Best Adult Partial Programs That Accept Medicare (2021)

If you are in need of mental health treatment, your doctor may be able to help you find adult partial programs that accept Medicare. To qualify for financial assistance through Medicare, your doctor must state that you need a partial program or else you’ll likely need full hospitalization. Finding a partial program near you should not be much of a problem, although you need to ensure any program you consider is a Medicare-approved facility.

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UPDATED: Nov 28, 2021

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Overview

  • Medicare may cover your involvement in an adult partial program if a licensed physician deems it medically necessary
  • To be covered, you will need to receive treatment at a Medicare-approved facility
  • If you are looking for a partial program, speak to your primary physician about your options

If you are 65 or older and have a history with a mental health condition, you may be curious about different adult partial programs that accept Medicare.

Depending on the reason for your need for a partial program, your Medicare health insurance coverage may help pay for your mental health outpatient treatment.

Because Medicare Part B covers outpatient procedures, you will want to know if Medicare Part B covers your involvement in a partial program.

Medicare intensive outpatient program guidelines are fairly broad, and you may meet the guidelines set by Medicare. This all depends on why you need treatment and whether it’s considered a medical necessity.

If you are looking for an affordable partial program covered by Medicare insurance, be sure to use our free tool above to search for the best Medicare coverage and compare quotes.

Will Medicare cover partial hospitalization programs?

Depending on your personal situation, it is very likely that Medicare could cover some of the costs associated with a partial hospitalization program.

If a medical professional has evaluated you and determined that you need outpatient mental health care in the form of a partial hospitalization program, Medicare will cover some of your expenses.

How much Medicare will cover is based on your particular Medicare plan and the facility you visit for treatment.

In order for Medicare to cover your visit, you must meet certain requirements. These requirements include:

  • That you receive your mental health care in a Medicare-approved facility
  • That your care is administered by a licensed physician
  • That a licensed physician certifies that a standard outpatient program would not be enough to keep you out of the hospital
  • That a licensed physician certifies that you will need hospitalization if you are not admitted into a partial hospitalization program

If you are in need of partial hospitalization, Medicare will cover some if not all of the program. Since Medicare Part B covers outpatient treatment, your Medicare Part B plan will be involved in coverage for partial hospitalization.

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How do I find a Medicare-approved partial hospitalization program near me?

It may seem daunting to find a partial hospitalization program near you that will work, but you certainly do not need to make this decision alone.

You will probably be recommended to a specific physician or facility by your primary doctor. If that’s the case, be sure to ask their advice about the facility and practitioner that would be a good fit for you.

Additionally, you need to be sure to visit a facility that takes Medicare if you want your program to be covered. Ask the facility you choose if they take Medicare to ensure you know ahead of time.

If your doctor suggests partial hospitalization, this means you are in serious need of mental health care. So you should act quickly to secure placement in a partial hospitalization program. Getting started as soon as you can is a great way to improve your mental and emotional health.

Does Medicare cover intensive outpatient programs?

Partial hospitalization and intensive outpatient programs are similar, but intensive outpatient programs tend to be a little bit shorter. You’ll be told if you need partial hospitalization vs. intensive outpatient care during your visit.

The same standards for coverage apply for outpatient programs that apply for partial hospitalization. If a licensed physician confirms that you need the treatment, Medicare Part B will help pay for it.

If you truly believe you are in need of partial hospitalization, speak to your physician. You shouldn’t attempt to finance what your health insurance won’t cover, so help your doctor advocate for you by being honest about your experiences and your needs. You can also shop for extra Medicare coverage, like Medicare Supplement insurance, to reduce your out-of-pocket costs.

If you want to buy Medicare insurance that covers partial programs, enter your ZIP code into our free tool below to get started in your search for the right Medicare plan.

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