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Insurance Guide

Medicare and Online Therapy

What seniors need to know about telehealth mental health coverage under Medicare Part B and Medicare Advantage plans in 2025.

Updated December 2025 10 min read
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2025 Policy Update

Medicare telehealth flexibilities have been extended through January 30, 2026. Mental/behavioral health telehealth services remain covered without geographic restrictions when received at home. Congress continues to debate making these policies permanent.

Key Takeaways

Good news for Medicare beneficiaries: telehealth mental health coverage has expanded significantly since 2020, and many of those flexibilities remain in place. If you're a senior looking to access therapy from home, Medicare now covers a wide range of online mental health services.

This guide explains what's covered, which platforms accept Medicare, and what costs you can expect.

What Medicare Part B Covers

Medicare Part B (medical insurance) covers outpatient mental health services, including telehealth visits. Here's what's included:

Covered Mental Health Services

  • Psychotherapy with psychiatrists, psychologists, clinical social workers, clinical nurse specialists, nurse practitioners, and physician assistants
  • Psychiatric evaluations and diagnostic assessments
  • Medication management for mental health conditions
  • Marriage and family therapy (as of 2024, these providers are permanent Medicare telehealth providers)
  • Mental health counseling from licensed mental health counselors
  • Substance use disorder treatment including counseling and medication-assisted treatment

Mental Health Telehealth: The Special Rules

Mental/behavioral health telehealth has permanent special rules that are more flexible than general telehealth:

No Geographic Restrictions

You can receive mental health telehealth from anywhere—including your home. This is permanent for behavioral health, unlike other telehealth services.

Audio-Only Allowed

Phone-only sessions are covered for mental health if you can't use video. Providers must document that audio-only was appropriate.

⚠️ In-Person Visit Requirement

For mental health telehealth, Medicare typically requires an in-person visit within 6 months of your first telehealth appointment, then annually thereafter. However, this requirement has been delayed through January 30, 2026. If you started telehealth before October 2025, you're considered "established" and only need annual in-person visits. Check with your provider about current requirements.

What You'll Pay

Medicare telehealth visits cost the same as in-person visits:

Part B Deductible (2025)

$257 per year before Medicare pays

Coinsurance

20% of Medicare-approved amount

Example Cost

If the Medicare-approved amount for a therapy session is $150, you'd pay 20% = $30 after meeting your deductible. A Medigap policy or Medicare Advantage plan may reduce this further.

Medicare Advantage: Often Better Coverage

Medicare Advantage (Part C) plans are required to cover everything Original Medicare covers, but many offer enhanced telehealth benefits:

Example: UnitedHealthcare Medicare Advantage plans announced they will continue expanded telehealth coverage for mental health services through 2025 and 2026, even after Original Medicare flexibilities expire. Check your specific MA plan for details.

Online Therapy Platforms That Accept Medicare

Not all online therapy platforms accept Medicare. Here are your main options:

Talkspace

Medicare Accepted

Accepts traditional Medicare (Part B) and many Medicare Advantage plans in most states.

  • • Individual therapy and psychiatry available
  • • Video and live chat sessions
  • • Check coverage during sign-up
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Headspace

Some Medicare Plans

Accepts some Medicare and Medicaid plans in addition to commercial insurance.

  • • App-based therapy access
  • • Self-guided content included
  • • Verify plan acceptance at sign-up

Grow Therapy / Headway

Some Medicare Plans

Therapist directories that help providers get credentialed with Medicare and other insurers.

  • • Search by insurance coverage
  • • Individual therapist practices
  • • May have Medicare-accepting providers in your area

What About BetterHelp?

BetterHelp does not accept Medicare or any insurance. It's a cash-pay subscription service ranging from $65–$100/week. If you have Medicare, platforms like Talkspace that accept your coverage will be more affordable.

How to Use Medicare for Online Therapy

  1. 1

    Verify platform coverage

    Visit the platform's website and check if they accept Medicare. For Talkspace, enter your Medicare info during sign-up to verify coverage.

  2. 2

    Check your plan details

    If you have Medicare Advantage, call the number on your card to confirm telehealth mental health benefits and any copay requirements.

  3. 3

    Confirm provider credentials

    Make sure your therapist is a Medicare-enrolled provider. The platform should handle this, but it's worth confirming.

  4. 4

    Understand the in-person requirement

    Know whether you'll need an in-person visit. Currently delayed through January 2026, but may apply after that date.

Common Questions

Does Medicare cover therapy apps like BetterHelp?
BetterHelp and similar subscription-based platforms don't bill Medicare. However, Talkspace does accept Medicare and offers a similar service model. If you want to use your Medicare benefits, choose a platform that's credentialed to bill Medicare.
Can I do therapy over the phone instead of video?
Yes, Medicare covers audio-only mental health telehealth if your provider determines it's appropriate and you either can't use video or don't consent to it. This is permanently allowed for mental health services.
Will telehealth coverage continue after 2025?
Mental/behavioral health telehealth has permanent special rules with no geographic restrictions. General telehealth flexibilities (for non-mental health care) have been extended through January 2026 but their future depends on Congressional action. Several bills aim to make all flexibilities permanent.
Does Medigap cover my telehealth copays?
Yes, if you have a Medigap (Medicare Supplement) policy, it can help cover your 20% coinsurance for telehealth visits, just like in-person visits. Check your specific plan for details.

The Bottom Line

Medicare now provides solid coverage for online mental health therapy, with permanent rules that allow you to receive behavioral health care from home without geographic restrictions. Whether you have Original Medicare or a Medicare Advantage plan, you can access therapy via video or phone at standard copay rates.

Talkspace is currently the most accessible online therapy platform for Medicare beneficiaries. Before starting, verify your coverage through the platform and understand any in-person visit requirements that may apply.

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