Medicare Resources for Mental Health Care

This resource guide is for people who are seeking mental health care coverage while on Medicare. Medicare for mental health includes services, programs, and treatments to diagnose and help manage mental health conditions. A mental health condition, such as anxiety or depression, affects your thinking, feeling, behavior, or mood.

Mental health coverage is available to all Medicare beneficiaries. It helps cover inpatient and outpatient services and prescription drugs to support optimal psychiatric and psychological health and wellness. You have access to your Medicare mental health care benefits whether you have Original Medicare or a Medicare Advantage Plan. Medicare drug plans, either standalone Part D plans or as part of a Medicare Advantage Plan, cover mental health care medications.

Learn about what services Medicare covers, how much they cost, how to get help paying for services and medications, and mental health care resources available to you.

Adapted from: Medicare and Your Mental Health Benefits

Medicare Eligibility, Benefits, and Coverage for Mental Health Care

You are eligible for mental health care coverage if you receive Medicare benefits through Original Medicare or a Medicare health plan, including Medicare Advantage Plans. As with all Medicare-covered services, mental health care must be deemed medically necessary. That is, needed according to accepted standards of medicine to diagnose or treat your mental health condition.

You must receive services from licensed professionals who agree to charge what Medicare approves for payment. If you have a Medicare Advantage Plan, you must follow your plan’s rules for how you receive mental health services, including network, referral, and prior authorization requirements.

Medicare for mental health includes inpatient and outpatient care. Medicare also covers prescription medications, but you must have a Medicare prescription drug plan (PDP) or a Medicare Advantage Plan that includes drug coverage.

Who is eligible for mental health care coverage under Medicare?

If you have Medicare, you are eligible for mental health care coverage. Medicare for mental health addresses your emotional, psychological, and social well-being. As with all Medicare-covered services, your care must be ordered by a physician and deemed medically necessary. Services must be provided by licensed professionals who take Medicare assignments.

To be eligible for inpatient mental health services, your physician or healthcare provider must certify that you require inpatient care and that your condition cannot be managed in an outpatient setting.

To be eligible for outpatient mental health services, your physician or healthcare provider must prescribe services from Medicare-approved providers. Your services must be documented as medically necessary initially and ongoing for Medicare to cover them.

Do Medicare Advantage Plans offer the same mental health coverage as Original Medicare?

Medicare Advantage Plans must offer the same mental health coverage as Original Medicare. The main differences in getting your Medicare for mental health care through your Medicare Advantage Plan are:

• Cost-sharing structure: With Original Medicare Part A, you pay a deductible for each inpatient benefit period. With Medicare Advantage, you pay a daily copay for a limited number of days for each inpatient admission. With Original Medicare Part B outpatient services, you pay your annual deductible plus 20% of the Medicare-approved charge. With Medicare Advantage, you pay a copay for each service rendered. Your plan may not charge a deductible.
• Out-of-pocket maximum: Every Medicare Advantage Plan has an out-of-pocket cap on what you may have to spend on Medicare-covered services. Once you reach that limit, your plan pays 100% for approved services.
• Prescription drug coverage: Most PPO and HMO Medicare Advantage Plans include drug coverage.
• In-network: With Original Medicare, you can choose any provider that takes Medicare assignment. With Medicare Advantage, you must see providers in the plan’s network. You may have access to out-of-network providers if you have a PPO, but you will typically pay more. Make sure your provider is in-network and compare plans before choosing a Medicare Advantage Plan.
• Referrals and prior authorizations may apply.

Depending on your plan, you may have access to supplemental benefits such as more telehealth services, grief counseling, and conflict resolution, which are not covered by Medicare.

What Outpatient Mental Health Care and Professional Services Does Medicare Cover?

Medicare for mental health includes outpatient services that you receive outside of an inpatient setting, such as a clinic, doctor’s office, community mental health center, residential treatment facility, or outpatient hospital department. Common services include individual and group counseling, depression screening, medication management, and treatment for alcohol and drug abuse.

