Key Takeaways

• Medicare now covers a wider range of mental health services, including individual and group therapy, counseling, and treatment by new provider types like marriage and family therapists (MFTs) and mental health counselors (MHCs).

• You have rights under Medicare to access covered mental health care in inpatient, outpatient, and home-based settings, including via telehealth, but it’s your responsibility to ask and ensure your provider accepts Medicare.

Mental Health Support Isn’t Just Optional—It’s a Covered Benefit

If you’re enrolled in Medicare, mental health services are part of your covered benefits. While many people think of Medicare in terms of physical health care, your emotional and psychological well-being is just as important. And in 2025, Medicare’s mental health coverage is stronger than ever.

You have access to a broad range of services to support emotional and behavioral health. This includes counseling, therapy, screenings, crisis intervention, and even treatment for substance use disorders. But understanding what you’re entitled to and how to access it is essential.

The Three Core Parts of Medicare Mental Health Coverage

Part A: Inpatient Mental Health Care

Medicare Part A helps cover inpatient mental health treatment if you need to be admitted to a general hospital or psychiatric hospital.

Covered services include:

• Semi-private room and meals

• Nursing care

• Therapy and medical services

• Medications while you’re an inpatient

There is a 190-day lifetime limit on inpatient psychiatric hospital care. This limit applies only to psychiatric hospitals, not general hospitals.

In 2025, you pay:

• A deductible of $1,676 per benefit period

• Daily coinsurance for longer stays: $419/day for days 61–90; $838/day after 90 days (lifetime reserve days)

Part B: Outpatient Mental Health Services

Most mental health services take place outside the hospital, and Medicare Part B covers them when delivered by a Medicare-assigned provider.

Covered services include:

• Psychiatric evaluations and diagnostic testing

• Individual and group therapy

• Family counseling (when related to treatment)

• Medication management

• Partial hospitalization programs (PHPs)

• Intensive outpatient programs (IOPs)

• Services from new eligible providers like MFTs and MHCs (as of January 1, 2024)

In 2025, after meeting your $257 annual Part B deductible, you usually pay 20% of the Medicare-approved amount for covered services.

Part D: Prescription Drugs for Mental Health

Medicare Part D covers medications prescribed to treat conditions such as depression, anxiety, bipolar disorder, schizophrenia, and more. Coverage depends on your plan’s formulary.

In 2025:

• The maximum annual out-of-pocket cost for prescription drugs is now capped at $2,000.

• Many plans also participate in the new Medicare Prescription Payment Plan, which allows monthly payments spread across the year.

You Can Now See More Types of Mental Health Professionals

One of the most significant changes in Medicare mental health coverage is the inclusion of more licensed providers. Starting January 1, 2024, Medicare expanded its provider eligibility.

Now, you can receive covered care from:

• Psychiatrists

• Psychologists

• Clinical social workers (CSWs)

• Nurse practitioners (NPs)

• Physician assistants (PAs)

• Marriage and family therapists (MFTs)

• Mental health counselors (MHCs)

These additions help fill critical access gaps, especially in underserved communities where specialized providers may be limited.

Telehealth for Mental Health Is Here to Stay

Medicare now permanently covers mental health telehealth visits. You can receive care by video or, in some cases, audio-only communication.

Covered telehealth services include:

• Therapy and counseling

• Psychiatric evaluations

• Medication management

• Group therapy

As of October 1, 2025, Medicare requires that you have one in-person visit every 12 months with your provider for ongoing telehealth services. There are exceptions for those with access challenges or special needs.

Preventive Mental Health Screenings Are Included

You also have the right to preventive care under Medicare. Screenings for depression and other mental health conditions are covered as part of your wellness and annual checkups.

Medicare pays for:

• One depression screening per year in a primary care setting

• Alcohol misuse screening

• Behavioral assessments during your Welcome to Medicare and Annual Wellness Visits

• Suicide risk assessments if your provider recommends it

These services are free to you when delivered by a Medicare-assigned provider.

Coverage for Substance Use Disorders

Mental health coverage under Medicare includes treatment for substance use disorders (SUDs), such as alcohol or opioid use.

You have access to:

• Counseling and therapy sessions

• Medication-assisted treatment (e.g., buprenorphine for opioid use)

• Structured outpatient programs like PHPs and IOPs

• Inpatient detox or stabilization when medically necessary

Providers must be approved and enrolled in Medicare to offer these services. Not all treatment centers accept Medicare, so you must verify this before starting treatment.

Knowing Your Rights as a Medicare Beneficiary

You have the right to:

• Access mental health care from qualified Medicare-enrolled providers

• Receive equal treatment for mental and physical conditions

• Appeal if a service or claim is denied

• Choose providers who accept Medicare assignment

• Use telehealth if appropriate for your condition

Medicare’s Mental Health Parity requires that coverage for mental health be no more restrictive than coverage for other medical conditions. This helps protect you from discrimination and ensures access to necessary services.

Important Limits and Responsibilities

While Medicare provides extensive coverage, there are still important limits and responsibilities you should be aware of:

• Deductibles and coinsurance apply: These are out-of-pocket costs you must pay unless you have other coverage.

• Provider participation matters: Always ask whether the provider accepts Medicare and whether they “accept assignment” to avoid unexpected charges.

• Inpatient psychiatric care limits: Remember the 190-day lifetime cap in psychiatric hospitals.

• No automatic coverage for long-term therapy: Services must be medically necessary and part of a treatment plan reviewed regularly.

Coordination with Other Coverage

Many Medicare beneficiaries have additional coverage that can help with mental health costs:

• Medicare Supplement (Medigap) plans may help pay your Part A and Part B coinsurance and deductibles.

• Employer or retiree coverage may offer broader networks or additional counseling benefits.

• Medicaid, for those eligible, can provide expanded mental health services.

• Medicare Advantage plans are required to cover at least what Original Medicare does for mental health. Some offer extras, but you must check your plan’s evidence of coverage document for specifics.

How to Start Receiving Mental Health Care

To access services, start by:

1. Contacting your primary care provider and requesting a referral or evaluation.

2. Searching the Medicare.gov provider finder tool to locate mental health professionals near you who accept Medicare.

3. Checking your plan’s provider directory if you’re in a Medicare Advantage plan.

4. Scheduling an annual wellness visit, where you can discuss mental health needs.

If you’re in crisis or need immediate emotional support, you can call or text 988, the Suicide and Crisis Lifeline. This service is free, confidential, and available 24/7, though it is not a Medicare benefit.

What to Do if You Face Access Barriers

Despite the improved coverage, some beneficiaries still face challenges, especially:

• Long wait times for appointments

• Shortage of Medicare-participating mental health providers

• Limited local resources in rural or remote areas

In such cases, you can:

• Use telehealth to expand your provider options

• Consider group therapy, which may be more readily available

• Speak with your state health insurance assistance program (SHIP) for help finding resources

• Talk to your plan’s case manager if you’re in a Medicare Advantage plan

Emotional Wellness Is a Medicare Right in 2025

You deserve access to mental health care just like you would for any physical illness. And in 2025, Medicare supports that right through expanded provider access, stronger telehealth benefits, and new drug cost protections.

If you’ve delayed getting help due to confusion, cost concerns, or access issues, now is the time to revisit your options. Use your annual wellness visit as a starting point, and don’t hesitate to seek professional care.

For help understanding your mental health coverage or for assistance in finding a Medicare-assigned provider, get in touch with a licensed agent listed on this website.