Medicare Reimbursement for Psychiatric Services for Depression, Anxiety Disorders Etc

By on June 26, 2014

by Mary Jane
(Indiana)

I just read an article that talks about how depression and anxiety disorders often go undiagnosed in the aging population. Many aging seniors and their family members attribute feelings of sadness or anxiety to growing old.

While depression and aging may not be a normal part of aging, I believe that this story missed an important factor.

What the story does not share, I believe your visitors would appreciate knowing.

Many seniors are financially stretched, living on a fixed budget.

Unfortunately, many seniors don’t get the necessary help or treatment for depression because Medicare reimburses psychiatric services differently.

The physicians are reimbursed at the rate of 50% of the allowed charge for a psychiatrist, psychologist or psychotherapist and the beneficiary (or the patient) is responsible for the other 50%. As you know,this can be costly.

There are new rules in effect for 2010 and 2011.

Medicare will reimburse at the rate of 55%.Leaving the patient to be responsible for paying the other 45%.

It will not be until 2014 that mental health services be reimbursed at 80% of the allowed charges, Leaving the remaining 20% to be paid by the patient.

Mary Jane,
You are so right about seniors being concerned about their money. I know close to the end of the year, many with HMO’s have prescription plans that run out of coverage and they are responsible for paying for their own medications. They make too much money to qualify for any type of assistance, but not enough to pay for the cost of the medications, the co pays to the doctors, all their bills, such as heat, air and food.

I can see why depression and anxiety goes untreated.

It is a vicious circle. Which comes first? Depression and anxiety or the inability to pay for necessary staples and chronic stress?

Thank you, again, Mary Jane for bringing attention to a very important subject.