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Medicare and Counseling

Declining health coupled with the challenges faced during the treatment of chronic diseases can put patients, especially elderly, at risk of depression and anxiety.

If you are struggling with a constant feeling of sadness and hopelessness or thoughts of suicide, you must speak to your doctor who may advise you counseling by a psychiatrist.

Fortunately, Medicare covers several treatments offered to improve the mental health of patients. Here is a brief discussion about whether Medicare covers counseling and the other treatment options related to the same.


Will Medicare help cover counseling?

Counseling is an integral part of preventive care that can help identify patients who could be at risk of mental health issues. A timely diagnosis of the deteriorating mental health and regular counseling can prevent the condition from worsening.

Medicare Part B covers mental health as it is considered preventive service. The coverage includes the costs of initial screenings to access the risk of certain mental health conditions.

Medicare covers the following mental healthcare benefits:

  • Annual depression screening: Medicare covers one evaluation for depression in a year provided the physician accepts Medicare assignment.
  • ‘Welcome to Medicare’ visit: it is an introductory preventive visit, which includes a review of the patient’s risk for depression. The test is conducted within the first year of signing up for Medicare.
  • Alcohol misuse screening: Medicare covers one screening for alcohol misuse per year. All Medicare enrollees including those who are not alcohol-dependent are qualified for this coverage. Alcohol-dependent patients would receive coverage even for counseling.
  • ‘Wellness’ visit: under this benefit, your doctor would evaluate your mental and physical health at an annual visit giving you an opportunity to discuss your mental health concerns. The doctor may make recommendations for counseling or additional treatments based on your risk factors.

Out-patient Medicare mental health coverage

Medicare Part B covers mental health services offered on an out-patient basis in the clinic or therapist’s office. Counseling services, including any diagnostic test, are covered by Medicare. The benefits may include:

  • Individual therapy
  • Psychiatric evaluation and tests
  • Group therapy
  • Family counseling, when the goal of the treatment is to improve the patient’s health
  • Up to four sessions of alcohol abuse counseling

Additional eligibility requirements might apply in some cases to qualify for the coverage of these mental health treatments. Some forms of counseling are not covered by Medicare such as marital counseling and counseling with a pastor.

Only those mental health services that are received through a clinical psychologist, licensed psychiatrist or a registered healthcare expert who accepts Medicare assignment are covered by Medicare.

In-patient Medicare mental health coverage

If the patient needs to be admitted in a hospital, the mental health services provided during hospital stay would be covered by Medicare Part A.

There is a cap on the Medicare coverage for in-patient counseling services when the patient stays at a psychiatric hospital. Medicare Part A would cover the in-patient psychiatric care for up to 190 days in the patient’s lifetime.

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