Medicare covers a range of mental health services. This includes therapy, evaluation, medication management, and hospitalization. Your coverage and costs depend on the type of service you need.
For those who qualify for Medicare, choosing the right plan can help support their care and treatment. Medicare coverage can also help offset some of the high costs of prescription drugs and therapy.
Here are the questions to ask when selecting a Medicare plan if you are living with a mental health condition.
If you’re looking to see a counselor, Medicare Part B (medical insurance) covers outpatient mental health services, including services from psychiatrists, clinical psychologists, and clinical social workers.
For Medicare to cover the cost of seeing a healthcare professional, they must accept assignment and be in network.
Healthcare professionals, like clinical social workers and clinical nurse specialists, often accept assignment. Deductibles and copays may still apply, even if your healthcare professional accepts assignment.
Important terms
What does it mean for Medicare to accept assignment?
An assignment is an agreement between Medicare and a health professional, binding the health professional to accept the payment Medicare approves for a certain service. The health professional must not charge you more than the Medicare deductible and coinsurance.
Not all healthcare professionals accept assignment, so it’s important to ask your doctor if they do or to look for a doctor who does.
What does it mean to be in network or out of network?
When a healthcare professional, hospital, or pharmacy is part of a Medicare plan, they are considered in network.
If you want to be evaluated for a mental health condition, some outpatient services that Medicare covers include:
- psychiatric evaluation
- yearly depression screening
- substance use disorder screening
- cognitive assessment
- developmental and neurobehavioral testing
- various diagnostic psychological and neuropsychological tests.
A Medicare Advantage (Part C) plan may offer additional benefits, such as certain types of counseling.
Original Medicare (parts A and B together) doesn’t cover prescription medications.
But if you need coverage for your prescription medications, such as antidepressant medications, for example, consider getting Medicare Part D, which is prescription drug coverage available as an add-on to Original Medicare.
You can instead choose a Medicare Advantage plan that includes psychiatric drugs. Each drug plan has a formulary, which is a list of the medications it covers.
Generic drugs usually cost less than brand-name ones. Medicare Part D covers medications such as:
- antidepressants
- anti-anxiety medications
- antipsychotics
- mood stabilizers
Original Medicare pays for 90 days of inpatient hospitalization during each benefit period. This includes hospitalization in a general hospital with a psychiatric unit or a dedicated psychiatric hospital.
Medicare beneficiaries who need to be in a hospital for more than 90 days in a benefit period can use some of their 60 lifetime reserve days.
Coverage includes semiprivate rooms, meals, nursing care, medications administered in the hospital, and other necessary treatments and supplies.
In some cases, you could be admitted to a general acute care hospital, even if the hospital doesn’t have a specialized psychiatric unit. In this case, coverage follows the same guidelines as any other inpatient care at the hospital.
Your costs depend on the part of Medicare providing coverage. The costs for 2025 are as follows:
| Part A (hospital) | Part B (medical) | |
|---|---|---|
| Premium | $0 for most people | $185/month |
| Deductible | $1,676 | $257 |
| Out-of-pocket | Days 1-60: $0 after deductible. Days 61-90: $419/day Days 91-150: $838/day After day 150: 100% of the cost | 20% of the cost after deductible |
The costs of Part D and Medicare Advantage plans vary by plan.
Does Medicare cover substance use disorder treatment?
Original Medicare also covers inpatient and outpatient treatment for alcohol use and substance use disorders. Medicare Part A pays for inpatient substance misuse treatment, and Medicare Part B pays for outpatient substance misuse treatment.
Learn more about Medicare coverage for the treatment of substance use disorders.
Does Medicare Advantage cover mental health services?
Medicare Advantage plans generally offer the same benefits as Original Medicare and, depending on the plan, someadditional benefits.
Who qualifies for Medicare mental health services?
Generally, older adults 65 years old or older or those who are younger but living with certain health conditions or disabilities qualify for Medicare coverage.
Learn more about enrolling in Medicare if you’re under 65 years old.
How many therapy sessions does Medicare cover?
Currently, Medicare doesn’t have a set limit on the frequency or amount of mental health counseling sessions you can get.
Medicare can help you pay for mental health care and treatment. It is important to confirm that your healthcare professionals are in-network and accepting assignments to cover your treatments.
If you have questions about Medicare coverage for mental health services, call 800-MEDICARE or contact your plan provider.