Does Medicare Cover Antidepressants?

Original Medicare — Medicare Part A and Part B — does not cover antidepressants or any other prescription drugs, but Medicare beneficiaries do have options for drug coverage under other Medicare plans.

You can buy a separate Medicare Part D prescription drug plan in addition to your Original Medicare coverage. Alternatively, you can buy a Medicare Advantage plan that includes Part D benefits. Either option will provide you with Medicare coverage for antidepressants.

To be eligible for coverage under these plans, you will need a doctor’s prescription for an antidepressant that has been approved for use by the U.S. Food and Drug Administration. You’ll also have to be under the care of a doctor to have your prescription renewed.

Medicare Advantage and Part D prescription drug plans are sold by private insurers. Medicare Advantage plans are required to cover everything Original Medicare covers, but these plans are allowed to provide additional benefits.

Original Medicare will cover other mental health services.

Medicare Part A cover some mental health services you receive if you are admitted to a hospital as an inpatient.

Medicare Part B will pay a portion of the cost for mental health services, including annual depression screenings and wellness visits, psychiatric evaluations and other tests. Part B also covers counseling and medication management.

A Medigap — Medicare Supplement insurance — policy can help you with your out-of-pocket costs for other treatments covered under Original Medicare.

How much you spend on antidepressants with Medicare drug coverage will vary depending on several factors. These include your Medicare Part D or Medicare Advantage plan’s costs and whether you use a brand-name antidepressant or a generic version.

You will want to check the Medicare Part D formulary — a list of drugs your plan covers. Your plan’s formulary will also classify your prescription into one of several tiers. The higher the tier, the more you will pay for the drug.

Your share of the cost in the lower tiers is usually a copayment — a fixed dollar amount. Higher tiers may require you to pay coinsurance — a percentage of the medication’s price.

How much you pay for drugs on each tier varies from plan to plan. You will need to contact your Medicare Part D or Medicare Advantage plan’s administrator to find out what your specific costs will be.

The retail prices of antidepressants can vary widely from brand-name drugs to generic prescription medicines. The most widely prescribed antidepressants are called selective serotonin reuptake inhibitors (SSRIs).

Other modern antidepressants include Wellbutrin (bupropion) and a class of drugs called serotonin and norepinephrine reuptake inhibitors (SNRIs).

In some cases, doctors may prescribe older antidepressants such as tricyclics, tetracyclics and monoamine oxidase inhibitors (MAOIs). These are not as frequently used because they have more side effects, but they work better for some people.