I suffer from bouts of depression. Does Medicare cover screenings for depression?
Yes. Medicare covers yearly screenings for depression. These screenings are completed by a doctor or other primary care provider to ensure correct diagnosis, treatment and follow-up. Medicare will cover one depression screening per year, as long as the screening takes place in a primary care setting.
Note: Hospitals, emergency rooms and skilled nursing facilities are not considered to be primary care settings.
The annual depression screening consists of a questionnaire that you complete by yourself or with the help of a doctor. If your doctor finds that you do suffer from depression, he/she may provide treatment or refer you to a mental health professional for further care.
If you have Original Medicare, you will not have to pay a deductible or coinsurance for the annual depression screening, as long as you see doctors who accept Medicare and take assignment. Doctors who accept Medicare and take assignment agree to accept the Medicare-approved amount as payment in full. Call 800-MEDICARE or visit www.medicare.gov to locate doctors who accept Medicare and take assignment.
If you have a Medicare Advantage plan, you will not have to pay anything for the screening, as long as you see in-network doctors. Contact your plan directly to locate in-network doctors.
My doctor gave me an Advanced Beneficiary Notice. What is an Advanced Beneficiary Notice?
An Advanced Beneficiary Notice (ABN), also known as a waiver of liability, is a notice that Medicare providers must give you when they know or have reason to believe that Medicare will not pay for a particular health care service or item. The ABN explains that Medicare may not pay for your health care services and allows you to choose whether you still want to receive those services.
Medicare providers will only give you an ABN if you have Original Medicare, the traditional Medicare program offered directly through the federal government. Your provider will give you an ABN for a health care service or item that Medicare may not cover, in your particular case. Bear in mind that providers do not have to give you an ABN for services or items that Medicare does not cover, such as hearing aids or routine dental care. If you have a Medicare Advantage plan, also known as a Medicare private health plan, you will not receive an ABN.
If you have Original Medicare and you sign an ABN before you receive a health care service, you are responsible for the full cost of the service you receive if Medicare does not pay for it. If your provider does not give you an ABN to sign before you receive a health care service, you do not have to pay the full cost of the service if Medicare does not pay for it.
Remember, an ABN is not an official denial of coverage by Medicare. If Medicare does not pay for a health care service you receive, you have the right to appeal (i.e. file a formal request for review of an official decision made by Original Medicare).
Does Medicare cover vision services?
Medicare generally does not cover routine eye care. It will pay for some eye care services, if you have a chronic eye condition, such as cataracts or glaucoma. In these cases, Medicare will cover:
Surgical procedures to help repair the function of the eye.
Eyeglasses or contacts only if you have had cataract surgery during which an interocular lens was placed into your eye.
An eye exam to diagnose potential vision problems.
If you have diabetes or you are at high risk for glaucoma, Medicare will pay for an eye exam once every 12 months to check for eye disease due to either condition.
Keep in mind that certain Medicare Advantage plans and Program for All-Inclusive Care for the Elderly (PACE) plans may offer limited vision coverage. You may also get coverage for vision care by going to reduced-cost clinics or by purchasing vision insurance. Lastly, Medicaid may cover vision care. Contact your state Medicaid program for more information on Medicaid coverage of vision care services.
The Medicare Rights Center is dedicated to helping people with Medicare get the health care and medications they need and make the most of their Medicare rights and options. They also offer comprehensive services to help people with Medicare and their caregivers fully understand the options and sources of support that are available to them. Learn more on the website at MedicareRights.org