Fair Square Medicare Wordmark

Does Medicare Cover Mental Health?

Mental health stock photo
By Daniel Petkevich
Oct 12, 2022

The Ins and Outs of Mental Health: Costs and Coverage for Different Types of Care

[Note: If you or someone you know is in crisis, call or text 988 or chat at 


(the free and confidential Suicide & Crisis Lifeline). For immediate medical emergencies, call 911.]

Stay Up to Date on Medicare!

Join the Fair Square Medicare Newsletter to stay informed on cost savings, changes to Medicare, and other valuable healthcare information.
Considering the challenges of the last few years, it is important to remember that your healthcare cannot and should not be separated from your mental well-being.
It's normal to feel low every once in a while. But if this sadness — paired with persistent tiredness or a lack of interest — continues for weeks or months, you might consider seeking mental health care.
In honor of World Mental Health Month, let's talk about the importance of mental health care and how to get coverage.
Visual asset.
World Mental Health Day | United Nations

What Is Mental Health?

Mental health refers to our emotional, psychological, and social well-being.
It affects how we feel, think, and act (i.e., how we cope with stress, relate to others, and make decisions).
Good mental health helps us handle stress and navigate life's challenges. But sometimes, keeping our minds healthy is easier said than done.
That's why we have mental health care!

What is Mental Health Care?

Mental health care involves services used to diagnose, treat, and support mental health conditions.
Examples include:
  • Psychotherapy
  • Counseling
  • Inpatient care
  • Support groups
  • Prescription medications

When Should I Seek Mental Health Care?

1. You Need Help Managing a Mental Health Condition

You may benefit from mental health care if you have a mental health disorder that affects your mood, thinking, and behavior — such as:
  • Depression
  • Anxiety
  • Schizophrenia
  • Eating disorders
  • Addictions
Mental health care can help you manage/treat the following symptoms:
  • Feeling sad, hopeless, or worthless
  • Struggling with sleep
  • Feeling confused or disoriented
  • Having trouble concentrating or making decisions
  • Avoiding social situations
  • Having suicidal thoughts
  • Feeling unusually tired
  • Lacking interest in activities you once enjoyed
  • Losing your appetite
  • Abusing alcohol or drugs

2. You Need Help Navigating Life Changes

Mental health care is not only for those with diagnosed mental health disorders.
It also helps individuals dealing with life transitions or situational stress, such as:
  • A career change
  • Moving to a new place
  • Feeling isolated during the COVID-19 pandemic
These situations can happen to anybody — regardless of their mental health status. Many people can benefit from receiving help with unfamiliar or stressful situations.

Does Medicare Cover Mental Health Care?

Original Medicare helps pay for both outpatient and inpatient services, as well as prescription drugs.
If you have a

Medicare Advantage Plan

, you may receive additional services not included in Original Medicare. Check your plan details or talk to your service provider about its specific benefits.

What Services Does Original Medicare (Parts A and B) Cover?

1. Inpatient Mental Health Care

Medicare Part A covers inpatient care — in both general and psychiatric hospitals.
It includes the following services:
  • Semi-private rooms
  • Meals
  • General Nursing
  • Drugs
  • Other hospital services/supplies as part of your inpatient treatment 
However, Medicare doesn't provide coverage for certain inpatient services:
  • Private duty nursing
  • A phone or television in the room
  • Personal items — toothpaste, razors, etc.
  • A private room (unless medically necessary)

2. Outpatient Mental Health Care

Medicare Part B covers outpatient visits to:
  • Clinics or doctors
  • Therapists
  • Psychiatrists
  • Clinical psychologists
  • Clinical social workers
  • Clinical nurse specialists
  • Nurse practitioners
  • Physician Assistants
It also includes the following outpatient services:
  • Depression screening once a year
  • Individual and group psychotherapy
  • Family Counseling
  • Testing to find out if you’re getting the services you need
  • Psychiatric evaluation
  • Medication management
  • Administering prescription drugs that can't be self-administered, like injections
  • Diagnostic tests
  • Partial hospitalization
  • A "Welcome to Medicare" visit — a one-time preventive visit within the first 12 months you have Part B
  • A yearly “wellness” visit
However, Medicare doesn't cover some outpatient services, such as:
  • Meals
  • Transportation
  • Support groups that bring people together to talk/socialize
    • (This is different from group psychotherapy, which is covered)
  • Testing or training for job skills that aren’t part of your mental health treatment
For Medicare to cover your outpatient services, your doctor or healthcare provider must accept the Medicare assignment.
  • This is the agreement between a doctor and Medicare regarding fees
  • A doctor who accepts an assignment agrees to charge you no more than the amount Medicare has approved for that service 

Does Medicare Cover Prescription Drugs for Mental Health?

