Medicare pays for mental screenings

05/06/2010 12:00 AM |

Dear Marci,

Does Medicare cover screenings for Alzheimer’s and dementia?


Dear Sun,

Yes. Medicare will cover medically necessary doctor visits and laboratory tests needed to diagnose any suspected disease or condition, including dementia or Alzheimer’s disease. Some methods to diagnose dementia or Alzheimer’s disease may include:

* Consultations with a primary care physician and possibly other specialists

* A mental status evaluation to assess your cognitive capabilities

* A physical examination

* A brain scan to detect other causes of dementia such as stroke

* A psychiatric evaluation

* A positron emission tomography (PET) scan to evaluate the cause of memory disorders that cannot be determined from any other diagnostic test

Medicare will cover 80 percent of your initial mental health visit, 80 percent of medication management and 55 percent of ongoing mental health treatment, such as psychotherapy.

Dear Marci,

I heard that Medicare will stop paying for care in a psychiatric hospital after a certain number of days. Is that true?


Dear Evelyn,

Yes. Medicare helps pay for inpatient mental health services in either psychiatric hospitals (those that treat only mental health patients) or in general hospitals. Your doctor will determine which hospital setting you need.

If you receive care in a psychiatric hospital, Medicare helps pay for up to 190 days of inpatient care in your lifetime. After you have reached your 190-day limit, Medicare may help pay for mental health care at a general hospital.

Your out-of-pocket costs are the same in a psychiatric hospital as they are in any hospital. If you enter a psychiatric hospital within 60 days of being an inpatient at a different hospital, you are in the same benefit period and do not have to pay the deductible again.

Dear Marci,

I have not worked long enough to get Social Security benefits, but my wife has. Does her work history qualify me for premium-free Medicare Part A?


Dear Theodore,

It depends on your situation. If you develop a disability before the age of 65 and do not have enough work history, you can’t qualify for Social Security Disability (SSDI) based on your spouse’s work history.

When you turn 65, you may be eligible for free Medicare Part A based on your spouse’s work history if:

* You are currently married and your spouse is eligible for Social Security benefits (either retirement or disability). You must have been married for at least one year before applying.

* You are divorced and your former spouse is eligible for Social Security benefits (either retirement or disability). You must have been married for at least 10 years and you must be single.

* You are widowed and you were married for at least nine months before your spouse died. You must be single.

To date, the federal government does not recognize domestic partners (either opposite-gender or same-gender) as spouses. Therefore, you can’t be eligible for Medicare based on the work history of a domestic partner.

Because Social Security and Medicare eligibility rules are complex and there are some exceptions to the rules listed above, you should call Social Security at 800-772-1213 or, if you are a railroad worker, contact your local Railroad Retirement Board field office to get the most accurate information regarding your particular situation.

Marci’s Medicare Answers is a service of the Medicare Rights Center (, the nation’s largest independent source of information and assistance for people with Medicare.