If you have Original Medicare, outpatient mental health care and services are covered under Part B. If you have a Medicare Advantage Plan (Part C), outpatient mental health care and services are covered by your plan according to Medicare guidelines. Still, your plan sets rules on how you obtain care.

What outpatient mental health care services does Medicare cover?

Medicare covers these outpatient mental health services:

• One depression screening per year that must be done in a primary care doctor’s office or primary care clinic that can provide follow-up treatment and referrals.
• Individual and group psychotherapy with doctors or certain other licensed professionals are allowed by the state where you get the services.
• Family counseling, if the main purpose is to help with your treatment.
• On-going evaluation and testing to find out if your plan of care for services and treatment is helping you.
• Psychiatric evaluation.
• Medication management.
• Certain prescription drugs that aren’t usually “self-administered” (drugs you would normally take on your own), like some injections.
• Diagnostic tests.
• Partial hospitalization for more intensive treatment.
• A one-time “Welcome to Medicare” preventive visit that includes a review of your possible risk factors for depression.
• A yearly “Wellness” visit when you can talk to your health care provider about changes in your mental health.
• Treatment of inappropriate alcohol and drug use.

Your costs for Medicare outpatient mental health services:

• You pay nothing for your yearly depression screening if your doctor or health care provider accepts assignment, or in the case of a Medicare Advantage Plan, are in-network

• With Original Medicare, you pay 20% of the Medicare-Approved amount for visits to your healthcare provider to diagnose or treat your condition. The Part B annual deductible ($233 in 2022) applies. With a Medicare Advantage Plan, you pay a copay for prior authorized, in-network services, in addition to the annual health deductible if your plan has one.
• If you get your services in a hospital outpatient clinic or hospital outpatient department, you may have to pay an additional copayment or coinsurance amount to the hospital.

What does Medicare cover for opioid use disorder treatment?

Medicare covers opioid use disorder treatment services provided by opioid treatment programs. Your healthcare provider or plan can tell you where to receive services, which include:

• Medication (like methadone, buprenorphine, naltrexone, and naloxone)
• Care coordination and case management
• Counseling and individual and group therapy (in person or virtually using your phone or computer)
• Drug testing
• Intake activities
• Periodic assessments

Medicare doesn’t cover:

• Transportation to or from treatment services
• Recreational activity therapy
• Support groups for socialization
• Testing or training for job skills that aren’t part of your treatment

Your costs:

• You pay nothing for these services with Original Medicare if you get them from an opioid treatment program that is enrolled in Medicare after you’ve met your Part B deductible ($233 in 2022).
• You pay nothing for these services with most Medicare Advantage Plans if you get them from an opioid treatment program and have received prior authorization from your plan. A deductible will apply if your plan has one.
• If you get your services in a hospital outpatient clinic or hospital outpatient department, you may have to pay an additional copayment or coinsurance amount to the hospital with Original Medicare or a Medicare Advantage Plan.

Does Medicare offer alcohol misuse screening & counseling?

Medicare covers one alcohol misuse screening per year for adults who use alcohol but don’t meet the medical criteria for alcohol dependency. If your healthcare provider determines you’re misusing alcohol, you can get up to four brief face-to-face counseling sessions per year in a primary care setting from a qualified provider.

Medicare doesn’t cover:

• Transportation
• Screening or counseling with a non-qualified or out of network provider
• Additional free counseling sessions beyond the four that are allowed

Your costs:

• You pay nothing if the qualified primary care doctor or other primary care practitioner accepts the assignment.
• With a Medicare Advantage Plan, your cost or copay depends on your plan’s rules. Typically, if a Medicare-covered service is no cost with Original Medicare, your Medicare Advantage Plan will follow suit.

Does Medicare cover partial hospitalization for mental health care?

