Q: My wife has Alzheimer’s. She’s become increasingly agitated and sometimes refuses to let the young woman, who helps us, into the house. Does Medicare cover any Mental Health services?
A: Medicare sometimes denies payment for psychotherapy services when the person has Alzheimer’s disease on the theory that such a person cannot improve from therapy. Depression, agitation, and aggression, however, are treatable conditions. It’s important that you ask the mental health provider to list your wife’s agitation (not her Alzheimer’s disease) as the main reason for which she is receiving therapy.
After you satisfy your annual $100 Part B deductible, Medicare pays 50% of the Medicare approved charge for mental health care, including diagnostic evaluation and outpatient medication management by a psychiatrist. This can be an important benefit if your wife takes medication to control the agitation. Medicare will also cover counseling services if the primary purpose is treatment of your wife’s agitation. For more information, I suggest you contact your local Area Agency on Aging. You can find the number in your local phone book or call the Eldercare Locator at 1-800-677-1116.
November 2002
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