Medicare covers mental health counseling, but the amount you pay and which therapists you can see depend on the type of Medicare you have and the kind of care you need.

Original Medicare (Part A and Part B) covers outpatient mental health services at the same rate it covers physical health services — you pay 20% of the cost after you meet your Part B deductible, and Medicare pays 80%. This includes therapy with a psychiatrist, psychologist, clinical social worker, or licensed professional counselor. Medicare Advantage plans (Part C) must cover at least the same mental health services as Original Medicare, though some plans offer more, and your out-of-pocket costs may be lower or higher depending on the plan.

The catch is that you need to see a provider who accepts Medicare. Not all therapists do, and some who do have limited availability. If you see an out-of-network provider, you will pay the full cost unless your plan has an out-of-network benefit — and even then, you may pay more than you would in-network.

Key Takeaways

  • Original Medicare covers 80% of outpatient mental health services after you meet your Part B deductible, and you pay 20%.
  • The therapist must accept Medicare for the coverage to explore; you can search for in-network providers on Medicare.gov or call 1-800-MEDICARE.
  • Medicare Advantage plans must cover at least the same mental health services as Original Medicare, but your copay or coinsurance may differ by plan.
  • Inpatient psychiatric hospital stays are covered under Part A if medically necessary, though there are limits on the number of days covered in a lifetime.
  • Telehealth mental health visits are covered by Medicare, which can make it easier to find a provider if in-person options are limited in your area.

What Original Medicare covers for mental health

Original Medicare Part B covers outpatient mental health services — meaning therapy or counseling you receive outside a hospital. This includes visits with a psychiatrist (a medical doctor who can prescribe medication), a psychologist, a clinical social worker, or a licensed professional counselor. The service must be medically necessary, meaning a doctor has determined it is appropriate treatment for a diagnosed mental health condition.

You pay 20% of the Medicare-approved amount for each visit after you have paid your Part B deductible for the year. The deductible is currently $240 per year, though this amount can change. If your therapist charges more than Medicare's approved amount, you may owe the difference — this is called balance billing, and it is only legal if the provider does not accept Medicare assignment (meaning they do not agree to accept Medicare's payment as full payment).

There is no limit on the number of mental health visits Medicare will cover in a year, as long as they remain medically necessary. However, your provider must document that the treatment is working and is still needed.

How Medicare Advantage plans handle mental health coverage

If you have a Medicare Advantage plan (Part C), the plan must cover at least the same mental health services that Original Medicare covers. However, the plan sets its own rules about how much you pay per visit, which providers are in-network, and whether you need a referral from your primary care doctor.

Some Medicare Advantage plans offer additional mental health benefits — for example, a lower copay for therapy visits, coverage for more types of providers, or a set number of free annual visits. Others may require you to use providers within their network or may have higher out-of-pocket costs than Original Medicare. You should review your plan's summary of benefits or call the plan directly to understand what your mental health coverage looks like.

If you switch to a Medicare Advantage plan or change plans during the annual enrollment period, check whether your current therapist is in the new plan's network. If not, you may need to find a new provider or pay out-of-pocket to continue with your current therapist.

Finding a Medicare-accepting mental health provider

The first step is to confirm that a therapist accepts Medicare before you schedule an appointment. You can search for in-network providers on Medicare.gov using the "Care Provider Search" tool, or you can call 1-800-MEDICARE (1-800-633-4227) and ask for a list of mental health providers in your area who accept Medicare.

Your primary care doctor can also refer you to a mental health provider, and many primary care offices have a list of therapists they work with regularly. Some therapists have long waiting lists, so it may take several weeks to get an appointment. If you are in crisis or having thoughts of suicide, call the 988 Suicide and Crisis Lifeline (call or text 988) — this service is free and available 24/7, and you do not need Medicare to use it.

If you live in a rural area or have difficulty finding an in-person provider, ask about telehealth options. Medicare covers mental health visits by video or phone with a Medicare-accepting provider, which can expand your options significantly.

