Wellcare CalViva Health Dual Align (HMO D-SNP): Outpatient Mental Health Care

Medicare covers mental health care services to help with conditions like depression and anxiety. These visits are often called counseling or psychotherapy and can be done individually, in group psychotherapy, or family settings, and in crises.

Covered outpatient mental health care services include mental health services provided by state-licensed psychiatrists or physicians, clinical psychologists, clinical social workers, clinical nurse specialists, nurse practitioners, physician assistants, marriage and family therapists, and mental health counselors.

Covered mental health care includes partial hospitalization services given by a community mental health center or by a hospital to outpatients. They also include intensive outpatient programs provided by hospitals, community mental health centers, federally qualified health centers, and Rural Health Clinics. Partial hospitalization and intensive outpatient services are more rigorous care than that offered in a provider's or therapist's office.

Types of mental health care visits

Group therapy is the treatment of multiple patients at once by one or more healthcare providers, wherein members of the group also create dialogue to support one another and reinforce adaptive thoughts and behaviors (and squelch maladaptive ones). It can be used to treat a variety of conditions including but not limited to emotional trauma, anxiety, depression, post-traumatic stress disorder (PTSD), and addiction.

Individual therapy is psychotherapy in which a trained professional helps a single person work through personal issues they have been facing. It is an effective treatment for a variety of emotional difficulties and mental illnesses.

Family therapy addresses interpersonal dynamics and communication patterns within a family system. It focuses on improving relationships, resolving conflicts, and promoting understanding among family members, with the belief that addressing the family unit as a whole is essential for individual well-being.

Crisis intervention therapy is a short-term, focused approach aimed at helping individuals cope with immediate and overwhelming life events or crises. This type of therapy emphasizes providing support, stabilization, and practical guidance to manage the immediate crisis and prevent further psychological distress.

Behavioral health integration services

If you or your loved one have a behavioral health condition (like depression, anxiety, or another mental health condition), Medicare may pay a provider to help manage that condition. Some providers that manage behavioral health conditions may offer integrated care services, like the Psychiatric Collaborative Care Model. This model is a set of integrated behavioral health services, including care management support:

• Care planning for behavioral health conditions

• Ongoing assessment of the condition(s)

• Medication support

• Counseling

• Other treatments as recommended by the provider