Lynn Cooper was going through an awful time. After losing her job in 2019, she became deeply depressed.
Reviewed by Danielle Ellis, B.Sc.Nov 3 2023 Then the covid-19 pandemic hit, and her anxiety went through the roof. Then her cherished therapist — a marriage and family counselor — told Cooper she couldn't see her once Cooper turned 65 and joined Medicare.
As a result, older adults anxious about worsening health or depressed by the loss of family and friends have substantial difficulty finding professional help. Barriers to care are made more acute by prejudices associated with mental illness and by ageism, which leads some health professionals to minimize older adults' suffering.
"As we emerge from the COVID-19 public health emergency, it is abundantly clear that our nation must improve access to effective mental health and substance use disorder treatment and care," Meena Seshamani, deputy administrator of the Centers for Medicare & Medicaid Services, said in a July statement.
Cooper, now 68 and a behavioral health policy specialist at the Pennsylvania Association of Area Agencies on Aging, bumped up against Medicare's limitations when she tried to find a new therapist in 2020: "The first problem I had was finding someone who took Medicare. Many of the providers I contacted weren't accepting new patients.
Several questions remain open as Medicare enacts these changes. The first is, "Will CMS pay mental health counselors and marriage and family therapists enough so they actually accept Medicare patients?" asked Beth McGinty, chief of health policy and economics at Weill Cornell Medicine in New York City. That's by no means guaranteed.
Another key issue: Will legislation proposing mental health parity for Medicare advance in Congress? Parity refers to the notion that mental health benefits available through insurance plans should be comparable to medical and surgical benefits in key respects. Although parity is required for private insurance plans under the 2008 Mental Health Parity and Addiction Equity Act, Medicare is excluded.
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