Will Medicare Parts A and B pay for treatment in a psychiatric hospital?

1 answer | Last updated: Nov 25, 2016
Steve-1 asked...

My wife is in a psychiatric hospital. She has Medicare Parts A and B. Will it pay?

Expert Answers

Yes, Medicare Part A can cover the inpatient costs for her care in a psychiatric hospital  -- meaning a hospital that accepts patients only for mental health care. Medicare can also cover her inpatient psychiatric care in a general hospital. The rules of payment are the same for either type of hospital, but the total amount of coverage is different. Medicare Part A covers only a total of 190 days in a patient's lifetime for inpatient care in a psychiatric hospital. There's no lifetime limit for psychiatric inpatient care in a general hospital.

For hospital inpatient coverage under Medicare Part A, your wife must pay the yearly Part A deductible ($1,024 in 2008) if she hasn't already paid it. She must also pay a daily co-payment ($256) for inaptient days 61 to 90 within any one benefit period, which means any one particular stretch of hospitalization. If she's in the hospital for more than 90 days in any one benefit period, she has to pay a copayment of $512 per day for days 91 through 150. These last 60 days of coverage are called "reserve days," and they are available only once during a lifetime – once the 60 reserve days are used up, there are no more. If she remains in the hospital longer than 150 days in any one period, Medicare Part A stops paying. However, she can return for more hospitalizations and start the payment cycle all over again, within the limit of 190 total lifetime days in a psychiatric hospital.

While she's in the hospital, Medicare Part B can pay most of the cost of the doctors, including psychiatrists, and other mental health providers who treat her there.