Online Therapy That Takes Medicare: Options and Limits

Medicare gives you two quite different routes, and the difference decides which platforms you can use. Original Medicare is run by the federal government, and a therapist enrolled with Medicare can bill it directly. Medicare Advantage plans are run by private insurers, and each one sets its own network and costs.

So start by working out which you have. Rula’s Medicare page says a red, white, and blue card from the federal government means Original Medicare, and a card from a private insurer with your plan name on it means Medicare Advantage. But Medicare’s booklet says people in Medicare Advantage keep the red, white, and blue card too and must use the plan’s card to get care, so which card you show for care is the better clue. If you are not sure, call 1-800-MEDICARE (1-800-633-4227), which Medicare.gov says is open 24 hours a day, 7 days a week, except some federal holidays.

We read each company’s own pages in November 2026. They describe what it takes today. We could not confirm which plans each platform will take in 2027, so check again if your plan changes.

Online therapy that takes Medicare at a glance

Ratings are the overall scores we use for each platform across Mindkindly. BetterHelp is not in the table because it does not take Medicare, and Alma is not in it because its own pages conflict (more below).

Original Medicare (Part B): coverage, cost, and who can bill

What it covers. Medicare.gov lists outpatient psychotherapy among the services you can get by telehealth. Through December 31, 2027, it says Medicare covers telehealth services you can get from anywhere in the US. For mental health care, CMS says the limits on where you can be were removed permanently, so therapy from home can continue after that date.

What it costs. After you meet the Part B deductible, you pay 20% of the Medicare-approved amount. Medicare.gov says that for most telehealth services, you pay the same as you would in person. The 2026 deductible is $283, and Medicare.gov does not list 2027 amounts yet.

Some platform pages show older figures. Rula’s Medicare page still says $257, the 2025 amount, and a Grow Therapy article gives the 2023 figure, so go by Medicare.gov.

As a rough guide to the 20%, Rula says its Medicare clients pay $20 to $35 a session on average, and Brightside says about $40 a visit. These are company averages, not quotes. Original Medicare also has no yearly limit on what you pay out of pocket, unless you have supplemental coverage.

Who can bill. Medicare.gov’s list includes psychiatrists and other doctors, clinical psychologists, clinical social workers, clinical nurse specialists, nurse practitioners, physician assistants, marriage and family therapists, and mental health counselors. A platform taking Medicare does not mean every therapist on it does, because the therapist has to be enrolled with Medicare too.

Ask whether they accept assignment. Medicare.gov says a provider who accepts assignment takes the Medicare-approved amount as full payment and can charge you only the deductible and coinsurance. It is usually your lowest cost.

CMS’s booklet for providers says clinical social workers, marriage and family therapists, and mental health counselors must accept assignment, so this matters most with doctors such as psychiatrists. A provider who does not accept assignment can charge up to 15% more in many cases, and you may have to pay the full cost at the visit. A provider who has opted out of Medicare is different again: Medicare will not pay for their services except in emergencies, and Medicare.gov suggests talking to your local SHIP before you sign a private contract with one.

Medicare Advantage: coverage, cost, and who can bill

What it covers. Medicare’s booklet on these plans says they must cover all medically necessary services that Original Medicare covers, and they may offer extra benefits. Medicare.gov adds that Medicare Advantage plans may offer broader telehealth benefits, so read your plan’s materials.

Who can bill. Your plan’s network decides this. You may need to use providers in the network for non-emergency care, and you may need a referral to see a specialist. Some plans pay for care out of network, typically at a higher cost. That is why a platform can take Medicare Advantage in general and still not take your plan.

What it costs. Medicare’s booklet says out-of-pocket costs vary by plan, and that plans have a yearly limit on what you pay for covered services. Rula says many plans charge a fixed copay per therapy session, often $0 to $40, instead of 20%. You cannot buy a Medigap policy to cover Medicare Advantage costs, according to the same booklet.

Do you need an in-person visit first?

Not today. CMS’s telehealth FAQ, updated in October 2026, says the requirement for an in-person visit before mental health telehealth takes effect after December 31, 2027. Medicare.gov’s telehealth page does not mention one either.

From January 1, 2028, CMS describes two situations.

If you began telehealth mental health care on or before December 31, 2027, you do not need a visit in the 6 months before. CMS says you will be “considered established,” and you will need at least one in-person visit every 12 months after that date.

If you begin on or after January 1, 2028, you need an in-person visit, not by telehealth, within the 6 months before your first telehealth session. After that, CMS says you need one within 12 months of each telehealth session, with limited exceptions.

If your own therapist cannot see you in person, CMS says a clinician of the same specialty in the same group practice can do the visit.

