Customers Perceive Shortfall in Medicare Advantage Plan Coverage of Mental Health and Substance Abuse Services

Overall customer satisfaction with Medicare Advantage plans has increased this year, thanks largely to improvements in billing and payments, cost and provider choice. However, according to the J.D. Power 2022 U.S. Medicare Advantage Study,^SM released today, some concerning trends are brewing beneath the surface of those positive headline numbers. Most notably, a majority of Medicare Advantage plan members are saying they do not have enough coverage for mental health and substance use disorder services.

“Medicare Advantage plans have recognized that the key to improved patient outcomes is building engagement with members, encouraging the use of preventive health services and fostering great relationships with primary care providers who are leading overall care coordination,” said Christopher Lis, managing director, global healthcare intelligence at J.D. Power. “With an estimated 1.7 million Medicare beneficiaries living with a diagnosed substance use disorder and one in four Medicare beneficiaries living with a mental health condition, there is a big opportunity for Medicare Advantage plans to support more patients and families in need. Older adults have been affected by loneliness and social isolation that increased throughout the pandemic. For some health plans, coverage can be improved. For others, increasing customer understanding of mental health benefits may be the bigger opportunity as beneficiaries might be aware that some coverage is available but may not fully understand which services and medications are covered. But coverage does not always guarantee access, as finding providers who accept Medicare may be a challenge in some areas.”

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