Does Medicare Cover Counseling? Guide to Coverage

Greg Wilson

Updated on:

Does Medicare Cover Counseling Guide to Coverage

    Part of getting the most out of your counseling requires having the right insurance. Here is everything you need to know about Medicare and counseling coverage.

    30% of adult Americans suffer from anxiety, and 25% of American adults suffer from depression. Anxiety and depression are both mental health conditions. If you suffer from one disorder or another, you may need to seek counseling.

    A mental health counselor can help you deal with the symptoms of your condition. Yet, understanding what's covered can be challenging when it comes to Medicare and counseling.

    It would help if you didn't have to live with mental health disorder symptoms, regardless of your health insurance. That's why we want to help you navigate the world of counseling coverage while on Medicare. 

    Are you ready to learn how to finally get the counseling services you need with the help of Medicare? Then keep reading for everything you need to know. 

    Medicare and Counseling: Which Services are Covered?

    Whether you have Original Medicare or a Medicare Advantage Plan for inpatient and outpatient counseling services, you're covered. Keep reading for the details about what's covered, what's not, and what you can expect in out-of-pocket costs. 

    Inpatient Services

    Medicare Part A covers inpatient counseling services. Inpatient counseling services include mental health treatment you receive at a psychiatric or regular hospital. 

    Remember that Medicare will only cover 190 days of inpatient care over a lifetime of coverage. After you've used up these days, you may be able to receive additional inpatient care hours. 

    Also, remember that Medicare still requires you to cover some of the costs of inpatient care. You must meet your deductible to receive coverage and, after 90 days, you have to pay coinsurance for the care you receive. 

    Outpatient Services

    Medicare Part B covers outpatient counseling services. Individual counseling, substance abuse treatment, and occupational therapy are all covered under Part B.

    Other types of outpatient counseling covered by Medicare Part B include:

    • Art, dance, or music therapy
    • Family Counseling
    • Psychological tests and lab tests
    • Prescription drugs a doctor must administer for you
    • Training on any medicines you must administer yourself
    • The annual depression screening

    Depending on when you signed up for Medicare, you'll have to pay a 20% coinsurance after meeting your deductible. There's one exception to this: depression screening. Medicare fully covers depression screenings. 

    By now, you may be wondering: what exactly is a counselor under Medicare Part B? A counselor is any health professional who provides mental health services. Psychiatrists, psychologists, social workers, specialized nurses, nurse practitioners, and physician assistants are counselors under Medicare Part B. 

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    Regarding Medicare and counseling, inpatient and outpatient services are covered. However, you'll still have to meet your deductible before Medicare kicks in for either service. You'll also have to pay coinsurance once you do meet your deductible.

    If you qualify for Medicare but don't know where to start, we have licensed insurance agents ready to answer your questions and help you enroll in Medicare Advantage, Medicare Supplement Insurance, and Prescription Part D plans.

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