Yes. Medicare provides prescription drug coverage if you're enrolled in a plan that covers prescription drugs, such as:
  • Medicare Part D
  • Medicare Advantage Plan (that includes prescription drugs)
Medicare drug plans generally cover most antidepressant, anticonvulsant, and antipsychotic medications (with a few


Each drug plan covers the drugs mentioned in its formulary.
  • If your doctor prescribes a medication that your plan's formulary doesn't cover, you can request a

    coverage determination

    (including an exception)
  • Medicare drug plans may change their formulary throughout the year. If you're already taking a drug that will no longer be covered, your plan will notify you in advance
Know your plan’s coverage rules and rights before enrolling in a drug plan. 

Compare various drug plans

to find out which one covers your medications.

Does Medicare Cover Substance Abuse Services?

Yes. Medicare covers screenings, services, and programs for substance use disorder, including:

1. Alcohol Misuse Screening and Counseling

Adults who use alcohol but do not meet the medical criteria for alcohol dependency can get one free alcohol misuse screening each year.
In addition, you can get up to four brief face-to-face counseling sessions per year if your primary care provider determines you are misusing alcohol.
To get coverage, ensure you get counseling in a primary care setting (like a doctor’s office).

2. Tobacco-Use Counseling and Prevention

If you're having difficulty quitting tobacco, Medicare Part B pays for up to 8 smoking and tobacco-use cessation sessions for one year.
A qualified doctor or Medicare-approved practitioner must provide the services.

3. Opioid-Use Treatment Services

Medicare covers treatment services for opioid use disorder, including:
  • Medications
  • Substance use counseling
  • Individual and group therapy
  • Drug testing
  • Intake activities
  • Periodic assessments
  • Opioid antagonist medications
  • Overdose education
To qualify, you must sign up for a program with a Medicare-enrolled provider. Talk to your doctor or visit the

Medicare website

to find the nearest treatment center.

Does Medicare Cover Partial Hospitalization?

Partial hospitalization is a daytime outpatient program that doesn't involve overnight stays.
It's not as involved as inpatient care, but it's more comprehensive than what you'd get in a doctor's or therapist's office.
Medicare may cover partial hospitalization under certain conditions:
  • If your doctor certifies that you would otherwise need inpatient care
  • If the program is provided through a hospital outpatient department or community mental health center
  • If your doctor and the program accept the Medicare assignment

How Much Does Mental Health Care Cost?

Medicare cost depends on the type of mental health service you need and your specific healthcare plan.
Let's dive deeper into the costs for those with Original Medicare:

Cost of Inpatient Services (Medicare Part A)

The exact cost depends on each benefit period.
  • A benefit period begins when you're admitted to a general or psychiatric hospital as an inpatient
  • It ends the day you leave the hospital or after 60 days
The amount you pay for each benefit period in 2023 are as follows:
  • $1,600 deductible
  • Days 1–60: $0 coinsurance per day
  • Days 61–90: $400 coinsurance per day
  • Days 91 and above: $800 coinsurance per each "lifetime reserve day". Lifetime reserve days begin after day 90 for each benefit period (up to a maximum of 60 reserve days over your lifetime)
  • Each day after the lifetime reserve days: All costs
Note: If you're in a psychiatric hospital (instead of a general hospital), Part A only covers 190 days of inpatient services during your lifetime.

