Does Medicare Cover Counseling for Depression? What You Need to Know About Getting Help

You've been feeling overwhelmed for months. The sadness won't lift. Your doctor suggests counseling, but you're on Medicare and worried about the cost. Will Medicare cover a therapist? How many sessions can you have? What will you actually pay?

Here's the good news: Medicare covers depression counseling without limiting your sessions. As long as your treatment is medically necessary, you can continue therapy indefinitely. But the system isn't simple, and the rules changed significantly in 2024.

If you're one of the millions of Medicare beneficiaries dealing with depression, you deserve to understand exactly what's covered, who can help you, and what it will cost. This guide breaks down everything you need to know about Medicare's depression counseling coverage—without the confusing insurance language.

What Depression Treatment Medicare Actually Covers

Medicare Part B covers individual therapy, group therapy, and family counseling when the main purpose is treating your mental health condition. This includes all types of evidence-based therapy approaches—whether your therapist uses cognitive behavioral therapy, problem-solving therapy, or other methods. The key is that services must be provided by a Medicare-approved professional and deemed medically necessary.

You also get one free depression screening every year in your primary care doctor's office. According to Medicare.gov, this preventive benefit requires no deductible or coinsurance. The screening takes about 15 minutes and uses standard questionnaires to check for depression symptoms. But here's the catch: it must happen in a primary care setting that can provide follow-up treatment, not at a mental health specialist's office.

For people with severe depression who need more than weekly therapy, Medicare covers intensive programs too. Partial hospitalization programs provide at least 20 hours of treatment per week while you live at home. Intensive outpatient programs, newly covered in 2024, offer at least 9 hours weekly—filling the gap between regular therapy and partial hospitalization.

Medicare also covers psychiatric evaluations, medication management visits with psychiatrists, crisis therapy sessions, and safety planning if you're at risk for suicide. After an emergency room visit for a mental health crisis, Medicare even covers follow-up phone calls to check on you.

Who Can Provide Your Depression Counseling

The biggest change to Medicare mental health coverage happened on January 1, 2024. Medicare added marriage and family therapists and mental health counselors to its covered providers—over 400,000 new professionals who can now treat Medicare patients. This was the first expansion of mental health provider types in decades.

These nine types of professionals can now provide Medicare-covered depression counseling:

• Psychiatrists (medical doctors who can prescribe medication and provide therapy)
• Other physicians, including your primary care doctor
• Clinical psychologists (doctoral-level therapists)
• Clinical social workers (master's level with 2+ years experience)
• Marriage and family therapists (new in 2024)
• Mental health counselors, including licensed professional counselors (new in 2024)
• Psychiatric nurse practitioners
• Clinical nurse specialists in psychiatric and mental health
• Physician assistants working with doctors

The new providers must have master's or doctoral degrees plus at least two years or 3,000 hours of supervised clinical experience. They must accept Medicare's payment rates, which protects you from surprise bills.

This expansion matters because finding a therapist who takes Medicare has been notoriously difficult. Only about 55% of psychiatrists accept Medicare—far lower than other medical specialties. Adding these new provider types gives you many more options for finding help.

What You'll Pay for Depression Counseling

Let's talk real numbers. With Original Medicare in 2025, you'll first pay the annual Part B deductible of $257. After that, you pay 20% of the Medicare-approved amount for each counseling session.

For example, if Medicare approves $150 for a 45-minute therapy session, you pay $30 (20% of $150). If you see your therapist weekly, that's about $120 per month after meeting your deductible. Your monthly Part B premium is separate—that's $185 for most people in 2025, though higher earners pay more.

Here's what makes Medicare different from most insurance: there are absolutely no limits on the number of counseling sessions. Some sources incorrectly claim Medicare has a 20-session limit for mental health—this is false. As long as your provider documents that treatment is medically necessary, Medicare continues covering sessions indefinitely.

