Medicare mental health coverage includes inpatient services, outpatient services, and partial hospitalization.
Original Medicare (parts A and B) covers mental health care, including inpatient services, outpatient services, and partial hospitalization.
Medicare Advantage (Part C), prescription drug coverage (Part D), and supplemental Medicare insurance (Medigap) may provide additional coverage.
Part A
Part A covers mental health services related to your inpatient hospital stays. This type of treatment may be especially important for people experiencing a mental health emergency.
With Part A, you’re covered for the cost of the room. Part A is also good for covering:
- standard nursing care
- inpatient therapy
- lab testing and some medications
Part B
Part B covers mental health services related to your outpatient treatment, including intensive outpatient treatment programs and yearly depression screenings. This type of treatment is important for anyone who needs ongoing mental health support.
Part B is good for:
- general and specialized counseling appointments
- psychiatry appointments
- clinical social worker appointments
- diagnostic lab testing
- certain medications
- intensive outpatient care, also known as partial hospitalization, including treatment for substance use disorder
Part B also covers one annual depression screening, with additional coverage for follow-up appointments or referrals to other mental health specialists.
Other parts of Medicare
Although parts A and B cover most of your mental health needs, you can get additional coverage by enrolling in the following Medicare plans:
- Part C: It automatically covers all Part A and Part B services, plus prescription drugs and other coverage areas.
- Part D: It can help cover some of your mental health medications, including antidepressants, anti-anxiety medications, antipsychotics, mood stabilizers, and more.
- Medigap: It can help cover some fees associated with your inpatient or outpatient care, such as coinsurance and deductibles.
If you’re looking for mental health treatment, visit the Substance Abuse and Mental Health Services Administration’s website to find behavioral health treatment services near you.
You must have Part A to be covered for inpatient mental health treatment at a general or psychiatric hospital.
Medicare will pay for most of your inpatient treatment services. However, you may still owe some out-of-pocket costs depending on your plan and the length of your stay.
Here are the basic costs for Part A in 2024:
- $278 to $505 premium, if you have one
- $1,632 deductible for each benefit period
- 20% of all Medicare-approved costs during the stay
- $0 coinsurance for days 1 through 60 of treatment after you pay your deductible
- $408 coinsurance per day for days 61 through 90 of treatment
- $816 coinsurance per day for days 91 through 150 of treatment while using your 60 lifetime reserve days
- 100% of the treatment costs for days 151+
It’s important to note that while there’s no limit to how much inpatient care you can receive in a general hospital, Part A will only cover up to 190 days of inpatient care in a psychiatric hospital.
You must have Part B to be covered for outpatient mental health treatment, partial hospitalization, and annual depression screenings.
Medicare will cover most of your outpatient treatment services, but there are certain financial requirements you must meet before Medicare can pay.
Here are the basic costs for Part B in 2024:
- $174.70+ premium, if you have one
- $240 deductible
- 20% of all Medicare-approved costs during your treatment
- any copayment or coinsurance fees
There’s no limit to the frequency or number of sessions that Medicare will cover for outpatient mental health counseling.
However, because there are out-of-pocket costs associated with these services, you’ll have to review your own financial situation to determine how often you can seek treatment.
If you’re looking to begin counseling or therapy appointments under your Medicare plan, here is a list of mental health care professionals that Medicare approves:
- psychiatrist or doctor
- clinical psychologist, social worker, or nurse specialist
- nurse practitioner
- physician assistant
- marriage and family therapist
- mental health counselor
There are many types of mental health specialists that you can visit for help. If you’re unsure who to see, talk with a general physician or primary care professional about which specialist may be best for you.
If you have Original Medicare or Medicare Advantage, you’re covered for both inpatient and outpatient mental health services. This includes hospital stays, therapy appointments, intensive outpatient care, yearly depression screenings, and more.
Some costs are associated with these services, so it’s important to choose the best Medicare plan for your needs.