Baby boomers embrace behavioral healthcare but face Medicare coverage hurdles

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Despite their widespread acceptance and use of behavioral healthcare, baby boomers are beginning to face challenges with Medicare's limited coverage of therapy and similar services. 

Vaile Wright, senior director of healthcare innovation at the American Psychological Association, told The Wall Street Journal that baby boomers were the first generation to significantly embrace behavioral healthcare like therapy. But as more and more boomers become eligible for Medicare, they face limited coverage for therapy. 

Therapists have significantly lower rates of Medicare acceptance than physicians in other specialties. About 55 percent of psychiatrists accepted Medicare from 2009-2010, compared to 86 percent of other physician specialties. 

Medicare pays psychologists $103 for a 45-minute session and social workers $77, according to the Journal. The low rates and additional paperwork mean many behavioral healthcare professionals don't find it worthwhile to accept Medicare coverage.

Medicare recipients who want to seek care see average costs around $300 for a psychologist and between $120 and $180 for a social worker. However, unlike some private coverage, Medicare does not allow practitioners to bill patients for the difference between what Medicare covers and the practitioner's rate, according to the Journal

Psychiatrist Robert Trestman, PhD, MD,  chair of the American Psychiatric Association's Council on Healthcare Systems and Financing, told the Journal that a patient who is 70 years old may require more medications, requiring him to spend increased uncompensated time consulting the patient's other specialists.

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