JOEL MEKLER: Will Medicare cover grief counseling?

Medicare provides some coverage for grief counseling.

The nightmare of the coronavirus continues to claim upwards of 1,000 lives on a daily basis.

It’s estimated that for every person who dies from the virus, nine close family members are affected. For the majority of the population, coping during this time is extremely stressful.

While the word “grief” is most commonly associated with the death of a loved one, many people are surprised to learn that grief can also follow the loss of almost anything. It can follow many other events such as the loss of a job, support system, home, pet, relationship, ability, or sense of security/safety. Grief can manifest in the form of physical symptoms. While many people consider bereavement to be an affliction of the heart and mind, those who are suffering from a recent loss will tell you that it’s much more than that.

For older adults, losing a loved one, such as a spouse, can cause many health issues, such as depression, insomnia, anxiety, and more. Grief may reoccur in response to a reminder of something or someone they lost in the past, especially if that loss was traumatic or life-altering. And grief left untended has long-term mental and emotional consequences that can impact people long after the pandemic is gone.

Dealing with the loss of a loved one or another major life change can be difficult and it can be hard to receive the support you need or even discuss your grief with others. That’s where grief counselors come in. A grief counselor is trained in traditional methods of counseling and also has sub-specialty training to help you deal with loss in a way that’s healthy, and develop strategies for coping both on an emotional and a practical level.

You don’t have to meet any specific eligibility requirements for grief counseling services under Medicare. Instead, you and your counselor will determine what mental health services you may need during the grieving process. These services may include counseling and group therapy appointments, short-term antidepressants, and in some cases, partial or full hospitalization.

Psychotherapy and other mental health services are covered for as long as they are medically necessary. If you have a loved one currently in hospice, Medicare will also cover grief counseling to family members of beneficiaries as well.

Medicare also covers some preventive services, such as depression screenings and wellness checks. You can receive a depression screening once very year at no charge to you. You can also get a wellness check once a year that includes an evaluation of your risk for depression. These visits are covered at 100 percent as long as you see a doctor who accepts Medicare assignment.

Medicare has rules and requirements for covered services. Medicare allows only the following medical professionals to provide grief counseling and other mental health services:

•Clinical nurse specialists

•Clinical psychologists

•Clinical social workers

•Nurse practitioners

•Physician assistants

•Psychiatrists.

Make sure the medical professional you see accepts Medicare assignment. If the provider doesn’t accept Medicare assignment, the visit may not be covered. Accepting Medicare assignment simply means the provider agrees to charge no more than Medicare’s approved price for the service.

Medicare Part B covers outpatient mental health services provided in a:

•Community mental health center

•Doctor’s office

•Hospital outpatient department.

Due to the COVID-19 outbreak, Medicare has expanded its coverage to pay for office and hospital visits enabled via telemedicine as of March 6, 2020. Yet we must always be mindful of the disparities in both the availability of technology and understanding how to use it. Not everyone can or wants to replace in-person grief counseling with technology.

Medicare Part B has an 80/20 split for cost-sharing as well as an annual deductible. As of 2020, the Part B annual deductible is $198. Once the deductible is met the 80/20 split kicks in. The patient pays 20 percent of the bill, while Part B pays 80 percent.

Medicare beneficiaries can enroll in a Medigap plan or Medicare Advantage plan. Both types of plans can lower out-of-pocket costs for mental health services. Medigap plans pick up all or some of the cost-sharing expenses Medicare leaves for the patient to pay.

Medicare Advantage plans are private insurance plans that fall under Part C of Medicare.

You must be enrolled in both Medicare Parts A and B to enroll in either a Medigap plan or a Medicare Advantage plan. However, because Medicare Advantage plan premiums are usually inexpensive, they are easier to afford each month.

On the other hand, you tend to have more costs on the back end with Medicare Advantage plans than you do with Medigap plans. You will owe a copay or coinsurance each time you receive a covered service.

If you’re enrolled in a Medicare Advantage plan, be sure the provider you choose is in the plan’s provider network. If he/she isn’t you may have to pay the full amount for the services you receive.

While the grieving process is incredibly hard, you don’t have to go through it alone. Here are some resources for finding professional help when you’re grieving:

•Substance Abuse and Mental Health Services Administration (www.samhsa.gov) is a national mental health resource with a 24/7 helpline. They can help you find grief support services in your area.

•American Counseling Association (www.counseling.org). The organization has a full page dedicated to articles, journals, and other specific resources for people who are grieving.

•GriefShare (www.griefshare.org) is an organization that hosts weekly grief support groups around the nation. Its website has a find a group tool to help you locate groups in your area.

•The National Alliance on Mental Illness Helpline can be reached Monday through Friday, 10 am – 6pm ET. 1-800-950-NAMI (6264) or info@nami.org)

You can also reach out to your Medicare plan directly to find therapists or other mental health professionals who specialize in grief counseling in your area.

 (Joel Mekler is a certified senior adviser. Send him your Medicare questions at mekbab2000@verizon.net.)

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