Does Medicare Cover Marriage Counseling?

Does Medicare cover marriage counseling?
Generally, no. Medicare does not cover marriage counseling or couples therapy when the primary purpose is relationship support. Medicare only covers mental health services that address diagnosable conditions—such as depression, anxiety, or substance use disorder—when provided by an eligible professional. If relationship issues are part of treating a covered mental health condition, therapy may be included.

Key Points

• What Medicare Covers

  • Individual and group psychotherapy for diagnosable mental health conditions.

  • Services must be provided by Medicare-approved providers (psychiatrists, psychologists, clinical social workers, psychiatric nurse specialists).

  • Therapy can include a spouse or partner if their involvement supports the patient’s treatment plan.

• What Medicare Does Not Cover

  • Standalone marriage counseling or couples therapy focused on relationship enrichment.

  • Therapy without a medically necessary mental health diagnosis.

  • Non-clinical counseling services, life coaching, or faith-based counseling unless part of a recognized treatment plan.

• Medicare Parts & Coverage

  • Part A: Covers inpatient psychiatric care if hospitalized.

  • Part B: Covers outpatient mental health services, including therapy sessions. Patients pay the annual deductible and typically 20% coinsurance.

  • Medicare Advantage (Part C): Must cover at least what Original Medicare covers, with possible lower copays.

  • Medigap: Can help reduce out-of-pocket costs for covered therapy.

• When Marriage Counseling Might Be Covered
  If couples therapy is part of a treatment plan for a mental health condition (e.g., major depression), and participation of the spouse helps improve the patient’s outcome, Medicare may cover it.

Frequently Asked Questions (FAQ)

Q1: Can I use Medicare for couples therapy if I’m struggling with depression?
Yes, if your doctor diagnoses depression and therapy—including partner involvement—is part of the treatment plan.

Q2: Will Medicare pay for counseling just to improve my marriage?
No. Medicare does not cover therapy aimed solely at relationship improvement or communication issues without a mental health diagnosis.

Q3: What type of provider must I see?
Medicare requires a licensed mental health professional such as a psychiatrist, psychologist, clinical social worker, or psychiatric nurse specialist.

Q4: What costs should I expect?
For outpatient therapy under Part B, you pay the deductible (~$257 in 2025) plus 20% coinsurance. Medigap may lower these costs.

Q5: Does Medicare Advantage cover marriage counseling?
Advantage plans cover the same as Original Medicare. Some may offer extra mental health benefits, but relationship-only counseling is still excluded.

Call to Action (CTA)

If you’re considering counseling, talk to your doctor about your mental health needs. If you qualify for therapy under Medicare, ask whether your spouse can join sessions as part of your treatment. For relationship-only support, consider private counseling options outside of Medicare.