Two things do not change. You can still have therapy from home, whether you live in a city or a rural area. And phone sessions remain possible: through December 31, 2027, you can have them at home, and from 2028 CMS allows them for mental health care at home when your clinician can do video but you cannot use it or do not agree to.

None of this needs a decision now. But the platforms’ Medicare pages we read do not say how they will handle the 2028 rule, so if you expect to stay in care past 2027, ask, especially if a platform is mostly video. Medicare Advantage members should ask their plan too. CMS’s dates come from current law, and they can change, so check Medicare.gov as 2028 gets closer.

Platform by platform

Talkspace: Original Medicare and Medicare Advantage, for therapy

Talkspace’s help center says its therapy is covered by Original Medicare (Part B) and by Medicare Advantage in all 50 states and Washington, DC. Original Medicare does not cover its psychiatry. A Medicare Advantage plan may, so ask yours.

On Original Medicare, your cost depends on your deductible, your coinsurance, and any other coverage. Talkspace says it forwards claims to a Medigap plan and will not bill you until Medicare and any secondary insurance have paid. It also says it cannot confirm your final cost until claims are processed.

Where its pages disagree. Its Medicare page says all 50 states in one FAQ and “some states” in another, and “some” Medicare Advantage plans in one place and “many” in another. Its general coverage page still says traditional Medicare is covered in select states and that Medicare Advantage is not covered yet.

Session limits differ too. The Medicare page says Original Medicare typically covers up to 20 online sessions a year, and sometimes more, and that many Medicare Advantage plans cover two sessions a month. The general page says some members may get unlimited sessions. Medicare.gov’s outpatient mental health page lists no 20-session limit.

The help center is the most specific, so we lead with it, but ask Medicare or your plan as well.

The honest downside: besides those conflicts, Talkspace lists a $0 average Medicare copay, while its Medicare page says you pay coinsurance, so do not count on $0. Its Medicare page describes live sessions and does not say whether Medicare covers messaging. Our Talkspace insurance guide has the full picture.

Rula: Original Medicare and many Medicare Advantage plans

Rula says it accepts Original Medicare and Medicare Advantage plans from major insurers. Its insurance search includes Medicare Advantage entries from Aetna, Humana, UnitedHealthcare, Wellcare, and several Blue Cross and Kaiser plans, and its main therapy page lists Kaiser “by referral” among its commercial plans, so ask how that works for a Kaiser Medicare Advantage plan.

Rula says it verifies your coverage and gives you a cost estimate before your first appointment. It also says Original Medicare needs no referral, and that you must be in the same state as your therapist during sessions. If you have both Medicare and Medicaid, Rula says Medicaid may cover your 20% and your deductible.

Where its pages disagree. Its Medicare page says “nationwide” and lists all 50 states, without DC, while its main therapy page lists “Medicare, Medicare Advantage, and Medicaid in many states,” which reads less broadly. The Medicare page also gives the session format as video, in person, or both, while an FAQ on the same page says all sessions are by video. It gives both 21,000+ and 23,000+ as its number of therapists.

The honest downside: if you may need in-person care, including for the 2028 rule, ask first, because Rula’s page does not give a clear answer. Our Rula cost guide covers its other fees.

SonderMind: Original Medicare and Medicare Advantage

SonderMind’s insurance page says it offers nationwide coverage with most major plans as well as Medicare and Medicare Advantage. Its insurance help page is more careful, saying its clinicians are in network with “various” Medicare fee-for-service (Original Medicare) and Medicare Advantage plans. Its general FAQ page does not mention Medicare at all.

Its insurance page says 50 states and DC are covered for therapy and psychiatry and marks every one covered on its map, but it calls the plans it shows illustrative, and we could not find Medicare shown by state or Medicare Advantage plans named on these pages. So “nationwide” and “various” do not settle it for you. Search its insurance partners by location, or call 844-THERAPY. Sessions are by video or in person, depending on the clinician.

The honest downside: SonderMind’s $25 average copay is not specific to Medicare, so do not plan around it. Our review covers its billing downsides, and our SonderMind cost guide covers its fees.

Grow Therapy: mostly Medicare Advantage

Grow Therapy’s page for clients says you can use your Medicare coverage through Grow as long as it is contracted in your state. It says that can cover video or in-person therapy or psychiatry, depending on where you live, and phone sessions in some cases. That page does not separate Original Medicare from Medicare Advantage.

Its help center for providers is more specific. It lists “state Medicare” in California, Florida, and Texas, and Medicare managed care plans, meaning Medicare Advantage, in 42 states and DC.

Where its pages disagree. The same help article says Grow does not allow providers to bill Medicare directly and works through managed care plans instead. So if you have Original Medicare, even in those three states, confirm before you count on it.

