Medicare recipients managing their health and finances will see a number of changes in costs and services coming up next year.
And one important benefit in particular will be worth exploring for many beneficiaries.
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Medicare Part A covers hospital insurance. While people are employed, they pay Medicare taxes. When they retire — provided they have consistently paid those taxes during the course of their careers — they are not required to pay a premium for this coverage.
During hospitalization, however, deductibles often must be paid.
For preventive care and outpatient services, Medicare Part B covers those costs. During 2024, a monthly premium of $174.70 was standard, unless the beneficiary had a large income.
In these cases, an increased premium is necessary, referred to as the Income-Related Monthly Adjustment Amount (IRMAA).
In 2025, it is anticipated that the standard premium for Medicare Part B will rise.
Medicare Part C, also known as Medicare Advantage, involves private companies that offer an option for the same health care benefits as those covered by Part A and Part B. Coverage for prescription medicines, offered by Medicare Part D, are also often covered under these private plans.
But one major component of health care coverage under Medicare for 2025 is getting some attention as the new year approaches.
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Medicare covers some mental health therapy
The Centers for Medicare and Medicaid Services (CMS) explains that the federal program, for the first time, will be covering outpatient services for mental health care in 2025.
"Medicare covers expanded mental health care, like intensive outpatient program services in certain locations and services from marriage and family therapists and mental health counselors," writes medicare.gov in a publicly available document.
"During your yearly 'Wellness' visit, your health care provider can also use a health risk assessment to better understand your social needs and refer you for appropriate services and support," the document continues.
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Common mental health conditions covered by Medicare include depression and anxiety. Outpatient visits for treatment exist in the form of counseling and psychotherapy, in individual and group settings.
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What Medicare mental health coverage includes
Services Medicare offers to treat mental health issues often involve marriage and family therapists in addition to mental health counselors.
In addition to standard outpatient services, the CMS describes what Medicare-covered mental health care includes with regard to partial hospitalization and intensive outpatient care:
- Partial hospitalization services that are given by a Community Mental Health Center or by a hospital to outpatients. This structured day program offers outpatient psychiatric services as an alternative to inpatient psychiatric care.
- Intensive outpatient program services that include intensive psychiatric care, counseling, and therapy. These services may be given in hospitals, Community Mental Health Centers, Federally Qualified Health Centers, Rural Health Clinics, and Opioid Treatment Programs (when services are for the treatment of Opioid Use Disorder).
Another service offered by Medicare to beneficiaries is obesity behavioral therapy. Counseling is covered if it is provided by an individual's primary care doctor (or other primary care provider) in a primary care setting.
Opioid use-disorder treatment services are also covered by Medicare in 2025. Medicare pays doctors and other providers for office-based treatment, including management, care coordination, psychotherapy, counseling activities, and allotment and distribution of medications.
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