Does Medicare Cover Family Counseling? 

Families can go through stress and trauma that affects the relationships within it. Psychotherapy, known as talk therapy, may be able to help resolve issues and improve communication. What does it include? Psychotherapy could involve conversations in a group setting with a mental health professional structured to help you recognize and change unhealthy behaviors, thoughts and emotions. Family therapy is group psychotherapy that can improve communication and behaviors in familial relationships. 

Generally, counseling is a short-term treatment honing in on a particular situation, such as marital issues. Psychotherapy is an in-depth, long-term treatment addressing a mental health condition. When canvassing therapists or counselors, it’s a good idea to ask about their experience, recommended approach, and time commitments expected of you and your family. 

If you have Medicare, you may be wondering what covered counseling services may be available.

Mental healthcare providers

Finding a health professional experienced in the specific counseling you need is essential. Family therapy or counseling professionals include a clinical psychologist, social worker, mental health counselor (MHC) and psychiatrist. Psychiatrists can have specific areas of specialty like geriatric mental health or addiction. Look for a state-certified and licensed therapist with expertise in your areas of concern. For example, if you are seeking therapy with a romantic partner, you may search for a marriage and family therapist (MFT).

Outpatient mental healthcare

Medicare Part B covers family therapy under the outpatient mental healthcare benefit. In addition to family counseling, outpatient mental health services include an annual depression screening, individual and group psychotherapy, psychiatric evaluation and substance abuse treatment. 

The treatment setting may be a healthcare provider’s office or a hospital outpatient department. Qualified Medicare providers include psychiatrists, clinical psychologists, clinical social workers, nurse practitioners, clinical nurse specialists and physician assistants.

Your cost is 20% of the Medicare-approved amount after you meet the Part B deductible. Hospital outpatient settings may charge an additional amount for a copayment or coinsurance that you pay the hospital. If you have purchased a Medigap plan or are enrolled in a Medicare Advantage plan, you may have help paying some of these out of pocket expenses.

How to find family counselors

The official government Medicare website offers a provider locator. Type your zip code and provider type. To filter your search further, type a keyword like psychiatry, psychologist or social worker. Also, your primary care physician may have a recommendation to offer. A local professional psychological association can serve as another resource for you.

Many Americans live in areas with limited mental health access. Organizations like the American Counseling Association and the American Association for Marriage and Family Therapy have been working to change that.

At the end of 2022, Congress passed the Mental Health Access Improvement Act to enable licensed professional counselors (LPCs) and marriage and family therapists (MFTs) to sign up as Medicare providers. LPCs and MFTs will also be eligible to enroll as network providers for Medicare Advantage plans. However, it will take about a year to set up internal systems and establish regulatory language to complete the process. Look for these changes in 2024.

Support in a crisis

Sometimes, when families are in crisis, it’s good to know counselors are available 24/7. The Suicide and Crisis Lifeline number is 988, and the online chat tool is accessible through 988lifeline.org.

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