Mental health and substance abuse disorder services are needed by people of all ages, including older adults. In February 2023, 20% of adults 65 and older reported symptoms of anxiety and/or depression. Medicare covers a range of mental health and substance use disorder services, and Medicare Advantage plans are required to cover the same set of services as traditional Medicare.
About 60% of Medicare Advantage enrollees were in plans that did not cover out-of-network outpatient mental health and substance use disorder services
98% of Medicare Advantage enrollees were in plans that required prior authorization for some mental health and substance use disorder services
Medicare Advantage plans can and do apply cost management tools to mental health and other services, such as prior authorization requirements, referrals, and limited networks that can restrict beneficiary choice of in-network physicians and facilities.
https://www.kff.org/medicare/issue-...isorder-coverage-in-medicare-advantage-plans/
About 60% of Medicare Advantage enrollees were in plans that did not cover out-of-network outpatient mental health and substance use disorder services
98% of Medicare Advantage enrollees were in plans that required prior authorization for some mental health and substance use disorder services
Medicare Advantage plans can and do apply cost management tools to mental health and other services, such as prior authorization requirements, referrals, and limited networks that can restrict beneficiary choice of in-network physicians and facilities.
https://www.kff.org/medicare/issue-...isorder-coverage-in-medicare-advantage-plans/