Are mental health services like therapy fully covered under Original Medicare?

Question

Steven Bleicher · Accepted Answer

Mental health is covered but it is up to you to review different company policies since they could vary widely from state to state. There is a limited number of days that should be covered. It is incumbent upon you to fully understand those limitations. This is why it is imperative to go over with a knowledgeable agent who can easily differentiate between what an Advantage plan covers vs. what a Med. Suppmt. (Medigap) covers in this extremely important area.

Answered by Steven Bleicher on April 11, 2025

Broker Licensed in AZ

Answered by Steven Bleicher Medicare Insurance Agent

Lt Col Tim Brown · Answer

Mental health is covered under medicare.  Therapy such as physical, speech, etc is covered also.   I hope that answers your question.

James ONeal · Answer

Original Medicare (Part A and Part B) does cover mental health services, including therapy, but not always fully. 

While Medicare Part B covers outpatient mental health services, including psychotherapy, it generally requires deductibles and coinsurance, meaning beneficiaries pay a portion of the cost. 

Additionally, while Part A covers inpatient mental health care, it is subject to benefit periods and may have deductibles and coinsurance costs.

Tammera Marrs · Answer

After a client pays the Part B deductible Medicare will pay 80% of the therapy that is deemed medically necessary. If a client has a Medicare Supplement plan as well as original Medicare a higher percentage of the therapy could be paid. It is always best to check with a provider's office to make sure Medicare has approved the therapy.

Answered by Tammera Marrs on May 5, 2025

Broker Licensed in KS

Answered by Tammera Marrs Medicare Insurance Agent

Michael Ferraro · Answer

Mental health services are covered however there is limitations varied costs depending on the plan.   This should be reviewed with your Medicare broker.

Diana Garner · Answer

No, mental health services are not fully covered by Original Medicare. There are some mental health services covered, but they may be limited, and there are out-of-pocket costs associated.

Paul Wyatt · Answer

Yes, they are covered under Part A and Part B. However, they will likely only be covered at 80% because Original Medicare is 80/20 insurance. You will typically pay coinsurance or a deductible when seeking these services with only Original Medicare.

Answered by Paul Wyatt on August 11, 2025

Broker Licensed in TN, KY, MO & MS

Answered by Paul Wyatt Medicare Insurance Agent

Fred Manas · Answer

No, mental health services like therapy are not fully covered under Original Medicare, but a substantial portion is covered, according to Medicare (.gov). Original Medicare, which includes Part A (Hospital Insurance) and Part B (Medical Insurance), offers coverage for both inpatient and outpatient mental health services, but there are limitations and out-of-pocket costs involved

Answered by Fred Manas on April 14, 2025

Agent Licensed in NY, CT, DC & 7 other states

Answered by Fred Manas Medicare Insurance Agent

Vachik Chakhbazian · Answer

Medicare Part B covers certain outpatient mental health services, there are still out-of-pocket costs like copayments or coinsurance. Original Medicare, which includes Part A and Part B, provides coverage for both inpatient and outpatient mental health services, but it's important to understand that not all mental health treatments are covered without any conditions.

Answered by Vachik Chakhbazian on April 12, 2025

Agent Licensed in CA, AL, AR & 22 other states

Answered by Vachik Chakhbazian Medicare Insurance Agent

Steve Brauer · Answer

This answer is provided in a video format. Watch the agent's video response here: https://medicareagentshub.com/questions/are-mental-health-services-like-therapy-fully-covered-under-original-medicare#steve-brauer

Carol Thompson · Answer

There is mental health coverage but it is not fully covered; it other words there will be some cost sharing.

Sam Silva · Answer

If you’re enrolled in a Medicare Advantage Plan, your costs and coverage may differ, but plans are required to offer at least the same mental health benefits as Original Medicare.

Part B covers outpatient therapy with a 20% coinsurance after you meet the deductible. Inpatient services are covered under Part A but have limits and additional costs.

Karen Ansell · Answer

Mental health therapy is covered inpatient and outpatient at 80% by Medicare leaving a 20% copay and one time deductible of $257.00 in 2025.

David Christian · Answer

Yes, Original Medicare, including Parts A and B, covers SOME mental health services. 

Part A covers inpatient mental health services in hospitals.

