Make sure your mental health needs are covered.
Medicare can seem complicated, but at SelectQuote, we’ll make it easy, ensuring you find the coverage you’re entitled to. There’s no obligation to enroll.
Medicare Mental Health Therapy and Coverage
Does Medicare cover mental health therapy?
When it comes to Medicare mental health coverage, you can expect Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) to cover many aspects of mental health therapy and hospitalization as long as both the outpatient treatment and inpatient care are done through Medicare-approved providers.
Medicare Mental Health Costs Covered by Part A
Medicare Part A will cover your hospital stay for inpatient mental health care and take care of costs associated with your room, meals, nursing and other related services and supplies. This care can be received in a general hospital or a psychiatric hospital.
Note that there is a lifetime limit of 190 days of inpatient care in a psychiatric hospital. Below is a list of Medicare Part A costs and expenses for mental health care**:- You will owe the Medicare Part A deductible of $1,600 (2023 rate) each benefit period (begins admission day to 60 days since care ended)
- You will pay ZERO coinsurance for inpatient days 1-60
- You will pay $400 coinsurance/day (2023 rate) for days 61-90
- You will pay $800 coinsurance/“lifetime reserve day” (2023 rate) after the 90th day. Lifetime reserve days are where you remain an inpatient beyond the 90-day hospital stay that Medicare covers. Medicare pays for your covered costs, charging you a daily coinsurance amount, for up to 60 of these days in your lifetime.
- You will pay all costs after your lifetime reserve days are used up
- You will owe the Medicare Part A deductible of $1,600 (2023 rate) each benefit period (begins admission day to 60 days since care ended)
- You will pay ZERO coinsurance for inpatient days 1-60
- You will pay $400 coinsurance/day (2023 rate) for days 61-90
- You will pay $800 coinsurance/“lifetime reserve day” (2023 rate) after the 90th day Lifetime reserve days are where you remain an inpatient beyond the 90-day hospital stay that Medicare covers. Medicare pays for your covered costs, charging you a daily coinsurance amount, for up to 60 of these days in your lifetime.
- You will pay all costs after your lifetime reserve days are used up
Medicare Mental Health Costs Covered by Part B
In addition to Part A expenses, you may be required to pay certain expenses associated with Medicare Part B. This could include doctor services, even when you’re a hospital inpatient. Mental health services given outside the hospital—such as visits with doctors, clinical psychologists and clinical social workers—are covered by Part B. Part B may cover services such as:
- Annual depression screenings (one free each year if administered by a Medicare-assigned healthcare provider)
- Certain doctor-ordered tests
- Psychiatric evaluation
- Medication management
- Approved psychotherapy sessions & family counseling
- Partial hospitalization (a structured program of outpatient psychiatric services as an alternative to inpatient mental health care)
- A one-time “Welcome to Medicare” preventive visit, including a review of your possible risk factors for depression
- A yearly “Wellness” visit to talk with your doctor or other healthcare provider about changes in your mental health so they can evaluate your changes year to year
Medicare Part B Costs and Expenses for Medicare Mental Healthcare:
- You will owe the Medicare Part B deductible of $233 (2022 rate)
- You will owe 20% of the Medicare-approved amount of healthcare provider services
- You will owe a possible additional copayment or coinsurance if you receive your services as a hospital outpatient (The amount you pay depends on the service provided but is generally 20% of the Medicare-approved amount)
IMPORTANT: Medicare deductible and coinsurance amounts may vary year to year.
Approved Health Providers and Facilities for Part B Coverage
Part B covers mental health services and visits with these types of health professionals:
- Psychiatrist or other types of licensed physician
- Clinical psychologist
- Clinical social worker
- Clinical nurse specialist
- Nurse practitioner
- Physician assistant
IMPORTANT: Medicare only covers the visits when they’re provided by a health care provider who accepts assignment.
Part B covers outpatient mental health services, including services that are usually provided outside a hospital, such as:
- A doctor’s or other health care provider’s office
- A hospital outpatient department
- A community mental health center
Mental Health Therapy and Medicare Advantage
If you’re enrolled in a Medicare Advantage plan—also known as Medicare Part C—you still get the same coverage listed above, and your plan might include additional benefits such as prescription drug coverage. Offered by private Medicare-approved insurance companies, Medicare Advantage plans must provide at least the same coverage as Medicare Part A and Part B (with the exception of hospice care, which Medicare does cover). You still continue paying your Medicare Part B premium along with any premium the Medicare Advantage plan may charge.
Does Medicare Part D pay for drugs used in mental health treatment?
Medicare Part D plans are required to cover nearly all drugs classified as antidepressants, antipsychotics and anticonvulsants. If considering this option, be sure to check to see what drugs are included in the plan.
Medicare Part D is a voluntary part of Medicare and a plan can be purchased alongside Original Medicare and Medicare Supplement Insurance plans.
Let SelectQuote Help
We can help you better understand your options when it comes to Medicare and mental health coverage. Don’t wait to ensure you’re getting all the benefits you need and deserve—get started today. It’s a free service and there’s no obligation to enroll.
