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Does Medigap Cover Depression

Written by Brian Gruss

While depression is a devastating mind and body state, it is treatable.  Research shows that the best treatment is a combination of medication and counseling.  Does Medigap cover that? Yes, because if Medicare covers it, Medigap will cover it.

And, yes, Medicare covers it.  However, you must follow the proper procedures.

Here’s what you need to do:

GET A MEDICAL DIAGNOSIS for Depression

  1. See your primary care provider.  Medicare covers one depression screening a year, for free; no charge to you.  In order to qualify for the free screening
  • It must be done in the office of your primary care provider (physician, physician’s assistant, or nurse practitioner)
  • The provider must accept the Medicare-approved amount as full payment
  • The provider must be able to give treatment or refer you elsewhere for treatment (those referred services are not free)

2. Your primary doctor will, then, initiate medication treatment or, if necessary, refer to a psychiatric specialist.  Does Medigap cover that? Yes, because Medicare covers this and if Medicare covers it, Medigap covers it.

Medical diagnosis coverage. Medicare covers 80% of physician services (as well as psychiatric nurse practitioners) for mental health diagnosis.  The remaining 20%? Yes, Medigap covers that remaining 20%. By the way, mental health services qualify for Part B deductible.  

If medication is prescribed, your drug plan is who will cover that.

Do I need Depression Counseling

Depression distorts our thinking, robs us of our energy and drive for tasks and activities, dulls our desire to be around people (even supportive ones), and significantly distorts our sense of our Self.  We call these effects “depression talking.” Medication can soften some of these effects but does not erase all of these symptoms. Counseling is a necessary part of treatment to counter the effects of “depression talk.”  Otherwise, even after medication has corrected the chemical depression, “depression talk” continues. This makes it much more likely for depression to recur. Counseling, therefore, is a critical component of full depression treatment.  Does Medigap cover that? Yes, because if Medicare covers it, Medigap covers it, but only for certain providers.

Medicare does cover outpatient visits but does not cover all types of therapy.  Choose carefully.

You can have counseling visits covered by Medicare if:

  • The provider is a psychiatrist, clinical social worker, or clinical psychologist
  • Medicare will not cover counseling with a pastor, nor will it cover master’s level counselors (LPC, LCPC, LMHP, MFT are not covered)
  • If your depression is connected to marital problems and you want marital counseling, Medicare will not cover this.
  • The provider must be registered with Medicare to accept Medicare reimbursement. So always ask your provider, before scheduling, if they accept Medicare payment

Medigap Coverage for Depression

Medigap plans can cover some or all of the costs of mental health care, dependent on the Medigap plan you choose.  For example, many Medigap plans do cover part of your costs, but only Medigap Plan C and F will cover all mental health service costs by a Medicare-approved provider.

Please call for an immediate quote for Plan C or Plan F.  352-508-4221 These plans will no longer be available for new Medicare subscribers after January 1, 2020.

If you think you are depressed, schedule an appointment with your primary care provider and get a free screening for depression now.  Then, follow through with medication treatment and counseling with the approved providers. There is help for you, and it can be covered.

Note:  Depression information courtesy of Dr. Catherine Brown, Ph.D., licensed clinical psychologist

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About Just Medigap

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