The only mental health limit in Medicare is for inpatient psychiatric hospitals—there's a 190-day lifetime limit for freestanding psychiatric facilities. But this doesn't affect outpatient counseling, therapy in general hospitals, or intensive outpatient programs.

Unlike Medicare Advantage plans, Original Medicare requires no prior authorization for mental health services. You don't need permission to start therapy or continue treatment. Your provider simply documents medical necessity in your records.

Getting Therapy from Home: Telehealth Options

The pandemic changed everything about telehealth, and mental health services got permanent improvements that other medical care didn't. You can now receive depression counseling via video or phone from your home permanently, with no geographic restrictions. HHS confirmed these flexibilities are permanent for behavioral health services.

Even better, Medicare allows audio-only therapy sessions using regular phone calls. This recognizes that not everyone has smartphones or reliable internet. Your therapist can provide phone sessions if you can't use or don't want video technology.

But there's an important deadline coming. Starting October 1, 2025, you need an in-person visit within six months before starting telehealth mental health treatment, then at least once per year after that. Congress might extend the current flexibility before then—they've done it repeatedly since the pandemic—but plan for this requirement just in case.

Telehealth therapy costs the same as in-person visits: 20% coinsurance after your deductible. All nine types of Medicare mental health providers can offer telehealth services, including the newly covered marriage and family therapists and counselors.

Original Medicare vs. Medicare Advantage: A Critical Choice

While both Original Medicare and Medicare Advantage must cover depression counseling, how they provide that coverage differs dramatically. This choice significantly affects your access to mental health care.

Original Medicare gives you freedom but no cost protection. You can see any mental health provider in the country who accepts Medicare. No networks, no referrals, no prior authorizations. You pay the standard 20% coinsurance everywhere. This flexibility matters when you're trying to find the right therapist or if you need specialized care. But Original Medicare has no out-of-pocket maximum—your 20% coinsurance continues indefinitely, creating unlimited financial risk if you need extensive treatment.

Medicare Advantage provides cost limits but restricts your choices. Research from KFF shows that 98% of Medicare Advantage enrollees face prior authorization requirements for some mental health services. You might wait days or weeks for approval to start therapy. About 60% of enrollees have zero coverage for out-of-network mental health providers. If you find a therapist you connect with who's outside your network, you could pay 100% of the cost.

Medicare Advantage plans typically charge $30-40 copays per therapy session instead of 20% coinsurance. They cap your annual out-of-pocket costs, usually between $5,000-8,000. Some plans offer extra benefits like transportation to appointments or additional therapy sessions. But their mental health provider networks are often limited, and they pay providers less than Original Medicare, which can affect whether therapists accept your plan.

What Medicare Won't Cover

Understanding what's not covered helps avoid surprise bills. Medicare doesn't cover these services that might help with depression:

Transportation to therapy appointments isn't covered by Original Medicare, though 39% of Medicare Advantage plans offered this in 2022. Support groups for socializing aren't covered—only group psychotherapy that's actual medical treatment. Marriage or couples counseling isn't covered unless it's family therapy primarily for treating your diagnosed condition.

Other excluded services include pastoral counseling, life coaching, vocational training, biofeedback, massage therapy, and home modifications for mental health. Medicare also doesn't cover experimental treatments or services that aren't considered medically necessary.

The 190-day lifetime limit on psychiatric hospital stays only applies to freestanding psychiatric hospitals, not psychiatric units in general hospitals. Still, this limit can create real hardship for people with severe mental illness requiring repeated hospitalizations.

Remember that Medicare Part B doesn't cover most psychiatric medications—you need Part D prescription coverage for antidepressants and other mental health drugs. Even with Part D, you might face prior authorizations and restrictions on certain medications.

Finding a Therapist Who Takes Medicare

Start with your primary care doctor. They often have relationships with mental health providers who accept Medicare and can make warm referrals that get you seen faster. Ask specifically: "Which mental health providers do your other Medicare patients actually see?"

