Getting Therapy Through Medicare Just Got Easier—If You Know Where to Look

Key Takeaways

• In 2025, Medicare covers a wider range of mental health providers, including marriage and family therapists and mental health counselors.

• While coverage rules are expanding, finding participating providers and understanding what’s included under each part of Medicare still requires effort on your part.

Mental Health Is Now a Medicare Priority

As of 2025, Medicare places greater emphasis on mental health care than it did just a few years ago. The Centers for Medicare & Medicaid Services (CMS) has broadened the scope of mental health services eligible for reimbursement. More types of therapists and treatment settings are covered, and efforts to reduce barriers to access are ongoing.

Yet even with these improvements, access remains uneven. If you’re seeking therapy under Medicare, understanding which services are covered, where to find providers, and how the costs break down is essential.

What’s Covered Under Original Medicare

Medicare divides mental health coverage into different parts:

Medicare Part A: Inpatient Mental Health Care

Part A covers inpatient mental health care you receive in a hospital. This includes:

• Semi-private room, meals, nursing, and medications

• Therapy and psychiatric services during a hospital stay

• Coverage for inpatient care in both general and psychiatric hospitals

Medicare caps coverage at 190 lifetime days for inpatient care in a standalone psychiatric hospital. If you’re treated in a general hospital, this cap does not apply.

Medicare Part B: Outpatient Mental Health Services

This is where therapy and counseling fall for most Medicare enrollees. Part B covers:

• Individual and group therapy

• Family counseling if it helps with your treatment

• Depression and anxiety screenings

• Psychiatric evaluations and medication management

Starting in January 2024, Medicare began covering services from marriage and family therapists (MFTs) and mental health counselors (MHCs). In 2025, these professionals continue to be vital access points for mental health treatment.

Covered providers now include:

• Psychiatrists

• Clinical psychologists

• Clinical social workers

• MFTs and MHCs

• Nurse practitioners and physician assistants trained in mental health

You must ensure your provider accepts Medicare assignment, or you may face higher out-of-pocket costs.

Telehealth Therapy Remains Available

Telehealth expanded rapidly during the pandemic, and Medicare embraced it. In 2025, telehealth remains a covered option for mental health services.

Medicare permanently covers:

• Virtual therapy from eligible providers

• Tele-psychiatry sessions

• Remote evaluations and medication management

Importantly, for mental health telehealth visits, you can receive care from your home. The requirement for in-person visits every 12 months was delayed again, so you may continue therapy sessions remotely without disruptions.

What You Pay for Therapy With Medicare

Understanding your costs helps you plan your care. Here’s how the breakdown looks under Original Medicare in 2025:

• Part B deductible: $257 per year

• Coinsurance: After meeting your deductible, you typically pay 20% of the Medicare-approved amount for therapy

• Medigap policies: If you have a Medigap plan, it may help cover that 20%

If you are enrolled in a Medicare Advantage plan, your costs may differ. These plans must provide the same Part A and B services as Original Medicare, but cost-sharing and coverage rules vary.

Finding a Therapist Who Accepts Medicare

Finding a provider who accepts Medicare remains one of the biggest barriers to mental health care access. While coverage has expanded, the network of participating mental health professionals hasn’t grown as quickly.

To find a therapist who accepts Medicare:

• Use the Medicare Care Compare tool on the official Medicare website

• Search by provider type: psychologist, counselor, therapist

• Contact your local mental health center or primary care doctor for referrals

• Confirm with the provider’s office that they accept Medicare assignment

Some therapists may be eligible providers under Medicare but choose not to enroll. Others may accept Medicare but limit the number of Medicare patients they see.

Medicare Advantage Plans and Therapy Access

If you’re enrolled in a Medicare Advantage (Part C) plan, your mental health benefits must meet at least the standard of Original Medicare. But many plans go further.

In 2025, many Medicare Advantage plans offer:

• Broader therapy networks

• Reduced copayments or coinsurance for outpatient mental health services

• Additional behavioral health support such as coaching or wellness apps

• Care coordination with primary care providers

You should always check your plan’s Evidence of Coverage document to see what’s included and what restrictions apply.

Keep in mind, though, that these plans often use provider networks. If you see a therapist out-of-network, your coverage may be limited or unavailable.

What About Prescription Drug Coverage?

Mental health treatment often includes medication. Medicare Part D (prescription drug coverage) helps pay for antidepressants, antipsychotics, anti-anxiety medications, and mood stabilizers.

In 2025, Part D includes the following updates:

• Out-of-pocket cap: A $2,000 annual limit on out-of-pocket prescription drug costs

• Coverage phases: After you meet your deductible and reach $2,000 in costs, your plan covers 100% of covered drug expenses for the rest of the year

You must choose a Part D plan that includes your prescribed medications in its formulary. Some plans offer medication therapy management (MTM) for those taking multiple drugs for chronic conditions, including mental illness.

Are You Eligible for Therapy Benefits?

Most people become eligible for Medicare at age 65, but younger individuals with certain disabilities or chronic conditions such as end-stage renal disease may also qualify.

To use your therapy benefits under Medicare, you generally need:

• A mental health diagnosis (such as depression, anxiety, PTSD, or bipolar disorder)

• A treatment plan developed by a Medicare-approved provider

• Ongoing therapy that is medically necessary—not simply for life coaching or self-improvement

Preventive screenings for depression are also included, even without a mental health diagnosis, as long as they’re performed in a primary care setting.

How to Get Started With Therapy

Here’s how to begin the process of receiving therapy through Medicare:

1. Get a referral from your primary care doctor (especially if you’re in a Medicare Advantage plan, which may require it)

2. Verify provider eligibility by checking the Medicare provider database

3. Ensure the therapist accepts Medicare assignment to avoid unexpected costs

4. Ask about costs upfront—even with Medicare coverage, you may have out-of-pocket responsibilities

5. Keep documentation—record your appointments, billing, and coverage communications

If you’re unsure where to start, your State Health Insurance Assistance Program (SHIP) can provide free support.

Therapy Support Is Stronger Than Ever, but Still Evolving

While Medicare’s mental health coverage has come a long way, there are still obstacles in your path. Workforce shortages, especially in rural areas, and limitations on telehealth expansion after 2025 remain challenges. But tools and protections available in 2025 give you more power than ever to pursue therapy under your Medicare plan.

Expanded provider options, broader telehealth access, and new cost-sharing limits all add up to a more accessible mental health safety net. The key is knowing where to look and who to ask for help.

Take Control of Your Coverage With Expert Help

You don’t have to figure out Medicare’s mental health benefits on your own. If you’re exploring your options for therapy, counseling, or prescription support, get in touch with a licensed agent listed on this website. They can help you review your plan’s mental health benefits and ensure you’re getting the care you deserve.