Inpatient psychiatric care and hospital stays

If you need to be admitted to a psychiatric hospital or a general hospital's psychiatric unit, Medicare Part A covers the cost after you pay your Part A deductible. Part A covers the hospital stay, meals, and nursing care, but not the psychiatrist's fees (those are billed under Part B).

There is a lifetime limit of 190 days of inpatient psychiatric hospital care covered by Medicare. This limit applies only to stays in a psychiatric hospital, not to psychiatric care in a general hospital. Once you have used 190 days, Medicare will not cover additional stays in a psychiatric hospital, though it will continue to cover psychiatric care in a general hospital setting.

If you have a Medicare Advantage plan, the plan may have different rules about inpatient psychiatric coverage, so check your plan documents or call the plan to understand your coverage before admission if possible.

What Medicare does not cover for mental health

Medicare does not cover therapy or counseling that is not medically necessary — for example, life coaching, career counseling, or marriage counseling aimed at improving a relationship rather than treating a diagnosed mental health condition. Some therapists offer these services, but you would pay out-of-pocket.

Medicare also does not cover substance use disorder treatment in the same way it covers other mental health services. However, Medicare Part B does cover outpatient treatment for substance use disorders, including counseling and medication-assisted treatment. Inpatient rehabilitation for substance use is covered under Part A, though there are limits on the number of days.

Prescription psychiatric medications are covered under Medicare Part D (prescription drug coverage) if you have it, but the copay depends on your plan and the specific medication.

Out-of-pocket costs and how to estimate them

With Original Medicare, your out-of-pocket cost for a mental health visit is 20% of the Medicare-approved amount, after you have met your Part B deductible. The Medicare-approved amount varies by location and provider, but a typical outpatient mental health visit might be approved at $100 to $150, meaning you would pay $20 to $30 per visit after your deductible is met.

With a Medicare Advantage plan, your cost per visit depends on your plan — it might be a flat copay (for example, $30 per visit), coinsurance (a percentage of the cost), or a combination. Some plans offer a set number of free mental health visits per year. You can find your plan's mental health copay or coinsurance amount in your plan's Summary of Benefits or by calling the plan.

If you see an out-of-network provider, you will likely pay more. Some Medicare Advantage plans do not cover out-of-network mental health services at all, while others cover them at a higher out-of-pocket cost. Original Medicare does not have in-network or out-of-network distinctions, but if a provider does not accept Medicare assignment, you may owe balance billing on top of your 20% coinsurance.

Frequently Asked Questions

Do I need a referral from my doctor to see a therapist on Medicare?

Original Medicare does not require a referral — you can see a mental health provider directly. However, some Medicare Advantage plans do require a referral from your primary care doctor. Check your plan's rules or call the plan to find out whether you need one.

Does Medicare cover therapy for depression or anxiety?

Yes, if the depression or anxiety is diagnosed by a doctor and the therapy is medically necessary. Medicare covers outpatient therapy with a psychiatrist, psychologist, clinical social worker, or licensed professional counselor. The number of visits is not limited as long as the treatment remains medically necessary and your provider documents that it is working.

What if my therapist is not in my Medicare Advantage plan's network?

You can continue to see the therapist, but you will likely pay more out-of-pocket. Some plans do not cover out-of-network mental health services at all. Contact your plan to find out whether out-of-network coverage is available and what you would owe. You may also want to ask your therapist whether they can become in-network with your plan.

Are telehealth mental health visits covered by Medicare?

Yes, Medicare covers mental health visits by video or phone with a Medicare-accepting provider. This expanded coverage has made it easier for people in rural areas or with limited local options to access care. Ask your provider whether they offer telehealth appointments.

What should I do if I cannot afford my mental health care?

Talk to your provider about the cost — some therapists offer sliding scale fees or payment plans. You can also ask your doctor for a referral to a community mental health center, which often charges based on income. Call 1-800-MEDICARE to ask about local resources, or contact your state's mental health department for information about low-cost or free services in your area.