Medicare & Mental Health: Truth, Tips & Tricks

Medicare Part B covers one depression screening each year to help identify depression and mental health concerns early. You do not need to have signs or symptoms of depression to qualify.

The screening must take place in a primary care setting, such as a doctor’s office or clinic. Medicare does not cover this preventive screening when provided in settings such as an emergency room, skilled nursing facility, or hospital.

The screening generally involves a questionnaire that you complete yourself or with help from your provider. If the results indicate that you may be at risk for depression, your provider can conduct a more thorough assessment and refer you for appropriate follow-up care.

With Original Medicare, you pay nothing for the covered depression screening when you receive it from a participating provider and Medicare’s requirements are met.

Medicare Advantage Plans are also required to cover Medicare-covered depression screenings. However, plan-specific rules, such as using an in-network provider, may apply.

Tip #1: Ask your doctor about your annual depression screening. You can usually receive it during a scheduled doctor’s office visit, although your provider may also schedule a separate visit for the screening.

Tip #2: Use your Welcome to Medicare visit and Annual Wellness Visit as opportunities to talk about your mental health. Your provider reviews your risk for depression and other mental health concerns during these visits, but a formal depression screening questionnaire is not automatically required as part of that review.

Tip #3: Be open with your healthcare provider about changes in your mood, sleep, appetite, energy, or interest in activities. Even if you don’t think you are depressed, sharing these changes can help your provider determine whether additional evaluation is appropriate.

Tip #4: If your screening identifies a possible concern, ask your provider what the next step will be and whether a referral or additional evaluation is recommended.

Trick #1: When scheduling your appointment, ask the office:

“Can I receive my Medicare-covered annual depression screening during this visit?”

Trick #2: Remember that a screening is not the same as diagnosis or treatment. If your provider needs to investigate symptoms, perform additional testing, make a diagnosis, or provide treatment, Medicare’s regular cost-sharing rules may apply to those services.

Trick #3: If you have Medicare Advantage, check whether your provider is in network before your appointment. Your plan may have specific network and cost-sharing requirements.

Trick #4: Don’t assume that because something is discussed during a preventive visit, it is automatically part of the free preventive service. Ask your provider whether additional diagnostic or treatment services could result in a copayment, coinsurance, or other cost.

The Bottom Line

Your mental health is an important part of your overall health. Medicare provides an annual depression screening to help identify concerns early. Know your benefits, ask questions, and speak up about how you’re feeling.

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