Cost of Outpatient Services (Medicare Part B)

Medicare covers 80% of the outpatient costs (after you pay the deductible), so you'll pay 20% (or less). Those with

Medicare Supplement Plans

(Medigap Plans) might pay less than 20% or nothing at all.
However, if you receive your services in a hospital outpatient clinic, you may have to pay an additional copayment or coinsurance.
The exact cost depends on your healthcare plan, whether your doctor accepts Medicare assignments, and which outpatient services you need.
Let's look at some examples:

Costs for Screenings

If your doctor accepts an assignment, Medicare covers 100% of the following services:
  • One depression screening per year (free)
  • Alcohol misuse screening and counseling (free)

Costs for Opioid Use Disorder Services

Once you pay the deductible, Medicare will cover the rest (as long as your provider accepts Medicare).

Costs for Partial Hospitalization

If your doctor recommends partial hospitalization, you'll have to pay for the following:
  • Part B deductible of $226
  • A percentage of the Medicare-approved amount for each service
  • Coinsurance for each day of partial hospitalization services


Age-related health issues, loneliness, and memory loss can make you feel stressed and challenge your mental well-being. Mental health disorders can come in different forms, and if you're struggling to overcome them, don't hesitate to reach out for care.


covers both outpatient and inpatient mental health care, as well as any prescription drugs required for treatment.
If you have any questions or concerns,

Fair Square Medicare

is here to help. Give us a call at 1-888-376-2028.

Stay Up to Date on Medicare!

Join the Fair Square Medicare Newsletter to stay informed on cost savings, changes to Medicare, and other valuable healthcare information.

Recommended Articles

Cover image
The Fair Square Bulletin: November 2023
Nov 15, 2023
Medsupp Thumbnail
Plan G vs. Plan N
Jan 28, 2022
Senior couple going over their finances stock photo
Explaining IRMAA on Medicare
Dec 21, 2022
Model of the lungs with the diseased part stock photo
Does Medicare Cover Ofev?
Dec 2, 2022
Doctor showing patient bone anatomy of skeleton of nose and nasal cavity on skull. Preparing for rhinoplasty surgery, correcting deviated nasal septum, localization of rhinitis, sinusitis in nose stock photo
Does Medicare cover Deviated Septum Surgery?
Nov 18, 2022
Cover image
Does Your Plan Include A Free Gym Membership?
Jul 12, 2023
Medicare Set Aside funds stock image
What Happens to Unused Medicare Set-Aside Funds?
Jan 20, 2023
Cover image
Can I Use Medicare Part D at Any Pharmacy?
Aug 28, 2023
a variety of pills in a daily pill organizer stock image
Does Medicare Cover Vitamins?
Dec 5, 2022
wart on the sole of a white man's foot stock photo
Does Medicare Cover Wart Removal?
Jan 17, 2023
Senior man receiving care from an optometrist stock photo
Does Medicare Cover Cataract Surgery?
Dec 22, 2022
air purifier stock image
Does Medicare Cover Air Purifiers?
Nov 18, 2022
Rattlesnake biting on a hiker's boot stock image
Does Medicare Pay for Antivenom?
Dec 6, 2022
Emergency section of a hospital exterior stock photo
How Does Medicare Pay for Emergency Room Visits?
Nov 21, 2022
Indianapolis skyline at night stock image
13 Best Ways for Seniors to Stay Active in Indianapolis
Mar 9, 2023
Nashville city skyline stock image
14 Best Ways for Seniors to Stay Active in Nashville
Mar 10, 2023
Medicare research stock image
Medicare Consulting Services
Apr 3, 2023
Pre-Existing condition stock image
Can Medicare Advantage Plans Deny Coverage for Pre-Existing Conditions?
Mar 28, 2023

More of our articles

13 Best Ways for Seniors to Stay Active in Columbus

13 Best Ways for Seniors to Stay Active in Jacksonville

14 Best Ways for Seniors to Stay Active in Washington, D.C.

14 Best Ways to Stay Active in Charlotte

2024 Medicare Price Changes

Can Doctors Choose Not to Accept Medicare?

Can I Change My Primary Care Provider with an Advantage Plan?

Can I Choose Marketplace Coverage Instead of Medicare?

Can I Have Two Primary Care Physicians?

Can Medicare Help with the Cost of Tyrvaya?

Do Medicare Supplement Plans Cover Dental and Vision?

Do You Need Books on Medicare?

