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

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

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

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.

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

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.

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.

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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