Key Takeaways

• In 2025, Medicare covers a broad range of mental health services, including therapy, psychiatric care, and substance use treatment, but understanding the rules around provider types, visit frequency, and costs is essential to getting access.

• You have rights under Medicare to receive mental health care in inpatient and outpatient settings, and recent expansions now allow you to see licensed counselors and therapists that weren’t previously included.

Why Mental Health Coverage Still Feels Complicated

If you’re enrolled in Medicare and considering mental health support, it may feel overwhelming to navigate the maze of coverage rules, approved providers, and potential out-of-pocket costs. Yet, the care you need is likely covered—if you understand how to access it. In 2025, Medicare has expanded its mental health benefits significantly, but you must take some important steps to use them.

Medicare divides its mental health coverage into three parts:

• Part A for inpatient psychiatric services

• Part B for outpatient therapy and evaluations

• Part D for medications used in mental health treatment

Each comes with its own rules and conditions, and you’ll want to know what applies to your situation before making appointments or filling prescriptions.

Inpatient Mental Health Coverage Under Part A

Medicare Part A covers care if you are admitted to a psychiatric hospital or a general hospital for mental health treatment.

Here’s what you should know in 2025:

• You can receive up to 190 days of inpatient psychiatric hospital care over your lifetime.

• For general hospital stays, there is no lifetime limit for mental health care.

• The 2025 inpatient deductible is $1,676 per benefit period.

• If your stay extends beyond 60 days, you start paying coinsurance: $419 per day for days 61-90 and $838 per day for lifetime reserve days.

It’s important to note that once you reach your 190-day lifetime limit for inpatient psychiatric hospital care, you can’t renew it, even if it’s a different hospital.

Outpatient Mental Health Services Under Part B

Outpatient therapy, counseling, psychiatric evaluations, and medication management fall under Medicare Part B. These services are crucial for ongoing mental health support and are more accessible now than ever.

Here’s what Part B covers in 2025:

• Psychiatric diagnostic evaluations

• Individual or group therapy

• Medication management

• Partial hospitalization programs (PHPs)

• Intensive outpatient programs (IOPs)

• Depression and substance use disorder screenings

• Family counseling related to your care

You pay 20% of the Medicare-approved amount after meeting the $257 Part B deductible for the year.

Who You Can See: Medicare-Approved Mental Health Providers

Until recently, Medicare only covered services provided by limited types of practitioners, but 2025 has brought new options.

Now, you can receive care from:

• Psychiatrists

• Clinical psychologists

• Clinical social workers

• Nurse practitioners

• Physician assistants

• Licensed Marriage and Family Therapists (LMFTs)

• Licensed Mental Health Counselors (LMHCs)

The last two were added in January 2024 under a change that aimed to expand access. These professionals are often more available and affordable, especially in areas with psychiatrist shortages.

Make sure your provider accepts Medicare assignment. If they don’t, you could face higher out-of-pocket costs or denied claims.

Partial Hospitalization and Intensive Outpatient Programs

For those who need more structured treatment than regular therapy visits but don’t need to be hospitalized, Medicare covers:

Partial Hospitalization Programs (PHPs)

• Structured programs provided during the day (typically 4-6 hours)

• Covered under Part B if prescribed by a Medicare-approved doctor

• Must be provided by a Medicare-certified hospital or mental health center

Intensive Outpatient Programs (IOPs)

• Less intensive than PHPs but more frequent than traditional therapy

• Focus on structured group therapy, skill-building, and support

• Added to Medicare in January 2024, expanding access in both urban and rural settings

These programs are ideal for managing conditions like depression, bipolar disorder, and anxiety disorders without requiring full hospitalization.

Telehealth for Mental Health: Still an Option in 2025

The COVID-19 pandemic led to a significant expansion of telehealth services, and many of those benefits continue in 2025.

Medicare now permanently covers:

• Teletherapy sessions via video and audio-only (phone)

• Visits from your home, including for new and existing patients

• Care provided by psychologists, social workers, and licensed counselors

There is, however, one condition starting October 1, 2025:

• If you use telehealth for mental health services, you must have an in-person visit at least once every 12 months, unless an exception applies.

Check with your provider to ensure they are aware of this requirement and schedule accordingly.

What About Prescription Drug Coverage for Mental Health?

Medications used to treat depression, anxiety, bipolar disorder, schizophrenia, and other conditions are covered under Medicare Part D.

Key points in 2025:

• Part D plans must cover at least two drugs per therapeutic class, including all antidepressants and antipsychotics.

• The deductible may be up to $590.

• Once you hit $2,000 in out-of-pocket costs, you enter the catastrophic phase, during which your plan covers 100% of approved drug costs for the rest of the year.

Review your plan’s formulary to make sure your medication is covered, and talk with your doctor about generics or therapeutic alternatives if your drug is excluded.

Coordination with Medicare Advantage Plans

Medicare Advantage (Part C) plans must cover at least the same mental health services as Original Medicare. However, there are a few differences to be aware of:

• Provider networks may be limited, so check if your therapist or psychiatrist is in-network.

• Prior authorization may be required for therapy sessions or inpatient stays.

• Additional benefits like wellness programs or care coordination may be included.

You cannot be denied mental health coverage if you qualify for a Medicare Advantage plan, but you should carefully review plan details during Open Enrollment.

Cost Considerations: What You Can Expect to Pay

Understanding costs upfront can help you avoid surprise bills. While Original Medicare sets standard rules, your out-of-pocket expenses depend on the following:

• Whether you’ve met the Part A and B deductibles

• Whether your provider accepts Medicare assignment

• Whether your service is inpatient or outpatient

• Whether you’re in a Medicare Advantage plan with coinsurance, copays, or out-of-network fees

Here are typical cost ranges in 2025:

• Outpatient therapy: 20% coinsurance after $257 deductible

• Inpatient hospital: $1,676 deductible per benefit period, with coinsurance starting after day 60

• Mental health drugs (Part D): 100% covered after reaching the $2,000 annual cap

Supplemental insurance, such as Medigap, may cover some of these costs if you’re enrolled in Original Medicare.

How to Find a Medicare-Certified Mental Health Provider

The key to getting your mental health services covered is working with a provider who is approved by Medicare.

Steps you can take:

• Use the Medicare.gov “Find & Compare” tool

• Ask providers directly: “Do you accept Medicare assignment?”

• Contact your Medicare Advantage plan to get a list of in-network behavioral health professionals

• Consider telehealth if local providers are unavailable or have long wait times

Mental Health Screenings: A Preventive Benefit You Shouldn’t Ignore

Medicare covers yearly depression screenings and substance use disorder screenings at no cost if conducted by a qualified provider during a primary care visit.

This is a crucial benefit, especially if you are not yet receiving formal mental health treatment. These screenings are an easy, confidential starting point.

Why You Shouldn’t Delay Getting Help

If you’ve been putting off therapy or counseling because you weren’t sure Medicare would help, now is the time to reconsider. As of 2025, the program covers more types of services and providers than ever before. Whether you need talk therapy, medication support, or short-term structured care, Medicare has benefits in place to support you.

But the key is knowing where to look and understanding how to apply the coverage. Otherwise, you risk delaying the care you need or paying more than you should.

Getting Mental Health Support Shouldn’t Be This Hard

You deserve to feel emotionally well and mentally strong, and Medicare has tools that can help. But you shouldn’t have to figure it all out on your own. If you still have questions about coverage, eligibility, or plan options, connect with a licensed agent listed on this website. They can walk you through your choices and ensure you get the care you need with the least hassle.