Health Affairs March 5, 2025
Medicare has a behavioral health and substance use treatment access problem. Particularly since the COVID-19 pandemic, the percentage of older adults reporting concerns about their mental health has increased substantially. Additional research shows Medicare beneficiaries are at a higher risk for opioid misuse and subsequent hospitalization, due to lack of access to treatment, partly attributable to Medicare coverage limitations. According to a report from the Center on Health Policy at Brookings (2024), older adults with any mental illness or substance use disorder were most commonly covered under Medicare and a supplement, while those with serious mental illness (SMI) were most commonly covered under Medicare only (with Medicare and Medicaid coverage being the next most common insurance status for this population).
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