Part B covers outpatient services like therapy and counseling. However, there are limitations, and some mental health services are not covered, such as psychiatric rehabilitation, assertive community treatment, or peer support. 

Inpatient Mental Health Services (Part A):
Medicare Part A covers inpatient mental health care in general or psychiatric hospitals.
For psychiatric hospitals, coverage is limited to up to 190 days lifetime.
This coverage includes services like lab tests, medications, nursing care, room fees, meals, and other related services. 

Outpatient Mental Health Services (Part B):
Medicare Part B covers outpatient mental health services, including visits with doctors, therapists, and other mental health professionals.  This includes services like psychiatric evaluation, individual and group therapy, and medication management. It also covers counseling services, diagnostic assessments, and other mental health treatments. 

What's Not Covered:
Some mental health services are not covered by Medicare, such as psychiatric rehabilitation, assertive community treatment, or peer support. Other items not covered include transportation, private rooms (unless medically necessary), private duty nursing, and personal items like toothpaste.

Robert Baez · Answer

Medicare-covered mental health care includes: 
• Services provided by marriage and family therapists, and mental health 
counselors. Partial hospitalization, Intensive outpatient program. Must check with your insurance plan/summary of benefits for more details.

Sonya Chandler · Answer

Generally a person would pay 20% of the Medicare approved amount and the Part B deductible applies for mental health care services.

Andy Kelly · Answer

Yes. Many mental health services are covered under Part B. You must meet your annual Part B deductible and either pay the remaining 20% unless you have a Medigap plan, which in that case, care may be fully taken care of.

Answered by Andy Kelly on June 4, 2025

Agent Licensed in WA & OR

Answered by Andy Kelly Medicare Insurance Agent

Rachael Metcalf · Answer

Yes! On Original medicare you have to meet your deductible which is $257 this year and then after you met it then you would pay 20%. If you were on an advantage plan, there are copays for those services which can range from $15-$35 depending on which plan you are on.

Answered by Rachael Metcalf on April 28, 2025

Agent Licensed in TN, FL, GA & 5 other states

Answered by Rachael Metcalf Medicare Insurance Agent

Calvin Fritz · Answer

1. Outpatient Mental Health Services (Part B)
This includes:

Psychotherapy or counseling (individual and group)
Psychiatric evaluations
Medication management
Depression screenings
Family counseling (if it helps with your treatment)

✅ Medicare pays 80% of the approved amount after you meet your Part B deductible ($257 in 2025).
❌ You pay 20% of the Medicare-approved amount (unless you have a supplement plan).

Robert Vitale · Answer

Yes, Original Medicare does cover mental health services, including therapy, under certain conditions. Medicare Part B covers outpatient mental health services, which includes individual and group psychotherapy with qualified professionals, while Medicare Part A covers inpatient mental health services.

Answered by Robert Vitale on May 21, 2025

Agent Licensed in FL & OH

Answered by Robert Vitale Medicare Insurance Agent

Angel Feliciano · Answer

Under Original Medicare, mental health services, including therapy, are covered, but there are specific details to be aware of:

1. **Coverage for Outpatient Mental Health Services**: Original Medicare (Part A and Part B) covers outpatient mental health services, which include individual and group therapy sessions provided by a licensed psychologist or psychiatrist.

2. **Cost-Sharing**: 
   - You typically pay 20% of the Medicare-approved amount for outpatient mental health services after you have met your Part B deductible. 
   - The deductible for Part B must be met before Medicare starts to pay its share.

3. **Inpatient Mental Health Services**: If you require hospitalization for mental health reasons, Medicare Part A will cover the costs of inpatient care after you meet the deductible. However, there are limits on the number of days covered in a psychiatric hospital (generally up to 190 days in your lifetime).

4. **Preventive Services**: Medicare also covers an annual depression screening as part of its preventive services, which may be beneficial for seniors.

5. **Limitations**: It's important to note that while many mental health services are covered, not all types of therapy or providers may be included. Always check if the provider accepts Medicare and if the services you need are covered.

In summary, while therapy and mental health services are covered under Original Medicare, there are costs involved, and it’s essential to understand your financial responsibilities. If you have any further questions or need assistance navigating your Medicare options, feel free to reach out to us at Feliciano Fiduciary Services!

Are mental health services like therapy fully covered under Original Medicare?

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Are mental health services like therapy fully covered under Original Medicare?

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