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Seniors and Access to Mental Health: Medicare Changes For 2014

Seniors and Access to Mental Health: New Changes For 2014

With mental health issues and challenges higher than ever in America, new changes in Medicare are making it easier for seniors to access mental health care.

While the Medicare program does cover certain aspects of mental health care, it does not include all costs associated with senior mental health care, which creates an issue around accessing this kind of treatment. In 2008, Medicare covered only 50% of the cost of psychological treatment for eligible beneficiaries. In 2013, it covered up to 65%. But what’s in store for Medicare beneficiaries in 2014?

2014 Medicare changes to mental health access

This year, for the first time since the program’s inception, Medicare will pay 80% of the bill for beneficiaries who seek psychological therapy. While beneficiaries are responsible for paying 20% of the bill themselves, this is the same percentage they pay for most medical services, bringing mental health costs in line with most other medical treatment.

Seniors can also get an annual depression screening which must be done in a primary care doctor’s office or primary care clinic that is able to offer follow-up treatment and referrals. This screening is also paid in full by Medicare.

Many in the industry see this as a stepping stone in helping elderly Americans gain access to mental health treatment or substance abuse therapy if needed.

Although cost sharing has changed, the parts of the Medicare program that cover mental health have not:

  • Medicare Part A (hospital insurance) helps cover mental health care in a hospital, as well as rooms, meals, nursing care, and other related services and supplies during inpatient care.
  • Medicare Part B (medical insurance) helps cover mental health services that beneficiaries would usually obtain outside of a hospital, such as visits with a psychiatrist.
  • Medicare Advantage covers the same mental health coverage as Part A and Part B for those enrolled, but may cover these benefits differently.
  • Medicare Part D (prescription drug coverage) helps cover drugs to treat a mental health condition.

If you struggle with mental illness, make sure you understand what care is available to you through your Medicare coverage. If you are enrolled in a Medicare private insurance plan, contact your insurance company to inquire about further details for accessing care.

Mental health issues in America

Here are some additional facts about the prevalence and treatment of mental health in America:

  • In any particular year, one in four American adults experiences a mental health disorder. That works out to be about 58 million people, according to the National Alliance on Mental Illness.
  • Among those 55 and older, 20% suffer from a mental disorder, the most common being anxiety.
  • It’s estimated that there are 552,000 mental health professionals working in the country as of January 2013. According to the Bureau of Labor Statistics, that works out to one mental health professional per 564 people.
  • Of those Americans who received mental health care, data from the Kaiser Family Foundation shows that a quarter listed themselves (not their insurance provider) as footing the bill.

Mental health care in America remains a contentious issue. Although access to this care has improved, unlimited psychotherapy treatments are still elusive for most people. Many argue that although there has been progress, it is still not enough.

This story is also covered by The New York Times.

Medicare has neither reviewed nor endorsed this information.

About Natalie Obrien

Natalie Dell O'Brien is a member of the communications team at eHealth, Inc. She has a Masters degree in Public Health and has worked in the health care industry for six years. She works on social media, communications strategy, content creation and management. A 2012 Olympian in rowing, you may have seen her with her teammates on the medals podium in London after winning a bronze medal in the women's quadruple sculls event.
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