The honest downside: Grow does not automatically enroll its providers with Medicare, so not every therapist there will take it. Billing and support are its weak spots, as our review explains. Our Grow Therapy cost guide covers copays and fees.

Headway: select Medicare Advantage plans only

Headway says it accepts select Medicare Advantage plans, and that it does not accept Original Medicare (Parts A and B) or Medigap on their own. To check, search “Medicare” in the insurance box on its site. You see an estimated cost before you book. If Headway does not support your plan, it suggests your insurer’s provider directory.

Where its pages disagree. Its help center says select plans “nationally.” Its online therapy page says “in some states,” and an article for providers says “in select states.” That article names Providence Medicare Advantage in Oregon and Washington, Blue Shield of California, and Blue Cross and Blue Shield of Texas, with others added regularly.

The honest downside: if you have Original Medicare, Headway is not an option, and on Medicare Advantage your plan, your state, and a credentialed therapist all have to line up.

Brightside: Original Medicare or certain Medicare Advantage plans

Brightside’s Medicare page says that, depending on your state, you can use Original Medicare Part B or certain Medicare Advantage plans, by video, for therapy and psychiatry. It checks your eligibility during sign-up.

Brightside says you pay about $40 a visit on Part B after the $283 deductible, an average that can vary by state or type of care. It says Medicare Advantage costs less than that, though your exact cost depends on your plan.

The honest downside: these pages do not name the states or Medicare Advantage plans it takes, so you only find out during sign-up. And since Medicare.gov describes your share as 20% of the approved amount, treat $40 as Brightside’s average and ask for your own estimate.

BetterHelp: does not take Medicare

BetterHelp says providers on its platform do not directly accept Medicaid, Medicare, or TRICARE, so you would pay for sessions yourself. Its insurance page points you to Medicare.gov and your Medicare plan for help finding covered care. If you still want to compare, our BetterHelp cost guide covers its self-pay prices, but check the covered options above first.

Alma: its pages conflict

Alma’s help articles do not agree. One says it supports Optum Medicare Advantage and people with both Medicare and Medicaid. Its plan list names Optum Medicare Advantage too, but the same article says Alma does not accept Medicare or Medicaid plans.

With those two answers on its own site, we would not count on Alma for Medicare. If you have Optum Medicare Advantage and want to try, get a clear answer from Alma and your plan first. Our guide to what insurance Alma takes has more.

Help paying your share

Medicare Savings Programs. These state programs help with Part A and Part B premiums, and Medicare.gov says they might also pay your deductibles, coinsurance, and copayments if you qualify. If you are in the Qualified Medicare Beneficiary program, Medicare providers are not allowed to bill you for services Medicare covers, though you may still get a bill for a small Medicaid copayment if one applies. You apply through your state, and Medicare.gov encourages you to apply even if you are unsure you qualify.

Medigap. With Original Medicare, a Medigap policy can help pay your 20%. Talkspace and Rula both mention it on their Medicare pages, but ask your Medigap plan what it covers.

Both Medicare and Medicaid. Medicare pays first, and your state may pay your share. Our guide to online therapy that takes Medicaid explains how that works.

TRICARE For Life. Our guide to online therapy that takes TRICARE explains how it works with Medicare.

When your Medicare Advantage plan can change

Networks change from year to year, so these dates are here for your information. You do not have to change anything because of a therapy platform.

The Medicare Advantage Open Enrollment Period runs January 1 to March 31. It is only for people already in a Medicare Advantage plan. Medicare.gov says you can switch to another Medicare Advantage plan or go back to Original Medicare, and Medicare’s fact sheet says you can make one change a year during this period. If you are new to Medicare and joining a plan, a similar period covers your first 3 months.

It does not let you move from Original Medicare to Medicare Advantage. That generally falls under Medicare’s yearly Open Enrollment, which runs October 15 to December 7, unless you qualify for a Special Enrollment Period.

We do not advise on which plan to choose. Your plan’s Annual Notice of Change lists any changes to coverage, costs, and networks for January, and a SHIP counselor can talk your options through with you for free.

Free help and low-cost care

SHIP, for free Medicare counseling. State Health Insurance Assistance Programs offer local, one-on-one counseling at no cost, and Medicare.gov points to them for help with plan choices, coverage, costs, and appeals. They help with Medicare questions, not therapy. Find yours at shiphelp.org, or call the national SHIP center at 877-839-2675.

Community mental health centers. Medicare.gov lists these among the places you can get outpatient mental health care. SAMHSA’s National Helpline, 1-800-662-4357, is free, confidential, and open 24/7 in English and Spanish, and it can often refer you to facilities that charge on a sliding fee scale or accept Medicare or Medicaid. You can also use SAMHSA’s locator at FindTreatment.gov, or text your ZIP code to 435748.