Medicare covers Partial hospitalization through Part B if your doctor certifies that you would otherwise need inpatient treatment. Partial hospitalization provides an intensive, structured day program of psychiatric services as an alternative to inpatient care. You don’t stay overnight, and you get services at a hospital outpatient department or community mental health center. Your partial hospitalization may include:

• Occupational therapy that’s part of your mental health treatment
• Individual patient training and education about your condition
• Individual or group therapy
• Family counseling (when the main purpose is treatment of your condition)
• Activity therapy
• Diagnostic services
• Certain drugs needed to treat your mental health condition

Medicare doesn’t cover:

• Transportation to and from your day program
• Services received from a non-Medicare facility or a facility outside of your plan’s network
• Services received from mental health providers who do not accept Medicare assignment

Your costs:

• With Original Medicare, you pay 20% of Medicare-approved charges for services received from qualified providers who accept Medicare assignment after meeting your annual deductible. You also pay a daily coinsurance for the outpatient hospital or community mental health center.
• With a Medicare Advantage Plan, you typically pay a daily copay after completing the referral and prior authorization process as determined by your plan.

What kinds of outpatient mental health care aren’t covered by Medicare?

There are many non-traditional or complementary therapies that may support mental health but are not typically covered by Medicare. Examples include:

• Nutritional supplemental vitamins and minerals
• Mind-body therapies: yoga, meditation, exercise, tai chi
• Herbal medications
• Acupuncture
• Massage
• Homeopathy
• Hypnotherapy

Medicare will not cover therapists and counselors who do not accept Medicare assignments.

If you want access to these types of outpatient mental health supports, talk with your practitioner or provider about payment options. You may be able to take advantage of a sliding ability to pay scale where you are charged what you can afford based on your income.

Alternatively, you can ask your Medicare Advantage Plan or Medicare provider if one of these complementary therapies can be included in a billable service, such as counseling. For instance, if you get neurofeedback therapy in a counseling session, your provider may bill using an approved code for Medicare-approved counseling.

Medicare Advantage Plans may offer supplemental benefits to support mental health that are not covered by Medicare. Ask your plan representative for more details about what is available to you.

What Inpatient Mental Health Care Does Medicare Cover?

Medicare Part A (hospital insurance) covers inpatient mental health care services you get in either a general hospital or a psychiatric hospital that only cares for people with mental health conditions. The main reason you may be hospitalized with a mental health concern is to help you be properly diagnosed, treated, and stabilized so you can safely return to your community.

There’s no limit to the number of benefit periods you can have when you get mental health care in a general hospital. You can have multiple benefit periods when you get care in a psychiatric hospital, but there is a lifetime limit of 190 days.

Inpatient hospital care includes care you get in:

• Acute care hospitals
• Critical access hospitals
• Inpatient rehabilitation facilities
• Inpatient psychiatric facilities
• Long-term care hospitals
• Inpatient care as part of a qualifying clinical research study

What inpatient mental health care services does Medicare cover?

You will be involved in therapy and medication management regimens while you are inpatient with a mental health concern. Medicare-covered hospital mental healthcare services include:

• Semi-private rooms
• Meals
• General nursing
• Drugs as part of your inpatient treatment (including methadone to treat an opioid use disorder or drugs to help with detoxification of substances)
• Other hospital services and supplies as part of your inpatient treatment
• Part B covers mental health services you get from doctors and other qualified mental healthcare professionals while you are in the hospital. For instance, you may see a psychiatrist, therapist, nurse practitioner, or have group or individual therapy

Medicare doesn’t cover:

• Private duty nursing
• A phone or television in your room
• Personal items like toothpaste, socks, or razors
• A private room, unless medically necessary

Your costs:

• With Original Medicare, you pay a deductible ($1,556 in 2022) for each 90 day benefit period. There is no coinsurance for days 1 to 60.
• For days 61 to 90, you pay $389 per day.
• For days 91 and beyond, you pay $778 for each “lifetime reserve day” (you get up to 60 days over your lifetime).
• If you have exhausted all of your lifetime reserve days, you are responsible for all costs.
• You pay 20% of the Medicare-approved amount for all Part B services you receive while you are in the hospital (such as doctor’s visits or therapy sessions).
• If you have a Medigap policy, it may cover all your deductibles and coinsurance costs for Parts A and B benefits, plus an additional year’s worth of inpatient hospital days.
• If you have a Medicare Advantage Plan, you pay a daily copay for a limited number of inpatient days. Medicare Advantage Plans do not consider benefit periods the same way Medicare does. Each inpatient admission or transfer requires you to pay the limited daily copay, and prior authorizations apply. Inpatient copays go towards your maximum out-of-pocket cap.

