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Medicare Coverage for Marriage and Family Counseling


Marriage and family counseling can be helpful, but does Medicare cover this service? While these services are beneficial, Medicare will only cover under specific circumstances. For example, the service needs to be part of the treatment for mental illness. We’re going to help by you understand coverage by answering some of the most frequently asked questions about marriage and family counseling from others on Medicare.

Does Medicare Cover Marriage and Family Counseling?

Family counseling has coverage through Part B. Marriage counseling is a type of family counseling. Therefore, references to family counseling include marital counseling. But, Part B will cover counseling and other psychotherapy services that treat a mental illness issue. So, coverage requires counseling to be part of the patient’s mental health treatment. Meaning, the patient must have a mental health condition, such as depression or anxiety.

For Part B to cover the counseling, you must see a professional that accepts Medicare. Going to a doctor that doesn’t accept Medicare will mean you pay the full cost of care. Outpatient mental health services medicare covers include family therapy to help you through treatment.

If you get treatment from any of the following professionals, you have coverage:

  • Clinical psychologist
  • Psychiatrist or doctor
  • Clinical social worker
  • Clinical nurse specialist
  • Nurse practitioner
  • Physician Assistant

Also, the facility where the service takes place must accept Medicare assignment. Otherwise, there is no coverage for the service and you pay the full price of care.

Counseling is available in any of the following settings:

  • The professional’s office
  • The outpatient department of a hospital
  • A community mental health center
  • Virtually, as telehealth counseling

Does Medicare Pay for Marriage and Family Counseling?

Part B pays a portion of marital and family counseling costs to treat mental health. So, yes, Medicare will pay some of the costs. Now, you can sign up for a Medigap policy that would pick up the balance you’d otherwise pay. Depending on the policy you select, you may only pay a deductible. The cost of family therapy, without Medicare, usually ranges between $75-$150 an hour. And, most therapists suggest one hour sessions each week for three months. Although, it really depends on your specific needs and care plan.

FAQs

Does Part B cover marriage and family counseling?
Part B covers family counseling. Family counseling includes marriage counseling. The purpose of the counseling must be to improve the patient’s mental health, and the provider must accept Medicare assignment. A professional must administer the counseling service to obtain coverage.
Does Medicare Advantage cover marriage and family counseling?
Advantage plans must provide the same benefits as Part A and Part B. This means the Part B benefits that cover marital and family counseling are also available with an Advantage plan. If you’re on medication for depression, anxiety, or another mental health condition, an Advantage plan might also include Part D. Make sure to check the formulary to ensure it includes your prescriptions before signing up for a plan.
Can a Licensed Marriage Family Therapist bill Medicare?
A Marriage and Family Therapist is a counselor who holds a Marriage and Family Therapy license in their state. When a Marriage Family Therapist is a private practitioner, they’re unable to bill Medicare. However, if the Marriage Family Therapist is on staff at a practice that accepts Medicare assignment, services within the legal scope can be covered.

How to Get Help Paying for Marriage and Family Counseling with Medicare

If you have Medicare and want help paying for your counseling services, we’re here to help you find the right policy. A Medigap policy will allow you to pay little to no costs outside your premium. Medigap coverage can help you afford the cost of counseling, doctor visits, and more.

Give us a call at the number above. We’ll connect you with an agent that can help you find the best policy in your area. Our agents go over everything you need to know about Medicare and ensure the policy you select is a perfect match. Also, if you prefer to do the research yourself, you can discover rates online today.

Lindsay Malzone

Lindsay Malzone is the Medicare expert for MedicareFAQ. She has been working in the Medicare industry since 2017. She is featured in many publications as well as writes regularly for other expert columns regarding Medicare. You can also find her over on our Medicare Channel on YouTube as well as contributing to our Medicare Community on Facebook.

2 thoughts on “Medicare Coverage for Marriage and Family Counseling

  1. Hi my name is Lourdes I am in desperate need of a Marriage Therapist. I can’t seem to find anyone that takes Medicare.

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