Federally Qualified Health Centers. Medicare.gov says you usually pay 20% at these clinics, the Part B deductible does not apply, and they offer lower fees if you have limited income. HRSA’s rules say a health center cannot deny you service because you cannot pay. CMS says Medicare pays for behavioral health care these clinics provide remotely, so ask your local center what it offers. HRSA’s Find a Health Center tool lists them.

A yearly depression screening. Medicare.gov says this is free if your provider accepts assignment, in a primary care office or clinic that can provide follow-up.

For more low-cost routes, see our cheapest online therapy guide.

How to check your coverage, step by step

Step 1. Work out which Medicare you have. Check which card you show for care, or call 1-800-MEDICARE.

Step 2. On Original Medicare, ask about assignment. Ask the platform or therapist whether they are enrolled with Medicare and accept assignment, and what your share will be after the deductible.

Step 3. On Medicare Advantage, call member services. Ask whether this platform or therapist is in network, whether video and phone sessions are covered, what you pay per session, and whether you need a referral or prior approval. Ask too whether a separate company handles mental health benefits.

Step 4. Search the platform by your exact plan name. Do not stop at the word “Medicare,” since a platform can list some plans and not others.

Step 5. Keep your estimate. Screenshot it. Final costs can change when the claim is processed.

Step 6. If nothing fits, go local. Your plan’s directory, a community mental health center, or a health center may have video sessions. Our guide to finding a therapist who takes your insurance covers what to ask.

Common questions

Does Medicare cover online therapy? Yes. Medicare.gov lists outpatient psychotherapy among telehealth services. With Original Medicare you pay 20% after the Part B deductible, and with Medicare Advantage your plan sets the cost.

Does Medicare require an in-person visit for online therapy? Not through December 31, 2027, according to CMS. From January 1, 2028, you will generally need in-person visits, and the timing depends on when you started.

Does BetterHelp take Medicare? No. BetterHelp says its providers do not directly accept Medicare.

Does Talkspace take Medicare? Yes, for therapy. Its help center says Original Medicare and Medicare Advantage in all 50 states and DC, though its other pages are less consistent. Original Medicare does not cover its psychiatry.

Does Headway take Original Medicare? No, only select Medicare Advantage plans.

Do I need a referral? Rula says not with Original Medicare, and Medicare’s booklet says you usually do not need one for a specialist. With Medicare Advantage you may, so ask your plan.

The bottom line

On Original Medicare, look at Talkspace, Rula, SonderMind, and Brightside, and ask whether your therapist accepts assignment. On Medicare Advantage, those four plus Grow Therapy and Headway are worth searching by your exact plan name. BetterHelp does not take Medicare, and Alma’s pages conflict. You do not need an in-person visit before telehealth therapy through 2027, and for free help with any of it, your local SHIP is a good first call.

Sources

• CMS: Telehealth FAQ, updated October 2026
• Medicare.gov: telehealth
• Medicare.gov: outpatient mental health care
• Medicare.gov: Medicare costs
• Medicare.gov: does your provider accept Medicare as full payment?
• CMS: Medicare & Mental Health Coverage (booklet for providers)
• Medicare.gov: Medicare Savings Programs
• Medicare.gov: Medicaid and dual eligibility
• Medicare.gov: joining a plan
• Medicare: Understanding Medicare Advantage Plans (booklet)
• Medicare: Medicare Advantage and drug plan enrollment periods (fact sheet)
• Medicare.gov: talk to someone, including SHIP
• Medicare.gov: Federally Qualified Health Center services
• SHIP: State Health Insurance Assistance Programs
• Talkspace Help Center: understanding Medicare at Talkspace
• Talkspace: Medicare coverage
• Talkspace: insurance coverage
• Rula: Medicare therapists
• Rula: online therapy and insurance search
• SonderMind: insurance coverage
• SonderMind: insurance and payments help
• SonderMind: FAQs
• Grow Therapy: therapy through Medicare
• Grow Therapy Help Center: Medicare availability by state
• Grow Therapy: therapy coverage with Medicare (article)
• Headway: online therapy covered by insurance
• Headway Help Center: using insurance on Headway
• Headway Help Center: working with Medicare Advantage (for providers)
• Brightside: Medicare
• Brightside: insurance coverage
• Brightside: FAQs
• BetterHelp: insurance coverage
• Alma Support: why Alma does not participate with your plan
• Alma Support: participating insurance plans
• SAMHSA: National Helpline
• HRSA: sliding fee discount program
• HRSA: Find a Health Center

One important note: if you are in crisis or considering harming yourself, please reach out now. In the US, call or text 988 for the Suicide & Crisis Lifeline. Immediate human support is available.