Starting in October 2011, Medicare will cover yearly screenings for depression. These screenings are designed to be completed by a doctor or other primary care provider to ensure you are correctly diagnosed, treated and followed-up with. For Medicare to cover the annual depression screening, the screening must take place in a primary care setting. This means it will not be covered if you are screened in an emergency room, skilled nursing facility or as a hospital inpatient.
The annual depression screening includes a questionnaire that you complete yourself or with the help of your doctor. This questionnaire is designed to indicate if you are at risk or have symptoms of depression.
If the results of the questionnaire indicate that you may be at risk or have symptoms of depression, your doctor will do a more thorough evaluation to assess if you suffer from depression. If your doctor decides you do suffer from depression, they will provide treatment and follow-up or refer you to a mental health professional for further care.
Annual depression screenings can be performed separately by your primary care doctor but will typically take place when you have a scheduled office visit. The Welcome to Medicare Visit and first Annual Wellness visit require that your doctor review your potential for depression or other mental health conditions. However, these visits do not require your doctor to screen you for depression. A review is when your doctor discusses your risk factors for depression such as a family history of depression. However, you will not be given a screening questionnaire during a review.
If you have Original Medicare, you will not have to pay a deductible or coinsurances for the annual depression screening as long as you see doctors who accept assignment. If you have a Medicare Advantage plan, you will not have to pay a deductible, copay or coinsurances as long as you see network doctors.
If you need further evaluation to diagnose your condition or if you need mental health treatment, there will be cost sharing. You will need to pay deductibles, coinsurances or copays for this care. The amount you pay depends on the type of care you get.
For more information about your costs when you receive outpatient mental health care, please click here.