Medicare's mental health coverage: How COVID-19 highlights gaps and opportunities for improvement

Medicare's mental health coverage: How COVID-19 highlights gaps and opportunities for improvement

The COVID-19 pandemic has put a spotlight on gaps in Medicare mental health coverage, an issue brief from the Commonwealth Fund finds. According to the brief, Medicare's mental health coverage: How COVID-19 highlights gaps and opportunities for improvement (10 pages, PDF), one in four Medicare beneficiaries has a mental illness, with the prevalence of mental illness greatest among those under age 65 who have a disability and low-income beneficiaries who are eligible for both Medicare and Medicaid. Inadequate provisions in current mental health coverage include the 190-day lifetime limit for inpatient psychiatric stays, lack of coverage for services provided by licensed professional counselors, poor access to mental health providers in Medicare Advantage plan networks, and limited coverage for telehealth services. To address such gaps, the brief's authors recommend that the government remove various barriers to coverage, including limits on inpatient stays and exclusion of counselor services; enhance provider networks for Medicare Advantage; provide technical assistance to help practices expand depression screening and behavioral health integration services; reward Medicare ACOs for meeting mental health quality metrics and ensure that specialty mental health providers are included in ACO networks; and make permanent the telemental health policies put in place in response to COVID-19, including expanded access and payment parity.