When it comes to mental health treatment for people on Medicare, we can’t ignore out-of-pocket medication costs

By Dan Klein, President and CEO of the PAN Foundation and Michael Pollock, CEO of the Depression and Bipolar Support Alliance

More than 21 million people in the United States live with a mood disorder like depression or bipolar disorder.

And the toll these disorders can take is immense: U.S. Department of Health and Human Services figures show that these conditions account for up to 60 percent of the nation’s suicides each year.

Mood disorders, although life-threatening, are treatable. And many people can lead thriving, healthy lives with the right treatment plan. But if they can’t afford treatment—whether that’s medication or therapy—those affected by these disorders often have nowhere to turn for help.

This crisis is particularly acute for the 13 million Medicare beneficiaries with a mental health or mood disorder. For these people, Medicare is more than just health insurance: it’s their lifeline to treatment. And for many grappling with the uncertainties in their life brought on by COVID-19, access to appropriate mental healthcare is more important than ever.

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Cost sharing can impede treatment for mental health disorders

There has not been enough attention to the needs of Medicare beneficiaries living with mental health disorders.

Medicare covers a wide variety of healthcare services for older adults and people with disabilities. However, many beneficiaries face high out-of-pocket costs when it comes to prescription drugs—an essential component of treatment for people with mood disorders.

In the case of bipolar disorder, prescription medications can help a patient manage their symptoms and regain their health. It’s also common for patients to work with their healthcare provider to try different drugs before finding the medication that works best.

However, people on Medicare with a limited income may not be able to afford the many prescriptions it takes to find the right treatment or fill their prescriptions regularly, leading many to delay or stop treatment altogether.

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Lower costs can lead to better health outcomes

When patients can afford their out-of-pocket share for prescription drugs, they are more likely to adhere to this part of their treatment plan. Failing to take needed medications can pose a life-threatening disruption in care for people with mood disorders and increase the likelihood of in-patient hospitalization.

Until our nation’s leaders implement sustainable policy solutions that make prescription medications affordable to all—especially for the 13 million Medicare beneficiaries with a diagnosed mental health disorder—organizations like ours are here to help ensure that everyone can access vital mental health treatment. 

To fill the gap and provide critical support for people with bipolar disorder, the PAN Foundation and the Depression and Bipolar Support Alliance (DBSA) have expanded financial and support services for people on Medicare who are receiving treatment for bipolar disorder.

With COVID-19 exacerbating challenges to accessing mental health services, it is more important than ever that we band together to help people with bipolar disorder get the care they need.

Through the PAN Foundation’s Bipolar Disorder Assistance Program, eligible patients with Medicare insurance can get help paying for their bipolar disorder medications for 12 months. DBSA offers these patients a wide variety of empowering services, from peer-led support groups to practical, hands-on programs like the DBSA Wellness Wheel, designed to help people with mood disorders lead healthy, balanced lives.

During the COVID-19 crisis, DBSA has rapidly expanded access to virtual support groups to meet the growing need for compassionate listening and mutual aid among people with mood disorders.

Congress must pass legislation to limit out-of-pocket prescription drug costs

Everyone deserves access to appropriate and comprehensive mental health care. Out-of-pocket costs should never hinder anyone from starting and staying on treatment for a mood disorder. If you’re concerned about out-of-pocket costs, join us in calling on Congress to pass legislation to make Medicare prescription drug coverage affordable.

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