Do You Need Medigap if You're Eligible for Both Medicare and Medicaid?

Does Medicare Cover a Spinal Cord Stimulator?

Does Medicare Cover Boniva?

Does Medicare Cover Breast Implant Removal?

Does Medicare Cover Cartiva Implants?

Does Medicare Cover Cervical Disc Replacement?

Does Medicare Cover Geri Chairs?

Does Medicare Cover Hearing Aids?

Does Medicare Cover Hepatitis C Treatment?

Does Medicare cover Hyoscyamine?

Does Medicare Cover Hypnotherapy?

Does Medicare Cover Inqovi?

Does Medicare Cover Inspire for Sleep Apnea?

Does Medicare Cover Jakafi?

Does Medicare Cover Kidney Stone Removal?

Does Medicare Cover Linx Surgery?

Does Medicare Cover Macular Degeneration?

Does Medicare Cover Oxybutynin?

Does Medicare Cover Piqray?

Does Medicare Cover PTNS?

Does Medicare Cover SI Joint Fusion?

Does Medicare Cover Tymlos?

Does Medicare Cover Urodynamic Testing?

Does Medicare Cover Xiafaxan?

Does Medicare Pay for Varicose Vein Treatment?

Does Medicare Require a Referral for Audiology Exams?

Explaining the Different Enrollment Periods for Medicare

Fair Square Bulletin: We're Revolutionizing Medicare

Finding the Best Vision Plans for Seniors

Health Savings Accounts (HSAs) and Medicare

How Can I Get a Replacement Medicare Card?

How Do Medicare Agents Get Paid?

How Does the End of the COVID-19 Public Health Emergency Affect Your Medicare?

How Much Does a Pacemaker Cost with Medicare?

How Much Does Rexulti Cost with Medicare?

How Often Can I Change Medicare Plans?

How to Choose a Medigap Plan

How to Deduct Medicare Expenses from Your Taxes

How to Enroll in Social Security

Is Botox Covered by Medicare?

Is Fair Square Medicare Legitimate?

Is HIFU Covered by Medicare?

Is the Shingles Vaccine Covered by Medicare?

Medicare Explained

The Easiest Call You'll Ever Make

The Fair Square Bulletin: July 2023

The Fair Square Bulletin: October 2023

The Fair Square Bulletin: The End of the COVID Emergency Declaration

What Are Medicare Part B Excess Charges?

What Does Medicare Cover for Stroke Patients?

What Is a Medicare Advantage POS Plan?

What is a Medicare Beneficiary Ombudsman?

What Is a Medicare Supplement SELECT Plan?

What Is Medical Underwriting for Medigap?

What is the Medicare ICEP?

What to Do When Your Doctor Doesn't Take Medicare

What's the Deal with Flex Cards?

When Can You Change Medicare Supplement Plans?

When to Choose Medicare Advantage over Medicare Supplement

Why You Should Keep Your Medigap Plan

Your Medicare One-Stop-Shop

Your guide to Medicare Parts A & B, Medicare Advantage, and Medigap. 100% free.
Get the Fair Square Bulletin

Medicare savings tips, helpful guides, and more.


Medicare 101

Current Clients

Medicare Supplement Plans

Medicare Advantage Plans

Fair Square 2023

Terms of Use
Notice of Privacy Practices

Virgil Insurance Agency, LLC (DBA Fair Square Medicare) and www.fairsquaremedicare.com are privately owned and operated by Help Button Inc. Medicare supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. This is a solicitation of insurance. A licensed agent/producer may contact you. Medicare Supplement insurance is available to those age 65 and older enrolled in Medicare Parts A and B and, in some states, to those under age 65 eligible for Medicare due to disability or End-Stage Renal disease. Virgil Insurance Agency is a licensed and certified representative of Medicare Advantage HMO, HMO SNP, PPO, PPO SNP and PFFS organizations and stand-alone PDP prescription drug plans. Each of the organizations we represent has a Medicare contract. Enrollment in any plan depends on contract renewal. The plans we represent do not discriminate on the basis of race, color, national origin, age, disability, or sex. Plan availability varies by region and state. For a complete list of available plans please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov. © 2022 Help Button Inc

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.