Does Medicare cover mental health?

Does Medicare cover outpatient mental health services (therapy, counseling or psychologists)?

Medicare Part B (Medical Insurance) helps cover mental health services you generally get outside of a hospital (clinic, doctor’s office or therapist’s office) and services in a hospital’s outpatient department. Here are some of the outpatient services Part B helps pay for if your doctor or other health care provider accepts assignment:

• A one-time “Welcome to Medicare” preventive visit within the first 12 months you have Part B, which includes a review of your potential risk for depression
• One depression screening each year
• Family counseling (if the main purpose is to help with your treatment)
• Psychiatric evaluation
• Medication management
• Diagnostic tests
• An annual “Wellness” visit, which is a good chance to talk to your doctor or other health care provider about changes in your mental health

Part B may also cover a partial hospitalization program if you meet certain requirements and your doctor certifies you would otherwise need inpatient treatment.

Note: If you have a Medicare Advantage (Part C) plan, it may offer extra benefits like mental health counseling not covered by Original Medicare. Check your plan for details.

Outpatient coverage for mental health providers

Part B covers mental health services with the following providers who accept assignment:

• Psychiatrists
• Clinical psychologists
• Clinical social workers
• Clinical nurse specialists
• Nurse practitioners
• Physician assistants

How much you’ll pay for outpatient services

In general, you pay 20% of the Medicare-approved amount for visits to diagnose or treat your condition after you meet the Part B deductible ($240 in 2024). You pay nothing for a yearly depression screening or alcohol misuse screening and counseling if your doctor or health care provider accepts assignment.¹

Does Medicare cover inpatient mental health?

Medicare Part A (Hospital Insurance) helps cover mental health services in a hospital that requires you to be admitted as an inpatient. You can get these services in a general hospital or a psychiatric hospital that only treats mental health conditions. No matter which type of hospital you choose, Part A will help cover:¹

• A semi-private room
• Meals
• General nursing
• Drugs
• Other hospital services and supplies as part of your inpatient treatment

How much you’ll pay for inpatient mental health services

Medicare measures your use of hospital services (including in a psychiatric hospital) in benefit periods. A benefit period begins the day you’re admitted as an inpatient and ends after you haven’t had any inpatient care for 60 days in a row.¹

Here are the Part A costs for hospital stays in 2024:

• Deductible–$1,632 for each benefit period
• Hospital coinsurance–$0 for the first 60 days of inpatient care each benefit period; $408 per day for days 61–90; $816 per each "lifetime reserve day" after day 90 for each benefit period (up to 60 days over your lifetime)
• Skilled nursing facility (SNF) coinsurance–$0 for the first 20 days of inpatient care each benefit period; $204 per day for days 21–100; all costs for each day after day 100

There’s no limit to the number of benefit periods for mental health care in a general hospital. However, if you get care in psychiatric hospital, Part A only pays for up to 190 days of inpatient psychiatric hospital services during your lifetime.¹

Does Medicare cover prescription drugs for mental health?

Parts A and B don’t include coverage for most prescription drugs. To get coverage for prescription drugs you must join a Part D prescription drug plan. Part D plans are run by private insurance companies, like Humana, that follow rules set by Medicare.¹

Each drug plan can vary in cost and the drugs it covers. Part D plans aren’t required to cover all drugs, but they’re required to cover all (with some exceptions) antidepressant, anticonvulsant and antipsychotic medications.¹

To explore Humana’s list of covered drugs and their costs, see our list of covered drugs for Medicare.

Mental health services not covered by Medicare

Some outpatient and inpatient mental health services are not covered by Medicare, including:¹

• Transportation to or from mental health care services
• A private room (unless medically necessary)
• Private duty nursing
• A phone or television in your room
• Personal items, like toothpaste, socks or razors

Finding a mental health provider that accepts Medicare

The Centers for Medicare and Medicaid Services (CMS) provides an online tool to find mental health providers near you who accept Medicare. Follow these steps to use the tool:

1. Go to this page: Find & compare providers near you.
2. In the MY LOCATION box, enter your Street, ZIP code, City or State.
3. In the NAME & KEYWORD box, enter Mental health services.
4. Click the SEARCH button.

After clicking SEARCH, you’ll be taken to a result page with a map and list of nearby mental health specialists.

Get mental health help now

Mental health conditions can affect anyone at any time. If you or someone you care about is struggling or in crisis, call or text 988, or chat online at 988lifeline.org. You can talk to a trained crisis counselor 24 hours a day, 7 days a week in the U.S.

For more information about Medicare mental health benefits and coverage, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227) (TTY: 1-877-486-2048).