mental health services. That way, you can receive the treatment you need without worrying about how you are going to pay for it. 

Finding the Right Mental Health Strategy 

Everything begins with a consultation. You can talk to your primary care doctor or directly to the experts at Port. St Lucie Hospital. Unlike a general hospital, Port St. Lucie Hospital has a variety of specialized treatment programs to help patients manage and overcome mental health problems.

At the consultation, patients and their loved ones can have a discussion with one of our doctors. Our mental health counselors will walk you through available options and how to begin getting the help you need.  Moreover, crisis care services are available 24/7 for patients in acute crisis who may need immediate care in a safe and structured environment. 

Transparency About Costs and Financial Options 

Our team at Port. St. Lucie Hospital knows that living with mental health conditions is challenging. At the first consultation you have, you will know how much treatment will cost you. There are no surprises. But it’s more than just clear prices. We’ll also help you find strategies to work with your health insurance company and if you have it, Medicare. We can even help you find payment options if you do not have insurance. 

medicare and mental health medicare enrollment form

Medicare and Mental Health

Does original Medicare cover mental health care at Port St Lucie Hospital? Yes, in two forms: Part A (hospital insurance) and Part B (medical insurance).  

Medicare Part A covers critical inpatient mental health including

  • nursing services
  • supplies (semi-private room, meals, medications part of your treatment) 
  • room and board
  • partial hospitalization and other services

Medicare Part A runs in benefit periods. It begins the day you’re admitted to a hospital and ends 60 days in a row after you end treatment. As of 2019, the Medicare Part A Deductible is $1,364

You may qualify for Medicare Part A if you:

  • are 65 or older AND a U.S. resident
  • are on disability
  • have End-Stage Renal Disease (ESRD)

Medicare Part B covers medically necessary services and preventive services. In terms of mental health treatment, it covers services such as visits from clinical social workers, psychologists, and doctors. It also provides many outpatient mental health services such as annual depression screenings, psychiatric evaluations, group or individual therapy, medication management, and more. The Medicare Part B Deductible is $185 in 2019. Medicare Part B also covers some prescription drugs, although it is beneficial in the long run to join a prescription drug plan. 

Furthermore, the Medicare Advantage Plan includes even more services. In general, payments may be significantly reduced or completely taken care of. 

The Bottom Line: Medicare Covers Your Mental Health at Port St. Lucie 

Don’t worry if all the different types of Medicare coverages makes your head spin. The good news is that regardless of what Medicare plan you have, you are covered at some level. With Medicare Advantage and/or private insurance, even more of your costs are covered. However, you don’t have to worry about going through the fine print of your Medicare agreement. Our professionals at Port St. Lucie Hospital will go through everything, so you can understand exactly what treatment is going to cost, your eligibility, what your Medicare-approved amount is, and how we can work with you to minimize your out-of-pocket cost. Mental health is important to living a full life and our team will ensure that you receive the best treatment at a price you can afford.

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