Yes, Medicare Covers Mental Health—But There Are Some Catches You Should Know

Key Takeaways

• Medicare does cover a wide range of mental health services in 2025, including therapy, psychiatric evaluations, and hospital stays.

• However, there are restrictions on provider types, coverage limits, and out-of-pocket costs you should understand before relying on it.

What Mental Health Services Are Covered by Medicare?

Medicare provides mental health coverage through both Part A and Part B, with additional prescription drug benefits through Part D. Each part plays a different role in your mental health treatment plan.

Medicare Part A

Part A covers inpatient mental health services, which include:

• Hospital stays in a general or psychiatric hospital

• Semi-private room, meals, and nursing care

• Medications and therapy provided during your stay

For 2025, Part A has a deductible of $1,676 per benefit period. You can receive up to 190 days of care in a psychiatric hospital over your lifetime. General hospital stays for mental health do not count toward that limit.

Medicare Part B

Part B helps with outpatient mental health care, including:

• Individual and group therapy

• Psychiatric evaluations and diagnostic testing

• Medication management

• Certain preventive screenings for depression or substance use disorders

The annual Part B deductible is $257 in 2025, after which you typically pay 20% of the Medicare-approved amount for covered services.

Medicare Part D

Part D covers prescription medications for mental health conditions, such as:

• Antidepressants

• Antipsychotics

• Anti-anxiety medications

You must be enrolled in a Part D plan to receive this coverage. In 2025, the maximum deductible for Part D is $590. After reaching the annual out-of-pocket cap of $2,000, your medications are fully covered for the rest of the year.

Who Can Provide Mental Health Care Under Medicare?

Medicare only covers mental health services if they are provided by eligible professionals. In 2025, Medicare recognizes the following:

• Psychiatrists and other medical doctors

• Clinical psychologists

• Clinical social workers

• Nurse practitioners

• Physician assistants

• Marriage and family therapists (MFTs) and mental health counselors (MHCs)

Make sure your provider accepts Medicare assignment. If not, you could be responsible for higher out-of-pocket costs or denied coverage.

Where You Can Receive Care

Medicare mental health coverage depends not only on the provider but also the setting. You can receive treatment in a range of locations:

• Doctor’s or therapist’s office: Common for talk therapy and evaluations

• Hospital outpatient departments: Good for coordinated care and specialized services

• Community mental health centers: Often used for intensive services and group sessions

• Inpatient psychiatric hospitals: Used for severe episodes requiring 24/7 care

Each setting has its own cost structure. For example, you may pay different coinsurance for outpatient hospital departments than for a therapist’s office.

Preventive Mental Health Screenings

Preventive care is a key part of Medicare’s mental health approach. These screenings are covered once every 12 months:

• Depression screening (must be done in a primary care setting)

• Alcohol misuse screening

• Annual wellness visit with a cognitive assessment

There is no cost to you for these services if the provider accepts Medicare. They are designed to catch early signs of mental health conditions and support early intervention.

Telehealth Options Are Still Available

In 2025, Medicare continues to support telehealth for mental health services. You can access eligible mental health professionals remotely if:

• You’ve had an in-person appointment with the provider within the last six months

• You maintain regular in-person contact at least once every 12 months

Telehealth services are available for therapy, psychiatric follow-ups, and consultations. Standard Part B costs apply.

Understanding Out-of-Pocket Costs

While Medicare helps cover mental health services, there are still out-of-pocket costs you need to be aware of:

• Deductibles: Part A ($1,676), Part B ($257), Part D (up to $590)

• Coinsurance: Usually 20% under Part B

• Copayments: May apply for prescription drugs and outpatient hospital services

These costs can add up, especially for those receiving ongoing or intensive mental health care.

What Medicare Doesn’t Cover

Some mental health services are excluded from Medicare coverage in 2025. These include:

• Non-medical counseling (life coaching, career counseling)

• Services provided by non-Medicare-approved providers

• Custodial care in assisted living or nursing homes

• Over-the-counter medications or supplements for mental health

Always check with a licensed agent or your plan’s customer service to verify whether a specific service or provider is covered.

Limits on Inpatient Mental Health Care

One of the most important limits to understand is the 190-day lifetime cap for inpatient care in psychiatric hospitals. Once you reach this limit, Medicare will not pay for additional psychiatric hospital stays unless they occur in a general hospital.

This limit only applies to psychiatric facilities, not to general hospitals that treat mental illness. If your treatment plan may require more than 190 days over your lifetime, discuss alternatives with your care team.

Coordination With Other Insurance or Assistance Programs

If you have other forms of coverage, they may work with Medicare to reduce your mental health expenses:

• Medicaid: May help pay for copayments or cover services not included in Medicare

• Employer or retiree insurance: Can coordinate to reduce your out-of-pocket costs

• Medicare Supplement Insurance (Medigap): Helps pay for deductibles and coinsurance

You must be enrolled in both Medicare and the other program for coordination to apply. Not all plans cover mental health the same way, so confirm details in writing.

Getting Prescription Drugs for Mental Health Conditions

Mental health conditions often require long-term use of medications. Under Medicare Part D in 2025:

• Plans must include most antidepressants, antipsychotics, and anticonvulsants in their formularies

• Prior authorization or step therapy may still be required for some medications

• You can appeal a denial if your medication is not covered or if the cost is too high

Work closely with your provider and pharmacist to ensure your prescriptions are covered and filled without disruption.

Planning for Long-Term Mental Health Care

If you require continuous support, such as therapy or medication over several years, planning ahead is essential. Here are a few things to keep in mind:

• Budget for annual deductibles and ongoing coinsurance

• Reassess your provider network each year during the fall Medicare Open Enrollment (October 15 to December 7)

• Ask your provider to document the medical necessity of long-term care to support coverage

Medicare may not cover all aspects of your long-term care needs, so reviewing your plan regularly can help you stay prepared.

Why Knowing These Details Matters

Mental health is as important as physical health, but the coverage landscape can be more complicated. Understanding what Medicare includes—and where it draws the line—can help you:

• Avoid surprise costs

• Choose providers who meet Medicare requirements

• Ensure continuity in your treatment

• Use preventive services to stay well

Not being informed can lead to unnecessary expenses or gaps in care that are avoidable with the right information.

Make Informed Decisions About Your Mental Health Coverage

Medicare offers a valuable foundation for mental health services, but it isn’t perfect. Between coverage limitations, provider rules, and cost-sharing responsibilities, it’s crucial to stay informed and proactive. If you’re unsure how to apply these rules to your situation, get in touch with a licensed agent listed on this website for professional advice tailored to your needs.