What kinds of inpatient mental health care aren’t covered by Medicare?

Whether you receive your benefits through Original Medicare or a Medicare Advantage Plan, Medicare for mental health won’t cover inpatient care that isn’t ordered and supplied by a qualified, licensed healthcare provider in your state. Hospitals and providers must be Medicare-approved and accept either Medicare assignment or payment according to network contracts of your plan.

Does Medicare Prescription Drug Coverage Include Mental Health Prescription Drugs?

Medicare Prescription Drug Coverage (Part D) includes drugs used to help manage mental health conditions. Whether you get your prescription drugs through a standalone drug plan or as a bundled service with your Medicare Advantage Plan, the rules governing the prescribing and dispensing of drugs are the same. Drugs must be FDA-approved and prescribed by a qualified, licensed healthcare provider, such as your primary doctor, a nurse practitioner, or psychiatrist.

All Part D plans have a formulary (drug list) and medications that are grouped into “tiers” based on cost. Lower tiers and generic drugs cost less, and higher tiers and brand or specialty drugs cost more. Each plan must offer at least two drugs to treat common disorders and conditions for seniors, and all drugs in “protected” classes, including antidepressants and antipsychotics.

Drugs that are commonly used to treat mental health concerns are:

• Antidepressants
• Anti-anxiety medications
• Stimulants
• Anti-psychotics
• Mood stabilizers

What rules do Medicare Part D plans have regarding prescription drugs for mental health?

Medicare Part D plans must include safeguards for mental health prescription drugs, many of which are considered controlled substances due to their misuse or abuse potential. Drug plan coverage rules include:

• Opioid safety checks, which may apply if you are taking opioids for pain management along with other commonly used drugs for mental health, like an anti-anxiety medication
• Prior authorization, which may be required depending on your plan’s rules
• Quantity limits, for safety and cost reasons, a one month’s supply is standard
• Step therapy, which means that you may be required to try a lower tier, less expensive medication to treat your condition first before using a higher tier drug

Your prescribing physician and pharmacist should be involved in advocating for you to receive the prescription medications that work best for you. You can submit an exception to your plan to request a medication that is not typically covered on their formulary or would bypass step therapy. You must have written documentation and a request from your prescribing physician.

Learn more about Medicare prescription drug coverage

Medications may be an important part of your mental health plan of care. Allow time for the trial and error process of finding the medications that work best for you. Most of the types of medications listed above don’t have a therapeutic effect immediately. You may have to try a medication for two or three weeks to determine if it is the right drug for you. And you may have to increase or decrease the dose every few days to find the best dose for you. Stay in close contact with your prescribing physician during this process.

Search for drug plans that include your preferred medications. When you search for a standalone prescription drug plan or a Medicare Advantage Plan that includes drug coverage, make a list of your current medications and search the plan’s formulary for availability and cost. Understand your plan’s rules for prior authorization and step therapy.

If you want to lower your drug costs:

• Talk with your doctor about generic drugs or other drugs that may work for you.
• Search for a different drug plan that includes your drugs, has a less expensive mail-order option, or offers additional coverage during the gap.

If you need help paying for your drugs:

• Find out whether there’s a Pharmaceutical Assistance Program that can lower prescription costs for the drugs you take.
• Find out if your state has a State Pharmaceutical Assistance Program.

Apply for Extra Help. A joint program with Medicare and Social Security for people with limited income and resources. If you qualify, you could pay no more than $3.95 for each generic covered drug and $9.20 for each brand-name covered drug.

How Can You Get Help with Mental Health Care Coverage if You Can’t Afford it?

