Key Takeaways
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In 2025, Medicare offers expanded mental health coverage, including therapy, medication, and preventive screenings.
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Your coverage depends on the type of Medicare you have and whether you meet specific conditions, such as seeing Medicare-approved providers.
Understanding the Scope of Medicare’s Mental Health Coverage
If you rely on Medicare and are facing challenges like anxiety, depression, grief, or other mental health conditions, it’s important to know what kind of support is available to you. In 2025, Medicare includes a broader range of mental health services than ever before. But navigating what’s covered, when it’s covered, and how much you might owe can still feel overwhelming.
Here’s a full breakdown of what you can expect from Medicare when it comes to therapy, medications, preventive care, and psychiatric treatment.
Medicare Part A: Inpatient Mental Health Services
Medicare Part A covers mental health care you receive in a hospital setting. This includes inpatient psychiatric treatment as well as general hospital stays for mental health crises.
What’s Covered
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Semi-private room and meals
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Nursing care and medications administered during your stay
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Therapy sessions (individual, group, or family, as part of your treatment)
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Diagnostic testing and medical evaluation
Lifetime Limitations
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If you are admitted to a psychiatric hospital, you are limited to 190 lifetime days.
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There is no lifetime limit if your care is provided in a general hospital.
Costs in 2025
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Inpatient deductible: $1,676 per benefit period
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Coinsurance: $0 for days 1–60, then $419/day for days 61–90, and $838/day for lifetime reserve days
Medicare Part B: Outpatient Mental Health Care
Part B provides coverage for most outpatient mental health services, which are typically ongoing and less intensive than inpatient care.
Services Covered
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Therapy and counseling (individual and group sessions)
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Psychiatric evaluations
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Medication management
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Partial hospitalization programs (PHPs)
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Intensive outpatient programs (IOPs)
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Family counseling (if it helps with your treatment)
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Telehealth therapy sessions
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Services from licensed clinical social workers, psychologists, psychiatrists, nurse practitioners, and physician assistants
New for 2025
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Medicare now covers services from licensed marriage and family therapists (LMFTs) and mental health counselors (MHCs).
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These services can be accessed in person or via telehealth, depending on provider availability.
Costs in 2025
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Annual deductible: $257
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Coinsurance: 20% of the Medicare-approved amount after deductible is met
Screenings and Preventive Mental Health Services
Medicare Part B also includes a set of preventive services aimed at early detection of mental health conditions.
Covered Screenings
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Annual depression screening: Once every 12 months
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Alcohol misuse screening: Once per year
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Cognitive impairment assessments as part of the Annual Wellness Visit
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Behavioral health risk assessments during your first 12 months on Medicare
These services are provided at no cost to you when performed by a participating Medicare provider and are part of your broader preventive health benefits.
Medicare Part D: Mental Health Medications
Part D helps cover the cost of prescription drugs, including many medications used to treat mental health conditions such as anxiety, depression, bipolar disorder, and schizophrenia.
Drug Classes Typically Covered
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Antidepressants
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Antipsychotics
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Antianxiety medications
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Mood stabilizers
What You Need to Know in 2025
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Annual deductible: Up to $590
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Out-of-pocket cap: $2,000 per year under the new Medicare Part D rules
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After reaching this cap, your plan pays 100% of covered medication costs for the rest of the year
It’s important to verify whether your prescriptions are on your plan’s formulary and whether your pharmacy is in-network.
Medicare Advantage (Part C): What’s Different?
If you’re enrolled in a Medicare Advantage plan, you still receive all services covered under Parts A and B. However, these plans often include additional benefits related to mental health.
Common Additional Features
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Expanded telehealth access
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Wellness programs or care coordination
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Broader networks for behavioral health providers
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Case management services
Points to Consider
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You may be required to get prior authorization for some services.
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Provider networks may be more limited than in Original Medicare.
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Copayments and coinsurance amounts vary by plan.
You should always check your plan’s Evidence of Coverage (EOC) for details.
Accessing Care: Who Can You See?
Not all providers accept Medicare. To ensure coverage, you need to receive care from providers who are approved by Medicare or your Medicare Advantage plan.
Eligible Providers in 2025
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Psychiatrists
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Psychologists
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Licensed Clinical Social Workers (LCSWs)
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Nurse Practitioners
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Physician Assistants
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Clinical Nurse Specialists
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Marriage and Family Therapists (LMFTs)
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Mental Health Counselors (MHCs)
These professionals must be Medicare-enrolled to qualify for reimbursement.
Telehealth Access
Medicare permanently covers mental health telehealth visits via video or audio. However, beginning October 1, 2025, you are required to have an in-person visit once every 12 months with your mental health provider if you use telehealth regularly. Exceptions apply for those in rural or hardship areas.
Partial Hospitalization and Intensive Outpatient Services
If you need structured therapy during the day but don’t require 24-hour inpatient care, Medicare covers two key types of treatment:
Partial Hospitalization Program (PHP)
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Structured, full-day treatment
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Covered under Part B
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Often includes group therapy, medication management, and individual sessions
Intensive Outpatient Program (IOP)
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Less intensive than PHP
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Usually a few hours per day, multiple days per week
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Covered under Part B
These services are covered if they are part of your treatment plan and deemed medically necessary by your provider.
Emergency Mental Health Services
In a mental health crisis, Medicare covers emergency room care and ambulance transportation if necessary.
What’s Covered
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Emergency department evaluation
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Stabilization treatment
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Psychiatric consultation
Standard Part A and Part B cost-sharing applies. If admitted as an inpatient, coverage transitions to Part A.
What Medicare Doesn’t Cover
Despite its progress, Medicare does not cover every mental health-related service.
Exclusions Include:
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Long-term residential treatment centers
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Life coaching or vocational counseling
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Alternative therapies (like acupuncture, unless approved for other conditions)
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Services by providers not enrolled in Medicare
Staying Within Your Rights
As a Medicare beneficiary, you have certain rights:
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You can appeal a coverage denial.
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You are entitled to an Advance Beneficiary Notice (ABN) if a service may not be covered.
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You can ask for a case manager if you’re dealing with complex or multiple mental health needs.
Taking the Next Step to Get Help
Understanding Medicare’s mental health benefits is the first step toward receiving the care you need. Whether you’re exploring therapy for the first time, managing a chronic condition with medication, or recovering from a recent crisis, Medicare in 2025 offers a wide set of tools—but only if you use them.
Always confirm coverage details directly with Medicare or your plan. For personalized help comparing your options, you can speak to a licensed agent listed on this website.
