Key Takeaways

• Medicare does cover many mental health services, but your coverage depends on the type of provider, your setting of care, and the type of service.

• Understanding what Medicare does not cover is just as important, especially if you’re seeking ongoing or specialized therapy or psychiatric care.

Understanding Medicare’s Mental Health Coverage

When you’re thinking about seeking therapy or psychiatric help, it’s essential to know where Medicare stands. While Medicare offers coverage for a broad range of mental health services, the type of coverage you get varies depending on your plan, your provider, and the setting where you receive care.

Medicare coverage includes services such as:

• Individual and group therapy

• Diagnostic evaluations

• Psychiatric hospital stays

• Medication management

• Partial hospitalization programs

• Substance use disorder treatment in some cases

Let’s break down how each part of Medicare handles mental health services and what you should know before making any decisions.

How Original Medicare Covers Therapy and Psychiatry

Original Medicare includes Part A and Part B. Here’s what each part covers when it comes to mental health:

Medicare Part A: Inpatient Care

If you need inpatient mental health care, Medicare Part A helps cover:

• Semi-private room and meals

• Nursing care

• Therapy and counseling as part of your inpatient treatment

• Medications related to your condition

However, there are limits. Medicare only covers 190 days of inpatient psychiatric hospital care in your lifetime. After that, you’ll need to seek care in a general hospital setting for inpatient psychiatric treatment to be covered.

Medicare Part B: Outpatient Services

For therapy or psychiatric care in an outpatient setting, Medicare Part B typically covers:

• Appointments with clinical psychologists or psychiatrists

• Individual and group therapy sessions

• Family counseling if it’s part of your treatment

• Medication management and follow-up visits

• Telehealth visits (when eligible)

You usually pay 20% of the Medicare-approved amount for outpatient services, after meeting the annual Part B deductible.

What About Medicare Advantage Plans?

Medicare Advantage (Part C) plans are offered by private companies approved by Medicare. These plans must provide the same coverage as Original Medicare, but may also offer:

• A broader network of mental health providers

• Lower out-of-pocket costs

• Additional wellness programs or behavioral health services

However, you must check the specific plan details to see what mental health services are offered and how costs compare. Since provider networks vary, coverage for a specific psychiatrist or therapist might differ.

Medication Management Under Medicare

Mental health care often involves prescription medications. Here’s how Medicare covers that:

Medicare Part D

Part D helps cover outpatient prescription drugs, including medications used to treat depression, anxiety, bipolar disorder, and more. All Part D plans are required to cover most antidepressant, antipsychotic, and anticonvulsant medications, which are commonly used for mental health treatment.

You may be responsible for:

• An annual deductible (up to $590 in 2025)

• Copayments or coinsurance based on drug tiers

• Costs up to an out-of-pocket maximum of $2,000 in 2025, after which catastrophic coverage begins

It’s important to confirm that your specific medications are included in your plan’s formulary.

Who Can Provide Mental Health Services Under Medicare?

Medicare only pays for therapy and psychiatric services when they’re provided by eligible professionals. These include:

• Psychiatrists (MD or DO)

• Clinical psychologists (PhD or PsyD)

• Clinical social workers (LCSW)

• Nurse practitioners and physician assistants with mental health training

Not all therapists or counselors are eligible under Medicare. For example, licensed professional counselors (LPCs) or marriage and family therapists (MFTs) may not be covered unless they’re approved as Medicare providers.

Always make sure your provider accepts Medicare before beginning treatment.

Telehealth and Virtual Therapy in 2025

As of 2025, Medicare continues to allow coverage for many telehealth mental health services. This includes:

• Virtual therapy sessions

• Psychiatric evaluations and medication management

These services are available if:

• You’ve had an in-person visit within the past six months (for certain services)

• The provider uses approved telehealth platforms

You can receive telehealth care at home, making it easier for those with mobility issues or in rural areas to access therapy.

Out-of-Pocket Costs: What You Should Expect

Mental health services under Medicare are not entirely free. You should prepare for some level of out-of-pocket spending depending on the service and the setting.

General costs you may face:

• Inpatient psychiatric care: You pay the Part A deductible ($1,676 in 2025) for each benefit period. Additional coinsurance may apply for extended stays.

• Outpatient therapy: You typically pay 20% coinsurance after the Part B deductible ($257 in 2025).

• Prescription drugs: Copayments or coinsurance vary by your Part D plan’s formulary.

Some supplemental insurance may help reduce these costs, but you must evaluate options carefully.

Does Medicare Cover Long-Term Therapy?

Medicare does not put a strict limit on the number of outpatient therapy sessions you can have. As long as your therapy is medically necessary and documented properly, you can continue with ongoing treatment.

However, expect periodic evaluations. Providers are required to show:

• That therapy is helping your condition

• That continued treatment is clinically justified

If your care stops meeting these standards, coverage may be denied.

What Medicare Does Not Cover

Even though Medicare covers a lot, there are mental health services that it typically doesn’t pay for:

• Services from non-Medicare-approved providers (like some therapists or counselors)

• Alternative therapies (acupuncture for mental health, hypnotherapy, etc.)

• Support groups not run by licensed professionals

• Life coaching or career counseling

If you’re unsure, ask your provider to clarify whether a service is covered.

Steps to Take Before Starting Therapy or Psychiatry Under Medicare

To make sure your mental health services are covered, take the following steps:

1. Verify provider eligibility. Confirm that the professional you want to see accepts Medicare.

2. Ask about referrals. Depending on your plan, a referral may be required for mental health services.

3. Check your coverage details. Review your Medicare Summary Notice or contact your plan to confirm what is covered.

4. Look into Part D drug coverage. If medication is part of your treatment, ensure it’s on your plan’s formulary.

5. Consider telehealth. If in-person visits are hard, virtual therapy might be a suitable option.

Mental Health Matters—And So Does Understanding Your Coverage

If you’re considering therapy or psychiatric treatment, knowing your Medicare coverage ahead of time makes a big difference. You don’t want to be surprised by costs or denied claims when you’re focusing on your health.

Whether you need help managing depression, anxiety, or another condition, Medicare can be a valuable resource. But how much it helps depends on the choices you make today—your provider, your plan, and your awareness of what’s covered.

Make sure you take the time to ask questions, understand your rights, and plan ahead. And if you’re unsure how to get started, get in touch with a licensed agent listed on this website for guidance tailored to your specific needs.