When searching online, remember that providers listed as "accepting Medicare" aren't necessarily taking new patients. Call at least 10 providers from any directory—studies show these lists are wrong about availability up to 50% of the time.

Consider all your options. You might wait months for a psychiatrist, but a clinical social worker or one of the newly covered mental health counselors might see you next week. For depression treatment, research shows therapy with these providers can be just as effective.

Don't forget about telehealth. You can now see providers anywhere in your state, dramatically expanding your options. Many therapists prefer video visits because they're more efficient, and some may have better availability for telehealth appointments.

How a Solace Advocate Helps You Get Depression Treatment

Finding mental health care on Medicare shouldn't be a full-time job, but that's what it can feel like. Solace advocates know which providers actually have openings versus those with endless waiting lists. Through professional relationships, they often know about appointments before they're publicly available.

When Medicare Advantage plans deny or delay authorization for your therapy, Solace advocates handle the appeals. They know the exact documentation needed and the specific language that gets approvals. While you focus on your mental health, they handle the insurance battles.

Advocates attend your appointments virtually, ensuring important details aren't missed when depression affects your concentration. They prepare questions beforehand, take notes during visits, and follow up on treatment plans. They also help coordinate between your therapist, psychiatrist, and primary care doctor—crucial when depression requires both therapy and medication.

If your current therapist doesn't take Medicare or your Medicare Advantage plan drops them from the network, advocates find alternatives quickly. They check if you qualify for financial assistance programs or help you switch to a plan with better mental health coverage during open enrollment.

Perhaps most importantly, advocates prevent treatment interruptions. They track when prior authorizations expire, submit renewals before you run out of sessions, and ensure paperwork problems never stop your care. For someone dealing with depression, having an advocate handle these details can make the difference between consistent treatment and giving up in frustration.

Frequently Asked Questions about Medicare's Coverage of Depression Counseling

How many therapy sessions does Medicare cover for depression?

Medicare has no limit on depression counseling sessions. As long as your provider documents that treatment is medically necessary and you're making progress, Medicare continues covering therapy indefinitely. You'll always pay your 20% coinsurance after the deductible, but there's no session cap like many private insurance plans have.

Can I use online therapy apps like BetterHelp with Medicare?

No, Medicare doesn't cover direct-to-consumer therapy platforms like BetterHelp or Talkspace. However, many traditional therapists who accept Medicare now offer video sessions that Medicare does cover. The key is that your provider must be enrolled in Medicare—commercial therapy apps aren't.

Do I need a referral from my doctor to see a therapist with Medicare?

With Original Medicare, you never need a referral for mental health services. You can call a therapist directly and schedule an appointment. However, if you have Medicare Advantage, your plan might require a referral from your primary care doctor—check your specific plan rules.

What's the difference between seeing a psychiatrist versus a counselor for depression?

Psychiatrists are medical doctors who can prescribe antidepressants and provide therapy, though many focus mainly on medication management. Counselors, social workers, and psychologists provide therapy but can't prescribe medication. For depression, many people see a counselor for regular therapy and a psychiatrist or primary care doctor for medication if needed.

Will Medicare cover therapy if I've been diagnosed with depression in the past but feel fine now?

Medicare covers mental health treatment when it's medically necessary. If you're not currently experiencing symptoms and your provider can't document current medical necessity, Medicare likely won't cover preventive therapy. However, if symptoms return or you're at risk of relapse, coverage would resume. The annual free depression screening can help identify when treatment is needed again.

This article is for informational purposes only and should not be substituted for professional advice. Information is subject to change. Consult your healthcare provider or a qualified professional for guidance on medical issues, financial concerns, or healthcare benefits.

Recommended Reading:

• Finding a Therapist Who Takes Medicare: Why It's So Hard and How to Succeed
• Breaking The Crisis Cycle with Preventive Mental Health Care
• What Should You Do When Your Mental Health Provider Doesn't Return Your Calls?
• How Long Should You Wait for a Psychiatrist Appointment?