Medicare in California · Solutions Psychiatry
Online psychiatry in California that accepts Medicare
A practice with a San Francisco office and telehealth care in every California county, in network with Medicare, with your cost confirmed before your first visit.
Solutions Psychiatry is the full practice: therapy and medication care from one clinician. If you want medication management only, that care has its own home at PsychMed Care.
Medicare in California, verified first
Solutions Psychiatry accepts Medicare in California. Before your first appointment, the practice verifies your coverage and confirms your exact cost, counting a supplemental policy or Medicare Advantage plan if you carry one. You will not be told that coverage is probably fine and left to learn otherwise from a denial letter.
California Medicare patients get the standard this practice holds for everyone: a 60 minute first conversation with Karel Winner, DNP, PMHNP-BC, and 30 minute Follow-up Appointments that are working sessions, not refill stops. If a specific plan does not verify, the self-pay figures are stated just as plainly: $350 for the Comprehensive Initial Appointment, $250 for each Follow-up Appointment, so the choice is yours with the numbers in front of you.
One more California reality belongs in the open: formularies change every year. A medication that was covered in January can move tiers the next, and a regimen nobody reviews quietly drifts out of alignment with the plan paying for it. Annual medication reviews are part of care here for that reason, checking each prescription against both the clinical picture and the current formulary, and simplifying where simplification is safe.
A San Francisco office, care in every county
The practice's California home is the San Francisco office at 220 Montgomery Street, Suite 600, in the Financial District. Day-to-day care runs on secure video, which is the design everywhere in this practice: the same clinician reaches you in San Diego, Sacramento, Fresno, Redding, or the North Coast without a commute eating the hour the appointment was supposed to save.
Bay Area patients feel the arithmetic most sharply. An appointment across town can cost half a day in traffic and parking before the conversation starts. Video care removes the relay: therapy and medication in one visit, from home, with your chart and your history in the same place. The offices are practice locations, not walk-in clinics, and when a federal or DEA requirement calls for an in-person visit, it is arranged in advance in the state where you are.
What your care can include
Both halves of psychiatry from one clinician: psychotherapy and medication management in a single course of care. The therapy bench is deep, Internal Family Systems at its highest training level, BrainSpotting, somatic work, and exposure therapy for OCD, which this practice treats as a specialty; the OCD page describes that work in full. Your prescriber hears your whole story in session, so a medication decision is never made from a symptom score alone.
The medical lens comes along too. Targeted labs check the contributors that imitate or amplify psychiatric symptoms, thyroid function, B12, folate, vitamin D, iron, and metabolic markers, and GeneSight pharmacogenomic testing is available when a medication history suggests your genes are part of the puzzle. Coverage for any test under your plan is settled during verification, before anything is ordered.
Getting started
From first click to first visit
1. Book the Comprehensive Initial Appointment
Choose a time and complete the intake forms and consents, about ten minutes, including the short treatment intention agreement.
2. Coverage confirmed
Your Medicare plan is verified before the visit, and you receive your exact cost in advance, with no billing surprises afterward.
3. One full hour
The Comprehensive Initial Appointment covers what brought you in, your history, your physical health, your sleep, and what a good outcome looks like for you.
4. Care that continues
Follow-up Appointments run 30 minutes, therapy and medication reviewed together, and if you relocate within the practice's 35 states, your clinician does not change.
Why Californians end up here
California has no shortage of psychiatry websites; it has a shortage of psychiatrists who will say clearly whether they take Medicare, and of practices where one clinician carries the whole picture instead of a third of it. Concierge fees on one side, seven minute refill visits on the other. This page is the alternative, stated plainly: Medicare accepted, verified up front, one clinician for therapy and medication. The other four states are on the Medicare page.
Contact between visits runs through the patient portal and Spruce for existing patients: prescription questions, scheduling, brief check-ins. Replies come on practice days rather than around the clock, which keeps the channel honest, and emergencies belong on the crisis lines. Most patients find the rhythm steadier than a portal that promises everything and is staffed by no one in particular.
One clinician for the whole conversation.
Start with a 60 minute Comprehensive Initial Appointment. Your insurance is verified before the visit, and you leave with a plan, not vague reassurance.