Does Medicare Cover Suicide Prevention

Does Medicare Cover Suicide Prevention? 

Suicide doesn’t seem to be addressed often enough. Each year, tens of thousands of Americans die by suicide, and over a million more attempt suicide. While these numbers are sobering, it should be a comfort to know that there are also countless medical professionals out there who work tirelessly to prevent suicide. This is often done through counseling and medications, but you can’t forget that there are also medical researchers working long hours to study the effectiveness of new suicide prevention approaches and mental health services in order to preserve the precious gift of life.

Does Medicare cover suicide prevention?

Because suicide prevention is something that is unique to each individual experiencing suicidal thoughts, there is no one thing that can be considered suicide prevention treatment. As such, Medicare does not cover suicide prevention as a general medical item. Medicare does, however, provide coverage for a range of mental health care services, including counseling, inpatient care and medications designed to address associated conditions like depression and anxiety.

In terms of counseling, Medicare provides coverage for depression screening once per year and ongoing individual and group therapy through Medicare Part B, the outpatient benefit. These services must be provided by a psychiatrist, a clinical psychologist, a clinical social worker, a clinical nurse specialist, a nurse practitioner or a physician’s assistant in order to qualify. These services are provided under traditional Medicare Part B coverage obligations in which you pay 20% of the cost and Medicare covers the remaining 80%. Additionally, your deductible will need to be met prior to benefits being applied.

Suicide prevention and medication support

Medications prescribed to address mental health concerns and prevent suicide are covered by Medicare Part D, the prescription drug benefit. Medicare Part D plans each have a formulary that lists all covered drugs. Most common medications for mental health conditions are covered by Medicare. If your medication is not covered and no suitable alternative exists, you may be able to work with your care specialist to file a waiver form for an exception.

Medicare Part D coverage only applies to medications that you are able to purchase from a retail pharmacy for home use. If a medication is administered during a clinical visit, Medicare Part B would apply. If a medication is given during a hospital admittance or while admitted to a skilled nursing facility, Medicare Part A coverage would apply.

Inpatient care and suicide prevention coverage

If inpatient care is required to address a mental health concern that is related to suicidal ideation, Medicare Part A offers coverage for up to 60 days at full coverage once your deductible is met for that benefit period. After this period, Medicare will cover an additional 30 days at a discounted rate in which you would be required to pay a coinsurance fee. From day 91 onward, you can utilize lifetime reserve days if available for additional discounted time spent hospitalized. Once lifetime reserve days have been exhausted, you are responsible for all costs.

It should be noted, however, that Medicare benefits do not place restrictions on the amount of benefit periods you can have if you’re receiving mental health services in a general hospital inpatient setting. To learn more about the specifics benefits of your plan, contact your plan administrator.

If you or a loved one is feeling suicidal thoughts or struggling with anxiety or depression, please reach out to a medical provider immediately. There are services available for help 24 hours a day, 7 days a week.