If you can’t afford your mental health care services or medications, there are resources at the federal and state level to help. The programs discussed below require you to demonstrate low income and resources that prevent you from being able to afford the care and coverage you need. Contact each program to see if you qualify and what you need to do to apply.

What programs exist for low-income Medicare patients in need of mental health care?

• Medicaid: A joint federal and state program that helps with medical costs for some people with limited income and resources. If you are dual-eligible for Medicare and Medicaid, most of your mental health care costs will be covered. Each state has different rules about eligibility and applying for Medicaid. According to the Kaiser Family Foundation (KFF), Medicaid plays a key role in financing mental health care for low-income individuals, and states are expanding access to Medicaid benefits. To see if you qualify and to find out what Medicaid coverage your state offers, call your State Medical Assistance (Medicaid) office. Visit Medicare.gov/contacts and use the drop-down menu to find your state. Or call 1-800-MEDICARE (1-800-633-4227) to get the phone number. TTY users call 1-877-486-2048.
• Medicare Savings Programs: For help paying your Medicare premiums, deductibles, and coinsurance if you meet income and resource limits. Contact your State Health Insurance Assistance Program (SHIP) to get unbiased help with Medicare options and programs in your state. Or, visit Medicare.gov/contacts, and use the drop-down menu to find your state. Or call 1-800-MEDICARE (1-800-633-4227) to get the phone number. TTY users call 1-877-486-2048.
• Extra Help: For helping your Medicare prescription drug costs, including premiums, copays, and deductibles, if you meet income and resource limits. Visit socialsecurity.gov/i1020 to apply for Extra Help online. Call Social Security at 1-800-772-1213. TTY users call 1-800-325-0778. You can apply for Extra Help by phone or ask for a paper application.
• State Pharmacy Assistance Programs (SPAPs): Many states have SPAPs that help eligible people pay for prescription drugs. Each SPAP makes its own rules on how to help its members. To find out if there’s an SPAP in your state and how it works: Visit this site: Find a Medicare plan to see if your state offers an assistance program. You’ll be able to view programs and eligibility criteria and contact available plans directly.
• Pharmaceutical Assistance Program: Some pharmaceutical companies offer financial assistance for certain medications for people who have a Part D prescription drug plan. Visit this site: Find a Medicare plan to see if you can get help to pay for your medications.
• Social Security Disability Income (SSDI) or Supplemental Security Income (SSI): If you are disabled due to mental health concerns and cannot work, you can apply for benefits from Social Security if you qualify. Find qualifications criteria here. Call 1-800-772-1213 (TTY 1-800-325-0778) or apply at ssa.gov.

How can you appeal Medicare coverage decisions?

As a Medicare beneficiary, you have rights and protections. If you disagree with a coverage or payment decision made by Medicare, your Medicare drug plan, or your Medicare health plan, including your Medicare Advantage Plan, you can make an appeal. Appeals are time-sensitive, and you must follow the procedures and utilize the forms dictated by your plan. You’ll need any information to help make your case, including:

• Doctor’s or healthcare provider notes on the reason for your service and how it has helped you make progress in managing your mental health.
• Any Medicare Summary Notice, Explanation of Benefits, or Coverage Determinations you have received from your plan.
• Your adherence to your plan’s rules for referrals, prior authorizations, or drug step therapy.

Follow the process outlined here, and keep a copy of everything you send in as part of your appeal.

Medicare Resources for Mental Health

If you need information or help with mental health concerns, there are resources for you. The Medicare.gov website has an easy search feature, and you can find information about any Medicare-related topic, with links to other sources.

