Does Medicare Cover Marriage Counseling?

Marriage counseling falls within family therapy and mental health care and is covered by Medicare Part B (medical insurance). Medicare extends its coverage to provide support and assistance in fostering healthier relationships and well-being.

Medicare Part B covers 80% of marriage counseling therapy costs when delivered by behavioral health care providers such as psychiatrists, physicians, clinical psychologists, clinical social workers, or nurse specialists.

If you have a Medicare Advantage plan, your coverage will be at least equivalent to Original Medicare, with the potential for additional benefits offered by many Advantage plans.

What is Not Covered?

It is important to note that Medicare generally does not provide coverage for family counseling, couple counseling, or couples therapy with licensed Marriage and Family Therapists (MFTs) unless they are employed by clinical facilities or work at clinical offices of Medicare-eligible practitioners.

However, there is a type of coverage referred to as “incident two coverage,” which requires the presence of a Medicare-eligible mental health professional at the facility during sessions with MFTs. Please be aware that this restriction applies to MFTs and not other therapists.

How Much Does Marriage Counseling Cost?

The cost of marriage counseling can vary greatly depending on several factors, such as the counselor’s qualifications, the length and frequency of the sessions, and the therapy location. Professional marriage counseling costs between $75 to $250 per hour-long session.

If your marriage counseling is covered by Part B, Medicare may cover 80% of the costs as long as you’ve paid your Part B yearly deductible, leaving you with 20% remaining to pay out-of-pocket.

Insurance can often offset some of these costs, but verifying the specifics of your Medicare coverage is essential. Some counseling services also offer a sliding fee scale based on income, which can make therapy more affordable for those on a tighter budget.

Bottom Line

Medicare may cover marriage counseling if it is medically necessary and included in your Medicare Part B plan. Seniors must also remember that not all aspects of counseling may be included, so always check your plan to verify your coverage.

Marriage counseling is essential for seniors as it improves relationship bonds and strengthens them. Counseling helps seniors address issues such as depression and anxiety, and other mental health conditions.

They can provide the necessary support to overcome them. Medicare beneficiaries should always seek counseling when needed, as it’s crucial to achieving a happy and fulfilled life.

Sources: Medicare.orgMedicare.govKFF

FAQs

  • Does Medicare Advantage cover marriage and family counseling?

    Medicare Advantage plans must offer at least the same coverage as Original Medicare, and many MA plans also provide additional benefits. Depending on your plan, you may be able to receive marriage and family counseling services through an in-network provider that Medicare Advantage covers.

Mark Prip

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