What You Need to Know Before Booking a Session
Marriage is beautiful, but let’s be honest, it’s not always smooth sailing. Every couple experiences rough patches, and sometimes professional help, such as marriage counseling, is the best lifeline. But as you start exploring therapy options, one question quickly surfaces: Is marriage counseling covered by Medicare?
If you or your partner is on Medicare, understanding what’s covered—and what’s not—can make a significant financial difference. This post breaks down exactly what you need to know, using real-world insights, relatable examples, and straight talk to help you feel confident about your next steps.
What Is Marriage Counseling?
Before diving into coverage details, let’s quickly define what marriage counseling actually is.
Marriage counseling (also called couples therapy) is a form of talk therapy designed to help couples improve their relationship. A licensed therapist works with both partners to:
- Resolve conflict
- Improve communication
- Rebuild trust
- Navigate life changes (like retirement or health issues)
It’s not just for couples on the brink of separation—it’s for any duo looking to strengthen their bond. And for older couples, especially, issues related to caregiving, chronic illness, or empty-nesting can create tension that’s best worked through with guidance.
Medicare 101: What’s the General Coverage?
This is the federal health insurance program for people age 65 and over, alongside certain younger folks who have disabilities of one sort or another. It is divided into parts:
- Part A covers inpatient hospital care
- Part B covers anything outpatient (including mental health services)
- Part C (Medicare Advantage) incorporates both A and B and may supply additional benefits beyond that
That is where therapy fits in. Usually, if you are researching mental health treatments—including counseling—Medicare Part B is what you should be looking at.
Yes, Is Marriage Counseling Covered by Medicare?
✅ When Medicare May Be Charged for Marriage Counseling
Medicare will cover the cost of psychiatrically necessary mental health counseling provided by a licensed psychiatrist or clinical psychologist who accepts Medicare payments.
So if one partner suffers from a psychiatric disorder (such as depression, anxiety, or PTSD) verified by a professional, and therapy aims to resolve this problem—even if that partner goes too—it may well receive insurance coverage. For instance:
Example: John, age 67, retired from his job and began to suffer from severe depression. His wife, Susan, accompanied him to the counseling sessions to help him manage it. Because, as an actual matter of fact, all this treatment is for the condition that John has been diagnosed with, plus the therapist is approved under Medicare Part B, Medicare pays.
This would usually be billed as individual therapy with the family member present, rather than couples counseling.
For further clarification on this issue, please contact the Centers for Medicare & Medicaid Services (CMS).
When Medicare Won’t Pay for Marriage Counseling
Usually, Medicare won’t pay for mental health counseling if:
- There’s no disorder of mental health
- It’s all about fixing a relationship for no real medical reason
- It’s lay counseling, coaching on marriage, etc.
Therefore, if you just want to improve your relationship or sort out everyday difficulties, you’ll pay for it out of pocket.
Example: Maria and her husband, in their 70s but with no diagnosed mental health condition, want help restoring their relationship. Their therapy sessions are valuable, but Medicare does not cover them.
Who Can Provide Medicare‑Covered Counseling?
The counseling provider must be:
- Licensed Clinical Psychologist
- Licensed Clinical Social Worker (LCSW)
- Psychiatrist or Professional M.D.
- Nurse practitioner
As of 2024, thanks to recent policy updates, marriage and family therapists (MFTs) or mental health counselors (MHCs) are now eligible for Medicare.
A Medicare provider’s status can be checked with the Medicare Care Compare tool. Therefore, you can easily see if a particular provider is a Medicare provider or not through this tool.
What About Medicare Advantage Plans?
If you have a Medicare Advantage (Part C) plan, then you might be able to receive more flexible service options from the delivery team.
Some Medicare Advantage plans provide more expansive mental health coverage, often including wellness benefits such as relationship counseling or life coaching in their supplemental benefits package.
Check your plan’s Evidence of Coverage (EOC) and ask your insurer about the benefits of specific marriage or couples counseling.
Pro Tip: Use your plan’s member website or call its customer service line to ask, “Is marriage or couples therapy a supplemental mental health benefit?”
What Does a Counseling Session Typically Cost?
If not covered by insurance, costs for marriage counseling may range from $75 to $200 per session, depending on:
- The provider’s credentials
- Session length
- Your location (city areas generally cost more)
Some therapists offer sliding-scale fees based on income, particularly for seniors or retirees on fixed incomes.
Other Ways to Pay for Marriage Counseling
If Medicare does not pick up the tab, do not lose faith. Below are a few creative options:
- Employee Assistance Programs (EAPs): If you or your spouse is still employed, see if your employer offers short‑term counseling benefits.
- Churches or faith-based organizations: Many provide free or low‑cost couples counseling.
- University training clinics: Counseling students offer therapy at discounted prices under the supervision of licensed professionals.
- Online therapy platforms: Virtual couples therapy (such as Talkspace or BetterHelp) can offer easy, low‑cost methods that are more convenient.
Why It Still Matters
Even if Medicare doesn’t cover traditional marriage counseling, investing in your relationship can pay off emotionally, mentally, and physically. Studies show that a healthy relationship can improve everything from heart health to life expectancy.
According to a study published in the National Library of Medicine, couples therapy is highly effective for improving relationship satisfaction and reducing conflict.
Final Thoughts: Is Marriage Counseling Worth It Without Coverage?
Absolutely.
While Medicare may not always cover the costs, the value of a strong, supportive relationship is priceless. If you’re experiencing relationship stress, don’t let insurance red tape stop you from seeking help.
Ready to Go from Here to There?
If you’re not sure where to start, talk with your general practitioner or Medicare plan provider about mental health services and related benefits.
You deserve a relationship at any age that feels connected, supportive, and fulfilling.
💬 Need help finding a therapist that takes Medicare? Use Psychology Today’s Therapist Finder and filter by accepted insurance.
Don’t wait until things are miserable and irreversible to change the way you approach your relationships.