• Call or text 911 in case of an emergency or mental health crisis.
• National Suicide Prevention Lifeline 1-800-273-TALK (1-800-273-8255): Talk to a crisis counselor 24 hours a day, 7 days a week. TTY users can call 1-800-799-4889.
• Medicare.gov/talk to someone: Click on your state to find resources for opioid treatment programs or your state Medicaid offices.
• Mentalhealth.gov offers one-stop access to U.S. government mental health and mental health problems information.
• National Institute of Mental Health (NIMH): Call 1-866-615-6464. TTY users can call 1-866-415-8051.
• Substance Abuse and Mental Health Services Administration (SAMHSA): Find treatment facilities or behavioral health treatment services in your area. Call 1-877-SAMHSA-7 (1-877-726-4727). TTY users can call 1-800-487-4889.
• Mental Health America: Call 1-800-969-6642. TTY users can call 1-800-433-5959.
• National Alliance on Mental Illness (NAMI): Call the Information Helpline at 1-800-950-NAMI (1-800-950-6264).
• National Council for Mental Wellbeing: Call 1-202-684-7457 or Email [email protected].
• Veterans Crisis Line: Call 1-800-273- 8255

State Mental Health Resources

In addition to the national resources listed above, each state has mental health resources to help you, including Medicaid agencies, pharmaceutical assistance programs, opioid treatment programs, and treatment facilities. Click on your state to access sites that serve as a hub for agencies and programs in your area.

Glossary

Coinsurance: Usually a percentage, for example, 20%, that you may pay as your share of costs for services received after you pay your annual deductible.

Copayment: A copayment is usually a set amount, for example, $10 or $20. You pay a copayment as your share of the costs for services received after you pay your annual deductible. For instance, a copay may be required for a doctor’s visit, a prescription drug, or a medical supply.

Coverage determination: The initial decision made by your Medicare drug plan about your drug benefits, including whether your particular requested drug is covered, if you met all the requirements for getting the drug, and how much you must pay for it. The determination also covers whether to make an exception to a plan rule when you request the drug. The drug plan must give you a prompt decision (72 hours for standard requests, 24 hours for expedited requests). If you disagree with the plan’s coverage determination, the next step is an appeal.

Deductible: The amount you must pay for health care or prescriptions before Original Medicare, your prescription drug plan, or your other insurance begins to pay.

Exception: If your Medicare prescription drug plan decides to cover a drug for you that is not on its drug list or waives a coverage rule, it is called an exception. Your prescriber must request an exception and provide a supporting statement explaining the medical reason for it.

Formulary: A list of covered prescription drugs available through your plan.

Inpatient care: care that takes place in a hospital or skilled nursing facility, covered by Medicare Part A. Mental health inpatient care can be a general hospital or a psychiatric hospital.

Lifetime reserve days: In Original Medicare, these are additional days that Medicare will pay for when you’re in a hospital for more than 90 days (a benefit period). You have a total of 60 reserve days that can be used during your lifetime. Medicare pays all covered costs for each lifetime reserve day except for a daily coinsurance. If you have a Medigap plan, you have an additional year’s worth of covered inpatient days after you have used your lifetime reserve days. A Medicare Advantage Plan views inpatient admissions and benefit periods differently. You have access to unlimited inpatient days as long as you follow the plan’s rules. Once you reach your out-of-pocket maximum for Medicare-covered services, your plan pays 100%.

Medicare-approved amount: In Original Medicare, this is the amount a provider that accepts assignment can be paid. It may be less than the actual amount charged. Medicare pays part of this amount, and you’re responsible for the difference. Medicare Advantage Plans typically contract with network providers to pay for services, and you’re responsible for copays for services received.

Medicare health plan: A plan offered by a private company that contracts with Medicare to provide Part A and Part B benefits to enrollees. Medicare health plans include:

• All Medicare Advantage Plans,
• Medicare Cost Plans,
• Demonstration/Pilot Programs,
• Programs of All-inclusive Care for the Elderly (PACE) organizations. PACE plans can be offered by public or private entities and provide Part D and other benefits in addition to Part A and Part B benefits.

Medicare Prescription Drug Plan Part D: Offered by Medicare-approved private insurance companies, adds prescription drug coverage to Original Medicare and some other Medicare health plans. Medicare Advantage Plans, like HMOs and PPOs, usually offer prescription drug coverage and must follow the same rules as Medicare Prescription Drug Plans.

