As part of its outpatient mental health benefits, Medicare Part B may cover sessions with a marriage and family therapist (MFT) as long as the therapist is licensed and accepts Medicare.
In the past, MFTs weren’t allowed to bill Medicare directly. But as of 2024, MFTs can legally bill Medicare. This means that if you go to a therapist who accepts Medicare, it is easier for Medicare to cover your treatment.
Read on to learn more about how to get marriage counseling covered by Medicare, the requirements for coverage, your anticipated costs, and more.
Medicare Part B should cover most types of mental health counseling when necessary and reasonable for your diagnosis or treatment. This can include family or marriage counseling.
Under Part B, Medicare doesn’t restrict the frequency or number of sessions you can have.
If you enroll in a Medicare Advantage (Part C) plan instead of Original Medicare (parts A and B), you should get the same coverage. Some plans may even offer additional coverage or benefits that parts A and B don’t cover.
Marriage counseling, like counseling in general, can come in various modalities, including:
- cognitive behavioral therapy
- psychotherapy
- emotionally focused therapy
- the Gottman method
That said, with Part B, you must get counseling from a licensed healthcare professional. This usually means a professional with a master’s degree or PhD or who has graduated from a post-graduate clinical training program.
For them to bill Medicare for your services, the healthcare professional also has to have completed at least 2 years
or 3,000 hours of supervised clinical work.
According to the non-profit organization Mental Health America (MHA), counseling costs between $75 and $200 out-of-pocket without insurance.
That said, your actual cost could be less or more. In addition, under Part B, your costs are divided between your premium, deductible, and copays. Your premium for 2025 starts at $185, though you may pay more depending on your income.
For covered marriage counseling sessions, you’ll need to meet your $257 deductible before Medicare coverage kicks in. Afterward, Part B should pay for 80% of your session costs.
Since private companies manage Medicare Advantage (Part C) plans, their costs will vary depending on the plan you choose in your area.
In addition, you can buy a Medigap plan to help you pay for Original Medicare costs. You cannot have Medigap and Medicare Advantage at the same time.
Is there a way to get free marriage counseling?
You may have resources for free marriage counseling in your area. Look for programs offered by religious institutions like churches or by state organizations.
Does Medicaid cover marriage counseling?
Generally, Medicaid covers mental health counseling. That said, whether it covers marriage counseling specifically depends on the rules in your state.
What is the difference between couples therapy and couples counseling?
Couples therapy helps you work on your relationship, whether you are married or not. Marriage counseling, however, is specifically aimed at resolving problems within a marriage.
In most cases, Medicare Part B should cover mental health counseling if necessary and reasonable for your specific diagnosis or treatment. This can include various forms of counseling, such as family or marriage counseling. You must receive counseling from a licensed healthcare professional who accepts Medicare.
If you choose to enroll in a Medicare Advantage (Part C) plan instead of Original Medicare (parts A and B), you should still have the same coverage for mental health counseling. Some plans may even offer additional coverage.