Key Takeaways
- Medicare covers many mental health services including therapy, psychiatrist visits, hospital stays, partial hospitalization programs, and prescription drugs.
- You will still need to pay some costs, like 20% for outpatient services after meeting your deductible, but Medigap policies can help cover these expenses.
- Telehealth options make mental health care more accessible, and studies show they can be as effective as in-person treatment for many conditions.
Medicare does cover many mental health services. This is good news for people who need help with mental health concerns. Let's look at what Medicare covers and how to get these services.
What Mental Health Services Does Medicare Cover?
Medicare helps pay for many mental health services. These include:
Outpatient Services
Medicare Part B covers visits to mental health providers like psychiatrists, psychologists, social workers, and nurse specialists. These visits can be in-person or through telehealth on your computer or phone.
Medicare covers these outpatient services:
- One depression screening per year
- Individual and group therapy
- Family counseling if it helps with your treatment
- Medication management
- Certain prescription drugs that aren't usually self-administered
When you get a depression screening, your primary care doctor will ask you questions about how you've been feeling. This screening is free once every 12 months if your doctor accepts Medicare assignment.
Therapy sessions with a licensed mental health professional can help you learn coping skills and strategies to manage your mental health.
Medicare helps pay for both individual therapy where it's just you and the therapist, and group therapy where you meet with other people who have similar concerns.
Inpatient Services
If you need to stay in a hospital for mental health treatment, Medicare Part A helps cover these costs.
This includes:
- Room and board
- Nursing care
- Therapy or other treatment services
- Lab tests and medications during your stay
Medicare Part A covers up to 190 days of inpatient care at a psychiatric hospital in your lifetime. This is different from the coverage for general hospitals, which doesn't have a lifetime limit.
Sometimes mental health conditions become so serious that inpatient care is needed. This might happen during a mental health crisis or when someone needs more intensive treatment than can be provided as an outpatient.
During an inpatient stay, you'll receive around-the-clock care from mental health professionals.
Partial Hospitalization Programs
Medicare also covers partial hospitalization programs (PHPs), which are structured mental health treatment programs that are more intensive than outpatient care but don't require an overnight stay.
These programs typically include:
- Individual and group therapy sessions
- Occupational therapy
- Family counseling
- Activity therapies
- Patient education
- Medication management
PHPs can be a good option if you need intensive treatment but don't need to stay in a hospital overnight.
Prescription Drugs
Medicare Part D helps pay for prescription drugs for mental health conditions. All Medicare drug plans must cover antidepressants, antipsychotics, and anticonvulsants.
Medications are often an important part of mental health treatment. Antidepressants can help with depression and anxiety disorders.
Antipsychotics may be prescribed for conditions like schizophrenia or bipolar disorder. Anticonvulsants, while primarily used for seizures, can also help stabilize mood for some mental health conditions.
Each Medicare drug plan has a list of covered drugs called a formulary. While all plans must cover mental health medications, the specific brands they cover and the costs may vary.
It's important to check your plan's formulary to see if your medications are covered.
What You Need to Pay
While Medicare covers mental health services, you still need to pay some costs:
- For outpatient services, you pay 20% of the Medicare-approved amount after you meet your Part B deductible.
- For inpatient care, you pay a deductible and possibly coinsurance depending on the length of your stay.
For 2025, the Part B deductible is $257 per year. This means you pay the full cost of outpatient mental health services until you've paid $257 in medical costs for the year.
After that, you pay 20% of the Medicare-approved amount for each service.
For inpatient mental health care in 2025, you pay:
- $1,676 deductible for each benefit period
- $0 coinsurance for days 1-60 of each benefit period
- $419 coinsurance per day for days 61-90 of each benefit period
- $838 coinsurance per "lifetime reserve day" after day 90 (up to a maximum of 60 days over your lifetime)
A study from the National Institute of Mental Health found that mental health issues affect about one in five adults in the United States. Getting help is important for your overall health.
Medicare Advantage and Mental Health
If you have a Medicare Advantage (Part C) plan, it must cover everything that Original Medicare covers, including mental health services. However, Medicare Advantage plans may have different rules, costs, and restrictions:
- You may need to use providers in the plan's network
- You might need referrals to see specialists
- Some services may require prior authorization
- Your copayments and coinsurance amounts may be different from Original Medicare
Some Medicare Advantage plans offer additional mental health benefits not covered by Original Medicare, such as more coverage for therapy sessions or wellness programs. Check with your plan to understand what mental health benefits are available.
Medigap and Mental Health Costs
If you have Original Medicare, you might want to consider getting a Medicare Supplement Insurance (Medigap) policy to help pay your out-of-pocket costs. Medigap policies can help cover your deductibles, coinsurance, and copayments for Medicare-covered services, including mental health care.
This can be especially helpful if you need ongoing mental health treatment, as those 20% coinsurance payments can add up over time.
How to Get Mental Health Care with Medicare
To get mental health care through Medicare:
- Talk to your doctor about your mental health concerns.
- Get a referral to a mental health specialist if needed.
- Make sure the provider accepts Medicare assignment to keep your costs lower.
- If you have Medicare Advantage, check if the provider is in your plan's network.
According to the Substance Abuse and Mental Health Services Administration, less than half of older adults who need mental health services actually receive them. Don't be afraid to reach out for help if you're struggling with your mental health.
Telehealth Options for Mental Health
Medicare has expanded coverage for telehealth services, especially for mental health care. This means you can receive therapy and psychiatric services from the comfort of your home using video conferencing technology.
Telehealth can be particularly helpful for people who:
- Live in rural areas far from mental health providers
- Have mobility issues that make it difficult to travel to appointments
- Feel uncomfortable seeking mental health treatment in person
- Prefer the convenience of appointments from home
Research published in the Journal of the American Medical Association found that telehealth therapy can be just as effective as in-person therapy for many mental health conditions.
Prevention and Early Intervention
Medicare covers not only treatment for mental health conditions but also services to help prevent problems or catch them early. For example, Medicare covers an alcohol misuse screening once per year and up to four brief counseling sessions per year if your provider determines you're misusing alcohol.