Medigap policy: Medicare Supplement Insurance sold by private insurance companies to fill “gaps” in Original Medicare coverage, like deductibles, copays, and coinsurance.

Original Medicare: A fee-for-service health plan with two parts: Part A (hospital insurance) and Part B (medical insurance). After you pay a deductible, Medicare pays its share of the Medicare-approved amount, and you pay your share (coinsurance and deductibles).

Outpatient care: Care received outside of a hospital or skilled nursing facility, covered by Medicare Part B. Mental health outpatient care includes things like counseling, group therapy, and depression screening.

Premium: A periodic payment (usually monthly) to Medicare or an insurance company for health or prescription drug coverage.

Frequently Asked Questions About Medicare Mental Health Care

Kelly Blackwell

Certified Senior Advisor (CSA)^®

As a health care professional since 1987, Kelly Blackwell has walked alongside and cared for seniors as they journey through the season of their fourth quarter of life. Blackwell holds a Bachelor of Science in nursing from the University of Northern Colorado, a Master of Science in health care administration from Grand Canyon University, an interprofessional graduate certificate in palliative care from the University of Colorado Anschutz Medical Campus and holds a Certified Senior Advisor^® credential from the Society of Certified Senior Advisors.

Blackwell contributes to the University of Colorado-Anschutz blog and has been published in “The Human Touch” distributed by the University of Colorado Center for Bioethics and Humanities. She cowrote “Dying Is” for Pathways Hospice.

A registered nurse, Blackwell understands health insurance choices influence quality of life and are driven by values, goals, and beliefs. She’s passionate about engaging with, educating, and empowering seniors as they navigate the health care system. She’s equipped to lend an experienced, compassionate voice to beneficiaries seeking information about Medicare Advantage Plans.

As a CSA^®, Blackwell has access to valuable resources for Medicare beneficiaries. Her work as a bedside nurse and clinical manager has given her the opportunity to see how Medicare rules, regulations, and benefits work when patients need them. With a passion to learn and to make a difference in the lives of seniors, Blackwell supports seniors through Medicare and fourth-quarter life decisions.

Kelly Blackwell

Certified Senior Advisor (CSA)^®

As a health care professional since 1987, Kelly Blackwell has walked alongside and cared for seniors as they journey through the season of their fourth quarter of life. Blackwell holds a Bachelor of Science in nursing from the University of Northern Colorado, a Master of Science in health care administration from Grand Canyon University, an interprofessional graduate certificate in palliative care from the University of Colorado Anschutz Medical Campus and holds a Certified Senior Advisor^® credential from the Society of Certified Senior Advisors.

Blackwell contributes to the University of Colorado-Anschutz blog and has been published in “The Human Touch” distributed by the University of Colorado Center for Bioethics and Humanities. She cowrote “Dying Is” for Pathways Hospice.

A registered nurse, Blackwell understands health insurance choices influence quality of life and are driven by values, goals, and beliefs. She’s passionate about engaging with, educating, and empowering seniors as they navigate the health care system. She’s equipped to lend an experienced, compassionate voice to beneficiaries seeking information about Medicare Advantage Plans.

As a CSA^®, Blackwell has access to valuable resources for Medicare beneficiaries. Her work as a bedside nurse and clinical manager has given her the opportunity to see how Medicare rules, regulations, and benefits work when patients need them. With a passion to learn and to make a difference in the lives of seniors, Blackwell supports seniors through Medicare and fourth-quarter life decisions.

Learn More From Our Sources

• KFF | State Policies Expanding Access to Behavioral Health Care in Medicaid | Last accessed January 2025
• Medicare | How to Get Prescription Drug Coverage | Last accessed January 2025
• Medicare |Medicare and your mental health benefits. | Last accessed January 2025
• Medicare | Mental health care (outpatient) | Last accessed January 2025
• Medicare | Inpatient Mental Health Care Coverage | Last accessed January 2025
• Medicare |Mental health & substance use disorder services | Last accessed January 2025
• Medicare | Mental health care (partial hospitalization) | Last accessed January 2025