Coverage by Plan Type
How mental health coverage works under each Medicare plan type.
Original Medicare (Parts A & B)
Partially CoveredOriginal Medicare covers a broad range of mental health services. Part A covers inpatient psychiatric hospital stays (up to 190 lifetime days in a freestanding psychiatric facility, unlimited days in a general hospital). Part B covers outpatient mental health services including therapy, counseling, psychiatric evaluations, and medication management visits: but you pay 20% coinsurance after the Part B deductible.
Medicare Advantage (Part C)
Covered + ExtrasMedicare Advantage plans must cover everything Original Medicare covers, including mental health services. Many plans offer additional benefits such as lower copays for therapy visits, telehealth mental health sessions, and wellness programs. Network restrictions apply: you typically must use in-network providers.
Medigap (Medicare Supplement)
Covers Cost-SharingMedigap plans help cover the 20% coinsurance you owe after Original Medicare pays its share for outpatient mental health services. Plan G, for example, covers the Part B coinsurance entirely after the annual deductible. Medigap does not add new mental health benefits: it reduces your out-of-pocket costs for services Medicare already covers.
Medicare Part D
Covers MedicationsPart D covers most FDA-approved psychiatric medications including antidepressants, antipsychotics, mood stabilizers, and anti-anxiety medications. These drugs are typically in tiers 2 through 4 on the formulary. The 2026 $2,100 out-of-pocket cap is especially helpful for beneficiaries on specialty psychiatric medications.
What Is and Is Not Covered
A complete list of mental health services under Original Medicare.
Individual therapy (psychologist, clinical social worker, therapist)
Group therapy sessions
Psychiatric evaluation and diagnosis
Medication management visits with a psychiatrist
Inpatient psychiatric hospital care (Part A)
Partial hospitalization programs (PHP)
Intensive outpatient programs (IOP)
Substance use disorder treatment
Annual depression screening (preventive, no cost)
Alcohol misuse counseling (preventive, no cost)
Telehealth mental health visits
Custodial care or long-term residential psychiatric care
Marriage counseling or couples therapy
Life coaching or non-clinical counseling
Your Costs for Mental Health in 2026
What you can expect to pay under Original Medicare for mental health services.
| Service | What Medicare Pays | What You Pay |
|---|---|---|
| Outpatient therapy visit | 80% after deductible | 20% coinsurance + $283 deductible |
| Psychiatric evaluation | 80% after deductible | 20% coinsurance |
| Medication management visit | 80% after deductible | 20% coinsurance |
| Annual depression screening | 100% | $0 (preventive) |
| Alcohol misuse counseling | 100% | $0 (preventive) |
| Inpatient psychiatric (general hospital) | Per Part A benefit period | $1,736 deductible per benefit period |
| Partial hospitalization program | 80% after deductible | 20% coinsurance per day |
Medigap Eliminates the 20% Coinsurance
If you have Original Medicare plus a Medigap Plan G, your 20% coinsurance for outpatient mental health visits is covered entirely after the annual Part B deductible ($283 in 2026). For someone attending weekly therapy, this can save over $1,000 per year. Learn more about Medigap plans.
Other Coverage Gaps to Know About
Mental health is one of the few areas where Original Medicare provides meaningful coverage. Dental, vision, and hearing are not covered at all.
Mental Health Coverage in Brandon and the Tampa Bay Area
Local guidance for Hillsborough County and surrounding communities.
Serving Brandon, Tampa, Riverview, Valrico, and Hillsborough County
Brandon and the greater Tampa Bay area have a growing network of Medicare-accepting mental health providers, including therapists, psychologists, and psychiatrists affiliated with BayCare Health System, AdventHealth, and HCA Florida Brandon Hospital. Telehealth has significantly expanded access for residents in Riverview, Valrico, and other Hillsborough County communities who may have limited local provider options.
If you are choosing between Original Medicare with a Medigap plan versus a Medicare Advantage plan for mental health coverage, the key question is whether your current therapist or psychiatrist accepts the plan. Many mental health providers in the Brandon and Tampa area accept Original Medicare but may not be in every Advantage plan's network.
Greg Wohl and the MIP team help Brandon and Tampa Bay area residents compare plans with their specific providers in mind. Call 813-699-5559 for a no-cost consultation.
Frequently Asked Questions
Common questions about Medicare mental health coverage.
Questions About Your Mental Health Coverage?
Whether you are choosing between Original Medicare and Medicare Advantage, or trying to reduce your therapy costs with a Medigap plan, Greg Wohl can help you find the right fit.