Does Medicare cover inpatient mental health care?

What inpatient mental health care does Medicare cover?

Medicare Part A (Hospital Insurance) covers mental health care services you get when you're admitted as a hospital inpatient, and Medicare Part B (Medical Insurance) covers the services you get from a doctor or other health care provider while you're in the hospital. Medicare.gov describes mental health care services as diagnosing and treating people with mental health disorders, like depression and anxiety.

You can get these inpatient services in a general hospital or in a psychiatric hospital, which is a facility that only cares for people with mental health disorders. Part A also covers medications for opioid use disorder, like methadone, buprenorphine and naltrexone, when you get them as a hospital inpatient; see what Medicare covers for addiction treatment.

What do I pay for an inpatient mental health stay?

What you pay for each benefit period in 2026 depends on how long you're getting care:

• Days 1 to 60: after you pay the $1,736 deductible, you pay $0 each day
• Days 61 to 90: you pay $434 each day
• Days 91 to 150: you pay $868 each day while using your 60 lifetime reserve days
• After day 150: you pay all costs
• You also pay 20% of the Medicare-approved amount for mental health services you get from providers while you're a hospital inpatient

What is a benefit period?

A benefit period is the way Original Medicare measures your use of hospital and skilled nursing facility services. A benefit period begins the day you're admitted as an inpatient in a hospital or skilled nursing facility, and it ends when you haven't gotten any inpatient hospital care (or skilled care in a skilled nursing facility) for 60 days in a row. If you go into a hospital after one benefit period has ended, a new benefit period begins, and you pay the inpatient hospital deductible for each benefit period. There's no limit to the number of benefit periods.

Is there a limit on psychiatric hospital days?

Yes, for a psychiatric hospital. If you're in a psychiatric hospital instead of a general hospital, Part A only pays for up to 190 days of inpatient psychiatric hospital services during your lifetime. CMS's Medicare Benefit Policy Manual says this limit applies only to services furnished in a psychiatric hospital, so it doesn't apply to inpatient mental health care in a general hospital.

Lifetime reserve days are a separate limit: they're additional days Medicare will pay for when you're in a hospital for more than 90 days. You have a total of 60 reserve days that can be used once during your lifetime, and for each one Medicare pays all covered costs except a daily coinsurance.

What doesn't Medicare cover during an inpatient stay?

Medicare doesn't cover these items during an inpatient mental health stay:

• Private duty nursing
• A phone or television in your room, if there's a separate charge for these items
• Personal items, like toothpaste, socks or razors
• A private room, unless medically necessary

Does Medicare Advantage or Medigap change inpatient mental health coverage?

Medicare Advantage Plans must cover all medically necessary services that Original Medicare covers, and plans may also offer extra benefits; rules and costs vary by plan. A Medicare Advantage Plan may require you to use its network and get approval (prior authorization) before it covers certain services, and plans have a yearly limit on what you pay for covered Medicare services.

With Original Medicare, a Medigap (Medicare Supplement Insurance) policy can help pay your share of costs like copayments, coinsurance and deductibles. You can't buy Medigap to cover out-of-pocket costs in a Medicare Advantage Plan. For care that's less than a hospital stay, Medicare Part B covers partial hospitalization and intensive outpatient programs; see what Medicare covers for therapy and counseling.