Medicare Mental Health Services

Background

At least one in five older Americans has a mental disorder. Among Medicare Authorized in 1965 under Title XVIII of the Social Security Act, Medicare provides health insurance coverage for people age 65 and older and for some disabled people under age 65. This federal program consists of Part A (Hospital Insurance), Part B (Supplemental Medical Insurance), Part… beneficiaries age 65 and older, the most common mental disorders are depression, anxiety, dementia, and other neurocognitive impairments. By 2030, the number of older people with such disorders is expected to double.

Mental disorders seldom occur in isolation and can often lead to serious physical health issues. For example, depression is associated with increased risk of coronary heart disease and premature death. Depression also often co-occurs with substance abuse disorder and other chronic illnesses such as Alzheimer’s disease, cancer, and arthritis.

However, they are frequently undiagnosed or misdiagnosed in older patients, and older adults are more likely than younger adults to receive inappropriate or inadequate mental health services. One reason is that primary care practitioners—who provide most mental health care under Medicare Authorized in 1965 under Title XVIII of the Social Security Act, Medicare provides health insurance coverage for people age 65 and older and for some disabled people under age 65. This federal program consists of Part A (Hospital Insurance), Part B (Supplemental Medical Insurance), Part… —have insufficient training in the assessment and treatment of mental disorders associated with aging.  Although geriatric mental health assessment tools exist, their use is often not part of routine practice. Perceived social stigma and denial can also impede accurate diagnosis and treatment.

Many older people are reluctant to seek counseling to help them cope with the challenges of later life such as bereavement, disability, loneliness, and isolation, which may explain why older Americans are disproportionately likely to die by suicide.

While Medicare Authorized in 1965 under Title XVIII of the Social Security Act, Medicare provides health insurance coverage for people age 65 and older and for some disabled people under age 65. This federal program consists of Part A (Hospital Insurance), Part B (Supplemental Medical Insurance), Part… ’s coverage of mental health and substance abuse services has improved over the years, restrictions that do not apply to other health services remain, such as a lifetime limit of 190 days for psychiatric care in freestanding psychiatric hospitals. Despite growing evidence supporting the effectiveness of multi-disciplinary, community-based geriatric mental health treatment teams (e.g., physicians, social workers, nurses, psychologists, and pharmacists), Medicare Authorized in 1965 under Title XVIII of the Social Security Act, Medicare provides health insurance coverage for people age 65 and older and for some disabled people under age 65. This federal program consists of Part A (Hospital Insurance), Part B (Supplemental Medical Insurance), Part… limits access to this type of care.

Medicare Authorized in 1965 under Title XVIII of the Social Security Act, Medicare provides health insurance coverage for people age 65 and older and for some disabled people under age 65. This federal program consists of Part A (Hospital Insurance), Part B (Supplemental Medical Insurance), Part… covers some mental health-related preventive services with no cost-sharing including annual screenings for depression and alcohol-misuse screening, but coverage for subsequent services can be limited. For those who screen positive for alcohol misuse, Medicare Authorized in 1965 under Title XVIII of the Social Security Act, Medicare provides health insurance coverage for people age 65 and older and for some disabled people under age 65. This federal program consists of Part A (Hospital Insurance), Part B (Supplemental Medical Insurance), Part… will cover four brief, face-to-face behavioral counseling interventions per year (see also this chapter’s section on Specific Needs and Services—Mental Health for a broader discussion of mental health issues).

Medicare Authorized in 1965 under Title XVIII of the Social Security Act, Medicare provides health insurance coverage for people age 65 and older and for some disabled people under age 65. This federal program consists of Part A (Hospital Insurance), Part B (Supplemental Medical Insurance), Part… covers outpatient mental health services provided by physicians (especially psychiatrists), clinical psychologists, clinical social workers, clinical nurse specialists Health care workers participate in mentoring other nurses, case management, research, and other activities.  Specialty areas include to adult health, community health, geriatrics, home health, pediatrics, psychiatric/mental health, school health and women's health. There are also… , nurse practitioners, and physician assistants. Medicare Authorized in 1965 under Title XVIII of the Social Security Act, Medicare provides health insurance coverage for people age 65 and older and for some disabled people under age 65. This federal program consists of Part A (Hospital Insurance), Part B (Supplemental Medical Insurance), Part… does not cover treatment by licensed professional counselors. For beneficiaries in rural areas, Medicare Authorized in 1965 under Title XVIII of the Social Security Act, Medicare provides health insurance coverage for people age 65 and older and for some disabled people under age 65. This federal program consists of Part A (Hospital Insurance), Part B (Supplemental Medical Insurance), Part… will pay only for mental health services delivered via  tele-health The use of electronic communications technologies and information to support and offer health care when distance separates patient from provider. Also sometimes referred to as telemedicine.   (video conference) to an approved location by a qualified mental health professional.

