Navigating Mental Health & Substance Use Disorder Coverage with Medicare
Mental health and substance use disorders affect millions of Americans every year—and for those on Medicare, getting the right support matters. Whether you’re managing anxiety, depression, alcohol use, or other behavioral health challenges, Medicare offers a range of services to help you get the care you need.
Here’s what you should know about your Medicare coverage for mental health and substance use disorder treatment:
What’s Covered?
Outpatient Services:
Medicare Part B helps cover outpatient mental health care, including:
- Individual and group therapy
- Family counseling (if it’s part of your treatment)
- Psychiatric evaluation and diagnostic testing
- Medication management
- Certain preventive services, like depression screenings
Inpatient Hospital Care:
Medicare Part A covers mental health care you receive when formally admitted to a general or psychiatric hospital. You’re covered for:
- Semi-private rooms
- Meals
- Nursing care
- Medications and therapy as part of your treatment plan
Note: Medicare covers up to 190 days of inpatient care in a psychiatric hospital during your lifetime.
Substance Use Disorder Treatment:
Medicare covers medically necessary services for substance use disorders, including:
- Hospitalizations and detox services
- Outpatient therapy and medication-assisted treatment
- Screening and brief interventions
Where to Get Help
You can receive care at various settings, including:
- Hospitals
- Community mental health centers
- Clinics
- In some cases, from your home via telehealth
Important Things to Know
- You may have to meet your deductible and pay coinsurance or copayments.
- Some services require a referral or prior authorization.
- If you’re in a Medicare Advantage Plan, your coverage may differ—check with your plan for details.
Your Mental Health Matters
Taking care of your mental and emotional well-being is just as important as managing physical health. If you or a loved one are struggling, don’t hesitate to reach out for help. Medicare can be a powerful tool in accessing the support you need.
For more details or to explore your specific coverage options, visit Medicare.gov or contact a licensed insurance advisor.