Key Takeaways
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Medicare does cover mental health therapy, but the eligibility rules, approved providers, and cost-sharing structures can be confusing if you’re not familiar with how Parts A, B, and D work together.
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In 2025, new updates expand mental health access under Medicare, including coverage for marriage and family therapists and mental health counselors, but you must meet specific conditions to qualify.
Medicare Covers Mental Health Care—But Only If You Know Where to Look
When you hear “mental health coverage,” you might not automatically think of Medicare. But in 2025, Medicare does provide mental health support across inpatient, outpatient, and prescription drug services. The challenge? Many beneficiaries miss out simply because the structure and rules are hard to decipher.
If you’re enrolled in Medicare, it’s important to understand exactly what’s covered, how to qualify, and how to avoid unexpected costs. Here’s a detailed look at what you’re entitled to under Medicare’s mental health coverage and what you need to watch for.
Inpatient Mental Health Treatment Under Part A
Medicare Part A covers inpatient mental health care in a general hospital or a psychiatric hospital.
What’s included:
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Semi-private room
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Meals
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Nursing services
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Medications and supplies as part of inpatient care
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Therapy and social services
Key rules to remember:
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Medicare covers up to 190 days of inpatient care in a psychiatric hospital over your lifetime.
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There’s no lifetime limit if you receive mental health care in a general hospital.
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You’ll be responsible for the Part A deductible (currently $1,676 in 2025) per benefit period, plus coinsurance after 60 days.
Outpatient Therapy Under Part B
Outpatient mental health services fall under Medicare Part B. This includes visits with mental health professionals, therapy sessions, and diagnostic evaluations.
Covered services:
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Individual and group psychotherapy
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Psychiatric evaluations and medication management
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Family counseling (when the primary focus is your treatment)
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Depression and substance use disorder screenings
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Partial hospitalization programs (PHPs)
2025 updates:
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Marriage and family therapists (MFTs) and mental health counselors (MHCs) are now recognized providers under Part B.
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Telehealth remains a permanent option for mental health services.
Costs to expect:
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You’ll first pay the Part B annual deductible ($257 in 2025).
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After that, you typically pay 20% coinsurance for services, unless you have a Medigap policy or other secondary coverage.
Prescription Medications for Mental Health Under Part D
If you need medication for depression, anxiety, bipolar disorder, or other mental health conditions, these are typically covered under Medicare Part D.
What’s included:
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Antidepressants, antipsychotics, anti-anxiety medications, mood stabilizers
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A wide range of generic and brand-name drugs
Cost structure in 2025:
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You may need to meet a deductible (up to $590 in 2025)
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Once your total out-of-pocket drug costs hit $2,000, you reach the new annual cap, and Medicare pays 100% of your covered drug costs for the rest of the year
It’s critical to ensure the specific medications you need are on your plan’s formulary. Not all plans cover all drugs.
Expanded Access with Telehealth
Telehealth is no longer just a pandemic-era exception. As of 2025, Medicare permanently covers many mental health services via telehealth. That includes video and audio-only visits.
Important guidelines:
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Telehealth mental health services must be provided by Medicare-approved providers
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Starting October 1, 2025, an in-person appointment is required at least once every 12 months to continue telehealth coverage (some exceptions apply)
Partial Hospitalization and Intensive Outpatient Programs
If you need more support than occasional therapy but don’t require overnight hospitalization, Medicare Part B can cover Partial Hospitalization Programs (PHPs) and Intensive Outpatient Programs (IOPs).
What these programs offer:
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Structured treatment during the day, returning home at night
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Therapy, medication management, and support services
What’s required:
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A physician must certify that you would otherwise require inpatient care
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Care must be provided by a Medicare-certified facility
Who Can Provide Your Mental Health Care Under Medicare
Medicare only covers services from providers who accept Medicare and are legally authorized to offer mental health treatment. As of 2025, the list has expanded.
Covered professionals include:
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Psychiatrists and other physicians
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Clinical psychologists
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Clinical social workers
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Nurse practitioners and physician assistants specializing in mental health
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Marriage and family therapists (MFTs)
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Mental health counselors (MHCs)
You must ensure your provider participates in Medicare. Some licensed professionals may not accept Medicare, and their services won’t be reimbursed.
What Medicare Does Not Cover
Even though Medicare’s mental health coverage is broadening, there are still some limitations.
Exclusions include:
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24-hour care at home
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Meals delivered to your home
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Transportation to therapy appointments (unless part of a covered hospital service)
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Support groups that aren’t led by licensed therapists
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Services from providers who don’t accept Medicare
How to Make the Most of Your Coverage
To get the mental health care you need, you must take a few strategic steps.
Start by:
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Confirming that your provider accepts Medicare and is licensed for the type of care you need
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Checking whether your medications are listed in your Part D plan’s formulary
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Tracking your out-of-pocket costs to ensure you don’t exceed budgeted amounts
If you have a Medigap plan or employer coverage, this could reduce or eliminate the 20% coinsurance on Part B services.
Mental Health Preventive Services in 2025
Medicare also includes preventive mental health services designed to identify and address issues early.
What’s included:
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Annual depression screening (free if conducted in a primary care setting)
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Alcohol misuse screening and counseling
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Cognitive assessment for memory issues
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Advance care planning for beneficiaries with mental health concerns
Preventive screenings do not require a mental health diagnosis and often have no out-of-pocket costs.
Common Reasons You Might Miss Out on Covered Care
Many Medicare enrollees unintentionally miss out on therapy because of avoidable missteps or misunderstandings.
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You assume therapy isn’t covered unless you’re hospitalized
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You think only psychiatrists are eligible providers
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You don’t confirm whether your provider accepts Medicare
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You don’t know about the new 2025 coverage updates (like MFTs and telehealth changes)
These mistakes can prevent you from accessing support that’s already available to you.
When You Need Prior Authorization or Special Approval
While most mental health services don’t require pre-approval, some Medicare Advantage plans may require prior authorization for:
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Partial Hospitalization Programs
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Intensive Outpatient Programs
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Certain prescription drugs
This doesn’t apply to Original Medicare, but if you’re in a Part C plan, check the rules before you start treatment.
Get Clear on Medicare’s Mental Health Coverage Today
Mental health is a critical part of your overall well-being, and Medicare is offering more support in 2025 than ever before. But knowing what’s covered—and how to use it—is just as important as having the coverage itself.
Review your options carefully. Ask your provider if they accept Medicare. Confirm your eligibility before making appointments. And don’t wait until a crisis to figure out your benefits.
If you’re uncertain about which services or providers are available to you under your current plan, speak to a licensed agent listed on this website. They can help you better understand your mental health coverage options and help you avoid costly surprises.
