Medicare Advantage is missing for mental health coverage


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Overall customer satisfaction with Medicare Advantage plans increased this year, largely due to improvements in billing and payments, costs, and provider choice. But according to the new JD Power 2022 US Medicare Advantage study, some concerning trends are emerging beneath the surface of these positive numbers.

Most notably, the majority of Medicare Advantage plan members say they don’t have enough coverage for mental health and addictions services.

The data of the Commonwealth Fund and the National Library of Medicine shows about 1.7 million Medicare beneficiaries living with a diagnosed substance use disorder and about one in four beneficiaries living with a mental health condition.

Older adults in particular, according to the study, have been affected by loneliness and isolation that have only increased throughout the COVID-19 pandemic. For some health plans, coverage may be enhanced, while others may have the ability to educate clients about mental health benefits, as many beneficiaries may be unaware of coverage and available medications.


Overall, member satisfaction with Medicare Advantage plans is up. Customer satisfaction reached 809 on a 1,000 point scale, an increase of three points from 2021 and 15 points over the past five years.

Despite this, only 38% of MA plan members report having sufficient coverage for mental health treatment, down from 39% a year ago. Only 27% of members say they have sufficient coverage for services related to substance use disorders.

These numbers compare to 91% of members who say they have sufficient coverage for routine diagnostics and 89% who say they have sufficient coverage for prevention and wellness services.

The use of telehealth, meanwhile, is declining. Only 24% of MA plan members have used telehealth in the past year, down from 35% in 2021. Of those who have used the technology, however, 48% say they are very likely to use it again , an increase of five percentage points over last year.

Health plan portals are still showing promise, but breaking the inertia is proving difficult. A strong majority (82%) of MA members are enrolled in their health plan member portal – up four percentage points from a year ago – but 14% have enrolled in the portal and do not never connected. Overall customer satisfaction scores are 72 points higher (823) when customers register and log in to the portal than when they do neither (751).

The Kaiser Foundation Health Plan ranks first in overall Medicare Advantage plan satisfaction, with a score of 844. Humana (824) ranks second and Highmark (811) ranks third.


The Centers for Medicare and Medicaid Services is researching ways to improve Medicare Advantage. The agency issued a request for information in July seeking public comment on the popular offering and seeking feedback on ways to make it more fair, affordable and sustainable.

As Medicare Advantage enrollment grows, so does concern and uncertainty about the benefits providers are raking in and whether “overpayment” is a problem. A report from the Brookings Institution says the top five insurers — UnitedHealthcare, Humana, Aetna, Kaiser Permanente and Elevance Health (formerly Anthem) — are inflating their results by disguising benefits as costs.

The report points out that insurers are able to do this because profits generated by related businesses are not regulated by medical loss ratio requirements.

Medicare Advantage plan payments are expected to get an 8.5% revenue increase for 2023. That’s up from the 7.98% proposed in the February advisory. The 2023 growth rate is set at 4.88%.

Twitter: @JELagasse
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