Many people serve as long-distance caregivers for friends and relatives who live far away. Long-distance caregivers can perform a variety of roles in the care of their friends and relatives, including by helping with finances or money management, arranging for in-home care, and providing emotional support for the primary caregiver. The National Institute on Aging suggests that if you are a long-distance caregiver, you should familiarize yourself with resources local to the person you are caring for. You can find these resources by visiting:

Eldercare Locator, 1-800-677-1116 (toll-free)
National Institute on Aging website
Family Care Navigator
Your state government’s website

Dear Marci,

I’m helping my father set up his treatment for substance use disorder. Does Medicare cover this kind of care?

-Saul (Arlington, VA)

Dear Saul,

Yes, Medicare should cover alcoholism and substance use disorder treatment for your father if:

His provider states that the services are medically necessary
He receives services from a Medicare-approved provider or facility
And, his provider sets up his plan of care
Medicare covers treatment in both inpatient and outpatient settings. Here are just a few examples of the services that Medicare covers:
Psychotherapy
Opioid treatment program (OTP) services
Patient education regarding diagnosis and treatment
Post-hospitalization follow-up
Part A should cover his care if he is hospitalized and needs substance use disorder treatment. If he is in an inpatient psychiatric hospital, keep in mind that Medicare only covers a total of 190 lifetime days. Once this limit has been reached, though, Medicare may cover care at a general hospital. A plan’s cost-sharing rules for an inpatient hospital stay should apply.

Part B should cover outpatient substance use disorder care he receives from a clinic, hospital outpatient department, or opioid treatment program. Original Medicare covers these services at 80% of the Medicare-approved amount. As long as he receives the service from a participating provider, he will pay a 20% coinsurance after meeting his Part B deductible. Visit www.medicare.gov or call 1-800-MEDICARE (1-800-633-4227) to find participating providers. If he is enrolled in a Medicare Advantage Plan, contact his plan for information about costs, coverage, and in-network providers for substance use disorder treatment.

I hope this information is helpful to you and your father. Wishing him well on his recovery.

-Marci

Join us for the Life After 50 Expo – Pensacola this Friday, may 12, 2023. Lots of Vendors and prizes – even a 50 inch TV! Music all day. A fun place to be and a great place to learn what Seniors need to know. Free Admission – Free Parking Open from 9am -2pm at Sanders Beach Resource Center – 913 S. I Street – on the water in Pensacola.

Dear Marci,

What mental health care does Medicare cover? I have anxiety and depression, and my primary care provider recommended I see a therapist or psychiatrist.

-Josefina (Cleveland, OH)

Dear Josefina,

Medicare covers both inpatient and outpatient mental health care. And Medicare prescription drug plans cover medications used to treat mental health conditions, but be sure to check the formulary to ensure the brands and dosages you take are included.

Medicare Part B covers outpatient mental health care, including the following services:

Individual and group therapy
Substance use disorder treatment
Tests to make sure you are getting the right care
Occupational therapy
Activity therapies, such as art, dance, or music therapy
Training and education (such as training on how to inject a needed medication or education about your condition)
Family counseling to help with your treatment
Laboratory tests
Prescription drugs that you cannot administer yourself, such as injections that a doctor must give you
An annual depression screening

Be sure to ask any provider you see if they take your Medicare insurance before you begin receiving services. If they don’t, you will likely be responsible for the full cost of the care. Psychiatrists are more likely than any other type of physician to opt out of Medicare, meaning Medicare will not cover any of the cost of the care from those doctors. Additionally, not all non-medical providers (like psychologists or clinical social workers) are Medicare-certified. If you need a list of providers near you who accept Medicare, you can go to www.medicare.gov/care-compare.

Medicare Part A covers inpatient mental health care that you receive in either a psychiatric hospital (a hospital that only treats mental health patients) or a general hospital. Your provider should determine which hospital setting you need.

If you receive care in a psychiatric hospital, Medicare covers up to 190 days of inpatient care in your lifetime. If you have used your lifetime days but need additional mental health care, Medicare may cover your care at a general hospital.

Medicare Part D covers most prescription drugs used to treat mental health conditions. You may have Part D coverage through a Medicare Advantage Plan or through a stand-alone Part D plan. All Part D plans must cover at least two drugs from most drug categories and must cover all drugs available in certain categories, including antidepressants and antipsychotic medications.

I hope this helps!

-Marci