Estimated change in health care use after enrolling in Medicare at age 65. Credit: USC Schaeffer Center
People with mental health symptoms from low- and middle-income households tend to receive much less mental health care upon aging into Medicare, according to new research from the USC Schaeffer Center for Health Policy & Economics.
Enrolling in Medicare was associated with a 71% decline in the likelihood of having any type of outpatient mental health visit, even after controlling for factors like employment and income. It was also associated with a 47% lower likelihood of receiving a psychotropic drug, such as antidepressants and mood stabilizers. These negative impacts were found for both traditional Medicare and its commercial equivalent, Medicare Advantage.
There has been growing concern about Medicare beneficiaries’ access to mental health care services, given the program’s limitations coverage and low participation among mental health providers.
The study in Health Services Research appears to be the first to investigate how enrolling in Medicare at age 65 affects use of common mental health care services for people with probable mental health symptoms.
“People with substantial mental health needs appear to receive drastically less mental health care once they age into Medicare,” said Schaeffer Center research scientist Grace McCormack, the lead study author. “This is especially concerning given the high and growing demand for mental health care among the over-65 population.”
Medicare enrollment, meanwhile, did not affect how often this same group of people received care from non-mental health providers and filled prescriptions for non-psychotropic drugs. This suggests that Medicare—regardless of whether people enroll in the traditional program or Medicare Advantage—poses specific access barriers to mental health care for people who would struggle to pay for care entirely out of pocket.
Notably, those with mental health from higher-income households saw no change in visits to mental health providers, while their use of psychotropic symptoms increased.
The study drew on a nationally representative survey of health care use, spending and insurance coverage from 2014–2021.
Other authors include Erin Duffy and Josephine Rohrer of the USC Schaeffer Center and Adam Biener of Lafayette College.
More information:
Grace McCormack et al, Enrollment in Medicare is associated with fewer outpatient mental healthcare visits among those with mental health symptoms, Health Services Research (2024). DOI: 10.1111/1475-6773.14423
Citation: Medicare enrollment linked to sharp decline in use of mental health care services (2025, January 17) retrieved 17 January 2025 from
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