Your Medicare Coverage

Is my test, item, or service covered?

Mental health care (inpatient)

How often is it covered?

Medicare Part A (Hospital Insurance) covers mental health care services you get in a hospital that require you to be admitted as an inpatient. You can get these services either in a general hospital or a psychiatric hospital that only cares for people with mental health conditions.

If you're in a psychiatric hospital (instead of a general hospital), Part A only pays for up to 190 days of inpatient psychiatric hospital services during your lifetime.

Medicare doesn't cover:

  • Private duty nursing
  • A phone or television in your room
  • Personal items, like toothpaste, socks, or razors
  • A private room, unless medically necessary

Who's eligible?

All people with Medicare are covered.

Your costs in Original Medicare

  • $1,216 deductible for each benefit period ($1,260 in 2015).
  • Days 1–60: $0 coinsurance per day of each benefit period ($0 in 2015).
  • Days 61–90: $304 coinsurance per day of each benefit period ($315 in 2015).
  • Days 91 and beyond: $608 coinsurance per each "lifetime reserve day" after day 90 for each benefit period (up to 60 days over your lifetime) ($630 in 2015).
  • Beyond lifetime reserve days: all costs.
  • 20% of the Medicare-approved amount for mental health services you get from doctors and other providers while you're a hospital inpatient.
Note

There's no limit to the number of benefit periods you can have when you get mental health care in a general hospital. You can also have multiple benefit periods when you get care in a psychiatric hospital. Remember, there's a lifetime limit of 190 days.

Note

Your doctor or other health care provider may recommend you get services more often than Medicare covers. Or, they may recommend services that Medicare doesn’t cover. If this happens, you may have to pay some or all of the costs. It’s important to ask questions so you understand why your doctor is recommending certain services and whether Medicare will pay for them.

Related resources

Note

If you or someone you know is in crisis, call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255). TTY users should call 1-800-799-4TTY (1-800-799-4889). You can call and speak with a counselor 24 hours a day, 7 days a week.

Call 911 if you're in immediate medical crisis.

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