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.
Medicare doesn't cover:
- The cost of private duty nursing
- A phone or television in your room
- Personal items, like toothpaste, socks, or razors
- A private room, unless medically necessary
All people with Medicare are covered.
Your costs in Original Medicare
- $1,216 deductible for each benefit period
- Days 1–60: $0 coinsurance per day of each benefit period
- Days 61–90: $304 coinsurance per day of each benefit period
- 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)
- 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.
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.
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.
- Substance Abuse and Mental Health Services Administration (SAMHSA)
- National Institute of Mental Health
- Find hospitals
If you need immediate help for yourself or someone in a crisis, call the National Suicide Prevention Lifeline at 1-800-273-TALK or 1-800-SUICIDE (1-800-273-8255). TTY users should call 1-800-799-4TTY (1-800-799-4889).