Q. I have monthly counseling sessions and group sessions. What will Medicare cover?
A: Medicare covers certain screenings, services, and programs that aid in the treatment and recovery of mental health and substance use disorders. Original Medicare Part B covers individual and group therapy, activity therapies such as art therapy, partial hospitalization programs and annual depression screening. This coverage is under Behavioral Health Care Services which encompasses both mental health illnesses such as depression and anxiety, and addiction-related issues such as alcoholism or substance abuse disorder.
For Original Medicare to cover these services, it is important to see a provider who is Medicare-certified and takes assignment (accepts Medicare’s approved amount as payment in full for services you receive.) If you have Original Medicare, you will pay a 20% coinsurance after meeting your Part B deductible. If you have a Medicare Advantage Plan, contact your plan to find in-network providers and learn about costs. If you have a Medicare Supplemental (Medigap) policy you could have coverage for any coinsurance or copays, as well.
This year Medicare Part B began covering intensive outpatient program services you get at a hospital, community mental health center, Federally Qualified Heath Center, or Rural Health Clinic. Intensive outpatient programs offer a level of mental health care between traditional once-weekly therapy or counseling, and inpatient psychiatric care. The services are more rigorous than care you’d get in a doctor’s or therapist’s office and may include group and individual therapy sessions.
You pay a percentage of the Medicare-approved amount for each service you get if your doctor or certain other qualified mental health professional accepts assignment. Again, after you meet the Part B deductible, you also pay coinsurance for each day of intensive outpatient program services you get in a hospital outpatient setting or community mental health center. You don’t need to qualify for inpatient treatment to get intensive outpatient program services, but you must participate in at least 9 hours of services per week to keep getting such services.
May is Mental Health Awareness month. If you or someone you know is in crisis, call or text 988 or chat 988lifeline.org.
Q. When will the coupon books for seniors to use at the fruit markets be available?
A. The Senior Project Fresh program is a statewide program which aims to help older adults eat healthier as they age. The program, which runs from May 1 to October 31 each year, provides participants free nutrition education and $25 in coupons that can be exchanged for fresh fruits, vegetables, and other healthy foods sold at local farmers’ markets and roadside stands. Financially eligible individuals over the age of 60 can usually obtain coupon books, containing five $5.00 coupons, in the first couple of weeks of May. Individuals age 55 or older who belong to a Michigan federally recognized tribe or urban tribal group are also eligible. Individuals can have a total household income of 185% or less of the federal poverty guidelines to qualify and must be a resident of the county in which the coupons are issued. Coupons are generally available first come, first served as supplies are limited in each county.
As of this writing, none of the three counties in Region IV Area Agency on Aging’s service area, Berrien, Cass, or Van Buren, have received the coupon books yet. In Berrien, the point agency is Michigan State University Extension office, while in Cass the coupons will be distributed by Cass County Council on Aging, and in Van Buren it will be Senior Services of Van Buren County distributing them. Each organization plans to have more than one distribution site and more than one day of distribution. Individuals can contact the appropriate lead agency to find out if they are eligible and when and where the coupon books will be available.
- Michigan State University Extension Office: 269-983-7111 ext. 4019
- Cass County Council on Aging: 269-445-8110
- Senior Services of Van Buren County: 1-866-627-8904
Sara Duris is community information liaison of Region IV Area Agency on Aging in Southwest Michigan. Questions on age or independence services? Call the Info-Line for Aging & Disability at 800654-2810 or visit areaagencyonaging.org. The Generations column appears each weekend in The Herald-Palladium.