Does Medicare cover therapy? What about other kinds of mental health treatment? How can you find a therapist, psychologist, or other provider who accepts Medicare?
While many resources dealing with insurance are cumbersome and dense, find answers below in fast-fact format.
Note: for the most accurate information or detailed guidance, visit Medicare.gov, or call 1-800-MEDICARE (1-800-633-4227).
Most mental healthcare coverage falls under Medicare Part B.
For free, each year, you can receive a depression screening through your primary care office.
Most other mental health benefits are available through Medicare providers for a small cost (consisting of your coinsurance and/or deductible). These benefits include:
After you’ve met your yearly “deductible,” (or maximum responsibility) you are only responsible for 20% of the cost of covered services. In the year 2020, the deductible under Medicare Part B was $198, but this amount may change from year to year.
If you feel you need more intensive mental health care, Medicare Part B does not usually cover inpatient mental health services. With a doctor’s approval, your Part B coverage should apply to “partial hospitalization,” which Medicare.gov defines below:
“Partial hospitalization is a structured program of outpatient psychiatric services provided to patients as an alternative to inpatient psychiatric care.”
On the other hand, Medicare Part A does cover inpatient hospitalization.
While not all therapists and clinical psychologists accept medicare, you might be surprised to learn that clinical social workers and clinical nurse specialists are required to “accept assignment”–meaning that they have made an agreement they will only bill you what Medicare approves as part of your deductible or coinsurance.
In addition to therapists, clinical psychologists, and LCSWs, you can also receive care from participating nurse practitioners (NPs), physician assistants (PAs), or primary care physicians.
On the Medicare.gov “Find Care Providers” page, select Provider Type “Doctors & clinicians,” then type any of the following search terms:
Once you’ve found a provider you’d like to see, be sure to confirm with them that they “accept Medicare assignment,” and ask them about the amount they bill Medicare.
Again, if you haven’t met your deductible yet, you will be responsible for this full cost. Once you’ve paid the amount of your deductible, you will only be responsible for 20% of the cost of each service.
Therapy can be a major pillar in later-life wellness, and if you can get coverage from your insurance, you should try to do so by all means! However, if you prefer not to go a clinical route, you’re not out of options. Consider chatting with peers–for instance, using a peer-to-peer mental health service like Supportiv.