Both original Medicare and Medicare Advantage plans cover mental health services, including grief counseling. Typically, grief counseling is an outpatient service, and Medicare Part B contributes toward the cost.
A person may experience intense sadness and sorrow following an event such as losing a loved one. These feelings are known as feelings of grief, and an individual may benefit from seeking professional advice from a psychiatrist, psychologist, or grief therapist who can offer help.
This article looks at how Medicare covers grief counseling and therapy. It also discusses additional support for mental health concerns and how to find assistance with costs.
We may use a few terms in this piece that can be helpful to understand when selecting the best insurance plan:
- Deductible: This is an annual amount that a person must spend out of pocket within a certain time period before an insurer starts to fund their treatments.
- Coinsurance: This is a percentage of a treatment cost that a person will need to self-fund. For Medicare Part B, this comes to 20%.
- Copayment: This is a fixed dollar amount that an insured person pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
Both original Medicare and Medicare Advantage plans provide cover for those who need mental health services.
Typically, grief counseling is an outpatient service covered by Part B. As long as the therapy is medically necessary, Medicare covers the costs for as long as a person needs it.
For Medicare to cover grief counseling, specific types of medical professionals must provide the service, including:
- clinical social workers
- nurse practitioners
- nurse specialists
- physician assistants
- social workers
Medicare’s Part B outpatient mental health services include:
- one annual depression screening
- individual and group psychotherapy
- family counseling
- psychiatric evaluation
- medication management and prescription drugs administered by a medical professional
- diagnostic tests
The different parts of Medicare cover various aspects of mental health services.
Medicare covers a stay of up to 190 days of inpatient psychiatric hospital services over a person’s lifetime.
During an inpatient stay, Medicare does not cover a private room unless medically necessary. It also does not cover personal items, in-room phones, in-room televisions, or private-duty nursing.
These services include grief counseling, individual and group psychotherapy, medication management, and psychiatric evaluations.
Sometimes, an individual may benefit from intensive counseling. In this case, Medicare Part B covers partial hospitalization, an alternative to inpatient psychiatric care. As long as a community mental health center or hospital outpatient department offers the service, Medicare will cover eligible costs.
Private insurance companies provide Medicare Part C plans, also known as Medicare Advantage.
These plans offer the same coverage as Medicare parts A and B for mental health services.
In 2021, 89% of Medicare Advantage plans will cover prescription drugs.
If a person has original Medicare, Part D covers the prescription medication needed as part of their mental health treatment.
These medications include antidepressants, antipsychotics, and anticonvulsants.
A person should check their Part D plan’s formulary — a list of covered drugs — to ensure the medication their doctor has prescribed is listed.
Most people experience some form of loss, such as the breakdown of a relationship or losing a job, that makes them feel grief.
Bereavement is a form of grief related to the death of a family member, partner, or other loved one.
Grief can involve feelings of deep sadness, guilt, regret, and anger, but grief or bereavement counseling can help a person through the grieving process and adapt to a significant loss.
Counseling usually consists of different services tailored to suit an individual. Some people may prefer one-on-one counseling with a qualified professional, while some find group sessions more helpful.
Some locations also have outreach programs, home visits, and check-ins to support people as they grieve.
An individual may find their therapist prescribes medications for depression and anxiety as part of the grief counseling process.
Grief can trigger intense emotions and distress, and although grief is exceptionally personal, nobody has to experience it alone.
There is a range of resources to help people who are grieving:
- Crisis Text Line: Available 24 hours a day. People can text “HELLO” to 741741 to connect with a crisis counselor who provides support and information.
- National Suicide Prevention Lifeline: Call 800-273-TALK (8255). It is available 24 hours a day to connect callers to their nearest crisis center that provides counseling and mental health referrals.
- Substance Abuse and Mental Health Services Administration: This national mental health resource helps people find local grief support services.
- GriefShare: Hosts weekly grief support groups. Their website has a helpful tool to locate local groups.
- Veterans Crisis Line: Call 800-273-TALK (8255). This is a free, confidential resource that provides trained responders. A person can also text 838255 to receive confidential support 365 days per year.
Medicare covers most costs associated with mental health services, but there are some out-of-pocket expenses that a person must pay.
For someone with original Medicare, 2021 expenses include:
- Part A (if applicable) premium of up to $471 per month
- Part A deductible of $1,484 per benefit period
- Part A inpatient copayment of $371 or more per day after 60 days in the hospital
- Part B premium of $148.50 or more per month
- Part B deductible of $203 per year
- Part B coinsurance of 20% of the Medicare-approved amount
People can enroll in a Medicare supplement plan, also known as Medigap.
Private insurance companies administer these plans that help cover some out-of-pocket costs from Medicare parts A and B.
Medigap plans often also cover some emergency medical costs that a person may need during travel outside of the United States.
A person cannot buy a Medigap plan if they are enrollees in Medicare Advantage.
The only cost associated with a Medigap plan is a monthly premium. A person may wish to carefully compare plan options to find out if they could save money overall.
Medicare parts A and B cover most grief counseling services. People can find help through individual therapy, group therapy, and other services.
Medicare Advantage plans provide the same benefits and usually include prescription drug coverage. People with original Medicare can add a stand-alone Part D plan to cover prescribed drugs.
Medigap plans can help cover some out-of-pocket expenses that original Medicare does not pay.
If someone needs grief counseling, they should talk with their doctor to direct them to appropriate services.