Dear Marci,
I’m new to Medicare and don’t know much about Medicare’s coverage of mental health conditions. Does Medicare cover depression screening?
– Linda (Beaufort, FL)
Dear Linda,
Yes, Medicare Part B covers an annual depression screening to help detect and address mental health concerns early. You don’t need to show signs or symptoms of depression to qualify for screening. However, the screening must take place in a primary care setting, like a doctor’s office. This means Medicare will not cover your screening if it takes place in an emergency room, skilled nursing facility (SNF), or hospital.
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 your results show that you may be at risk of depression, your provider will perform a thorough assessment and will refer you for follow-up mental health care if appropriate.
In most cases, you should receive your depression screening when you have a scheduled doctor’s office visit. However, your provider can choose to screen you during a separate visit.
Your provider is required to review your risk for depression and other mental health conditions during your Welcome to Medicare Visit and your first Annual Wellness Visit. However, your provider is not required to formally screen you for depression during these visits. During a review, your provider should discuss your risk factors for depression, such as a family history, but you will not receive a screening questionnaire.
If you qualify, Original Medicare covers depression screenings at 100% of the Medicare-approved amount when you receive the service from a participating provider. This means you pay nothing (no deductible or coinsurance). Medicare Advantage Plans are also required to cover depression screenings without applying deductibles, copayments, or coinsurance when you see an in-network provider and meet Medicare’s eligibility requirements for the service.
During the course of your screening, your provider may identify or need to investigate or treat a new or existing problem. This care is considered diagnostic or treatment, meaning your provider is investigating or treating you because of certain symptoms or risk factors. Regular Medicare cost sharing applies to diagnostic and treatment services, including services identified during and provided alongside preventative screenings.
Hope this helps!
-Marci