Have Medicare? You may be able to get better access to mental health care this year

The American population is aging—and much-needed mental health care providers are in short supply. Earlier this year, the federal government rolled out new rules to help older Americans access more services and give health care professionals the flexibility to help those in their community with the greatest needs.

But better health care access only works if the people poised to benefit understand the new rules. It's not unusual for Medicare patients to need to advocate for themselves in health care situations, and doing so may help those from underserved communities receive better care.

Foothold Technology analyzed resources from the Centers for Medicare and Medicaid Services, Substance Abuse and Mental Health Services Administration, the Centers for Disease Control and Prevention, and the Commonwealth Fund to explain how the new Medicare rules will expand access to behavioral health treatment.

The Health Resources and Services Administration reports that 1 in 3 Americans live in a part of the U.S. where there is a shortage of mental health care professionals. The new rules for Medicare, announced in November, are intended to expand avenues to access for patients who can get services covered for mental health and drug use disorders.

Medicare is a federal health insurance program for Americans 65 and older, or younger people who live with disabilities. It's not to be confused with Medicaid, the federal program for Americans with limited incomes.

About 1 in 5 Americans use Medicare, with higher use rates in more rural states like West Virginia, Maine, and Vermont, according to a 2021 analysis by KFF. Recipients often live in underserved communities and tend to have lower incomes, with around 1 in 3 of recipients earning less than 200% of the federal poverty level.

The ongoing shortage of mental health providers nationwide, combined with the increase in mental illness and substance use disorders, has made care hard to find—especially for Medicare and Medicaid users. A report from the Department of Health and Human Services released earlier this year found that Medicare- and Medicaid-covered providers are difficult to come by, forcing some to drive an hour or more for care.

In a December statement, Department of HHS Secretary Xavier Becerra said the rollout of the new rules is part of the government's commitment to "expanding access to behavioral healthcare for people with Medicare."

In particular, the department aims to address gaps in treatment for Medicare recipients in Native American communities, rural communities, and other underserved parts of the country. Many of the changes aim to make it easier for recipients to get early intervention and crisis intervention from the service workers closest to the communities they serve, make care more affordable, and expand access to the potential mental and behavioral health workforce for Medicare beneficiaries.

This Medicare tool allows enrolled Medicare recipients to find providers nearby who Medicare covers. Read on to learn more about the changes coming to Medicare this year.