Medicare & Mental Health: What’s Covered?

Mental health is just as important as physical health, and Medicare provides coverage for a range of mental health services to ensure beneficiaries get the care they need. Understanding what Medicare covers and how to access mental health services can help you or a loved one receive the right support.

Medicare Coverage for Mental Health Services

Medicare provides coverage for both outpatient and inpatient mental health services. Here’s what’s included:

1. Outpatient Mental Health Services (Medicare Part B)

Medicare Part B covers outpatient mental health care, including:

• Psychiatric evaluations and diagnostic tests

• Individual and group psychotherapy with licensed professionals (psychologists, social workers, and psychiatrists)

• Medication management provided by psychiatrists

• Family counseling if it’s related to your treatment

• Substance use disorder treatment

• Depression screenings (once per year, free of charge)

• Telehealth services for mental health evaluations and therapy

Costs:

• You pay 20% of the Medicare-approved amount after meeting the Part B deductible.

• If you receive services from a participating provider, Medicare covers 80% of the cost.

2. Inpatient Mental Health Services (Medicare Part A)

If you need hospital care for a mental health condition, Medicare Part A covers:

• Hospital stays in a general or psychiatric hospital

• Up to 190 days of inpatient psychiatric hospital care in a lifetime

• Medications and therapy while in the hospital

Costs:

• Part A hospital deductible applies ($1,632 per benefit period in 2024).

• Daily copayments apply after 60 days in a hospital stay.

3. Prescription Drug Coverage (Medicare Part D)

• Medicare Part D covers prescription medications for mental health conditions, such as antidepressants, anti-anxiety medications, and antipsychotic drugs.

• Each plan has its own formulary, so it’s important to check whether your medications are covered.

4. Medicare Advantage (Part C) and Mental Health

• Medicare Advantage plans include everything in Parts A and B and often offer additional mental health benefits, including wellness programs.

• Some plans may have lower copayments for therapy and medications than Original Medicare.

  
  

Does Medicare Cover Therapy?

Yes! Medicare covers therapy sessions with psychiatrists, psychologists, and clinical social workers as long as they accept Medicare. Therapy can be provided in person or via telehealth.

What’s Not Covered?

• Marriage counseling

• Life coaching

• Alternative treatments (acupuncture, holistic therapies not approved by Medicare)

  
  

How to Find a Mental Health Provider That Accepts Medicare

1. Visit Medicare.gov and use the provider search tool.

2. Ask your primary care doctor for a referral.

3. Contact your Medicare Advantage plan to check in-network mental health providers.

   
   

Take Advantage of Your Medicare Mental Health Benefits

Mental health care is essential, and Medicare ensures you have access to the support you need. If you or a loved one are struggling with mental health issues, don’t hesitate to seek professional help.

At Lindbergh and Associates, we help Medicare beneficiaries find the right plans and services to meet their healthcare needs.

📞 Contact us today to learn more about your mental health coverage options.