The Affordable Care Act ( ACA Comprehensive health care reform legislation passed by Congress and signed into law on March 23, 2010. ) made some significant improvements to Medicare Authorized in 1965 under Title XVIII of the Social Security Act, Medicare provides health insurance coverage for people age 65 and older and for some disabled people under age 65. This federal program consists of Part A (Hospital Insurance), Part B (Supplemental Medical Insurance), Part… ’s mental health service coverage. For example, Medicare Authorized in 1965 under Title XVIII of the Social Security Act, Medicare provides health insurance coverage for people age 65 and older and for some disabled people under age 65. This federal program consists of Part A (Hospital Insurance), Part B (Supplemental Medical Insurance), Part… Part D now covers barbiturates and benzodiazepines, which were originally excluded from Part D coverage. The ACA Comprehensive health care reform legislation passed by Congress and signed into law on March 23, 2010. also eliminated cost-sharing for certain Medicare Authorized in 1965 under Title XVIII of the Social Security Act, Medicare provides health insurance coverage for people age 65 and older and for some disabled people under age 65. This federal program consists of Part A (Hospital Insurance), Part B (Supplemental Medical Insurance), Part… -covered preventive services and authorized CMS to add coverage of additional preventive services through the National Coverage Determination process.

Based on the large and growing number of older adults who misuse substances like alcohol and prescription drugs, demand for mental health and substance abuse services is also expected to grow with the aging of the baby-boom cohort. The anticipated increase in demand for such services may be difficult to meet because older adults already have a tremendous unmet need for them.

MEDICARE MENTAL HEALTH SERVICES: Policy

Access to mental health services

In this policy: Federal

Medicare Authorized in 1965 under Title XVIII of the Social Security Act, Medicare provides health insurance coverage for people age 65 and older and for some disabled people under age 65. This federal program consists of Part A (Hospital Insurance), Part B (Supplemental Medical Insurance), Part… should provide more adequate reimbursement for mental health and substance abuse services, and should eliminate the 190-day lifetime limit on inpatient psychiatric care in freestanding psychiatric hospitals under Part A.

Medicare Authorized in 1965 under Title XVIII of the Social Security Act, Medicare provides health insurance coverage for people age 65 and older and for some disabled people under age 65. This federal program consists of Part A (Hospital Insurance), Part B (Supplemental Medical Insurance), Part… should expand the list of mental health professionals who can be reimbursed under Medicare Authorized in 1965 under Title XVIII of the Social Security Act, Medicare provides health insurance coverage for people age 65 and older and for some disabled people under age 65. This federal program consists of Part A (Hospital Insurance), Part B (Supplemental Medical Insurance), Part… to cover all providers who are fully licensed by their state for independent practice.

Medicare Authorized in 1965 under Title XVIII of the Social Security Act, Medicare provides health insurance coverage for people age 65 and older and for some disabled people under age 65. This federal program consists of Part A (Hospital Insurance), Part B (Supplemental Medical Insurance), Part… should expand its coverage of outpatient services that have been shown to help individuals with mental illnesses remain in the community.

CMS should ensure Medicare Authorized in 1965 under Title XVIII of the Social Security Act, Medicare provides health insurance coverage for people age 65 and older and for some disabled people under age 65. This federal program consists of Part A (Hospital Insurance), Part B (Supplemental Medical Insurance), Part… beneficiaries’ access to appropriate, high-quality mental health and substance abuse services, such as outpatient services and partial hospitalization services, as well as ensure access to such preventive services as screening for depression and alcohol misuse.

CMS should ensure that Medicare Authorized in 1965 under Title XVIII of the Social Security Act, Medicare provides health insurance coverage for people age 65 and older and for some disabled people under age 65. This federal program consists of Part A (Hospital Insurance), Part B (Supplemental Medical Insurance), Part… beneficiaries with mental health or substance abuse problems, particularly those residing in nursing homes or enrolled in managed care plans, have access to appropriate services. Data collection and other oversight activities must preserve beneficiary privacy and confidentiality.