Key Takeaways

• Many Medicare clients are unaware that mental health services are covered benefits. Your role as an agent includes bringing this into the conversation—clearly, confidently, and compassionately.

• Talking about mental health can set you apart as a trusted advisor. It strengthens your relationship with clients and helps ensure they get the care they need in 2025 and beyond.

Start With What Medicare Covers—And What That Means

When you explain Medicare plans to a new client, you probably start with the basics: hospital coverage, doctor visits, prescriptions. But mental health often gets sidelined. That’s a missed opportunity—both for your client’s health and your credibility as a comprehensive resource.

Medicare currently covers a wide range of mental health services, including:

• Psychiatric evaluations and diagnostic tests

• Individual and group psychotherapy

• Family counseling (if it’s part of your treatment)

• Medication management and prescription drugs (if enrolled in a drug plan)

• Partial hospitalization services

• Screenings for depression and substance use disorders

• Annual wellness visits that include cognitive assessments

Original Medicare (Parts A and B) covers mental health services in both inpatient and outpatient settings. Inpatient psychiatric care is limited to 190 lifetime days in a psychiatric hospital, though care in a general hospital doesn’t count toward this limit.

As a licensed agent, you should be fluent in these details. They can influence your client’s plan choice—especially if they’ve had prior diagnoses or show signs of needing support. Don’t just focus on doctors and drugs. Focus on the mind, too.

Clients Are Already Hurting—You Just Haven’t Asked Yet

Mental health conditions don’t always present themselves openly. Many clients don’t volunteer their struggles, especially in initial meetings. Seniors in particular may underreport symptoms due to stigma, generational beliefs, or fear of judgment.

But mental health challenges are not rare:

• More than 20% of adults over 65 report symptoms of anxiety or depression.

• Cognitive decline and dementia are rising with the aging population.

• Isolation, grief, and chronic pain are silent drivers of mental distress in retirees.

This means it’s on you to gently introduce the topic—not as a dramatic question, but as a normal, essential part of care.

Try phrases like:

• “Do you have someone you talk to about stress or emotional challenges?”

• “Have you ever used any of your Medicare benefits for counseling or therapy?”

• “Would you like to learn more about the support services Medicare includes beyond the medical side?”

These open the door without making assumptions or putting pressure on them to disclose personal information.

Don’t Just Focus on Diagnosed Conditions

A mistake many agents make is assuming that if a client doesn’t have a clinical diagnosis like depression or bipolar disorder, then mental health benefits aren’t relevant.

But Medicare coverage is preventive as well as reactive. Annual depression screenings are covered. So is substance use counseling. Even basic conversations about loneliness or memory changes can lead to services that are covered.

Bring this up especially during:

• Annual Enrollment Period (AEP) reviews

• Medicare Advantage Open Enrollment (January 1–March 31)

• Initial Enrollment Period consultations (when clients are first turning 65)

Remember: Clients often don’t know what to ask. They rely on your expertise to surface what matters.

Use Mental Health as a Trust-Building Bridge

When you talk about mental health with empathy, you’re not just helping the client access care. You’re showing them that you understand the full picture of their well-being. That builds trust—and trust builds loyalty.

Clients who feel seen and heard are:

• More likely to ask you questions about other benefits

• More likely to return to you during Open Enrollment

• More likely to refer friends and family

You don’t have to be a therapist. But you do have to be a caring, informed professional who makes it clear that mental health is part of the Medicare conversation—not a taboo topic to tiptoe around.

Highlight the Cost Value in Covered Mental Health Services

Many Medicare-eligible adults assume therapy is expensive. They may have skipped care in the past because of high copays or lack of insurance. It’s your job to clarify how Medicare helps relieve this burden.

In 2025:

• Medicare Part B generally covers 80% of outpatient mental health services after the deductible is met. Clients are responsible for the remaining 20%, unless they have a Medigap policy or an Advantage plan with different cost-sharing.

• Medicare Part D or integrated drug coverage includes medications used for anxiety, depression, and other mental health conditions. Clients with limited income may also qualify for Extra Help to reduce costs.

By framing the financial side in simple terms, you help remove a major barrier to care. This shows your value as an educator—not just an enroller.

Include Mental Health in Your Educational and Marketing Content

Mental health should show up in your:

• Educational seminars and webinars

• Social media posts and Medicare newsletters

• Annual Notice of Change (ANOC) reviews

• Plan comparison tools and consultation guides

Here are some examples of how you can frame this:

• “What mental health services are included in your plan?”

• “Could you save on therapy with a plan that covers more providers?”

• “Is loneliness affecting your quality of life? Let’s talk about support options.”

You don’t need to scare or sensationalize. Just make mental health a standard, normal part of your materials.

Understand What Mental Health Coverage Looks Like on the Back End

To confidently talk about mental health benefits, you also need to understand how those benefits work behind the scenes. That includes:

• Networks: Some plans limit mental health providers to specific networks. Make sure the client’s preferred therapists or clinics are in-network.

• Referrals and authorizations: Some services may require referrals from a primary care doctor or pre-authorization. You should know which plans are more restrictive.

• Telehealth: Many clients now prefer virtual visits, especially for therapy. Medicare permanently expanded telehealth coverage after the public health emergency ended in 2023.

These details can shape whether a client accesses care or gives up trying. Your role is to anticipate the red tape and help them avoid it.

Normalize the Conversation—And Keep It Going Year-Round

Don’t make mental health a one-time topic during AEP. Normalize it in your yearly client check-ins and policy reviews. Use these moments to:

• Ask if they’ve had their depression screening yet

• Remind them about telehealth availability

• Revisit their copays or changes to therapy coverage

By keeping it consistent, you reinforce that mental health is a legitimate, recurring part of care—not just a niche concern.

Agents Who Lead With Empathy Stand Out in 2025

Clients don’t just want a licensed agent. They want someone who makes them feel safe talking about hard things. Mental health is personal—but it’s also practical. Helping your clients get access to these benefits isn’t just thoughtful. It’s part of your professional responsibility.

We’re in a time where emotional wellness matters more than ever. You can either avoid the topic—or you can be the reason a client finally finds the support they need.

Be the Resource Clients Remember

Mental health isn’t a side topic. It’s central to the kind of service today’s Medicare beneficiaries need and expect. If you want to be the agent they trust—and return to—don’t skip it.

Start integrating mental health questions into your consults, reviews, and marketing today.

And if you’re ready for tools that make it easier to manage client conversations, track follow-ups, and build long-term trust, sign up on BedrockMD. We’ve built our platform specifically to help licensed agents like you do more of what works—without wasting time on what doesn’t.