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NAMI believes that all people with mental health conditions deserve access to effective medication and treatment options. NAMI supports Medicare’s “six protected classes” policy to ensure access to a broad range of antipsychotic and antidepressant medications.
Access to effective prescription medications is essential for many people with mental illness to successfully manage their condition and get on a path of recovery. Medicare is a lifeline for much of that care, providing health insurance for over 60 million U.S. adults, including millions of people with mental health conditions and accounting for about one-sixth of all mental health spending nationally.
In 2003, Congress established Medicare Part D which allows Medicare coverage of outpatient prescription drugs. This change provided much-needed prescription drug coverage for seniors and people with disabilities, including many people with mental illness. The current policy requires all Part D prescription drug plans and Medicare Advantage plans to include “all or substantially all” of the medications in “six protected classes” on their drug formularies. Two of the six protected classes are antidepressants and antipsychotics. This policy was created to ensure that Medicare beneficiaries with some of the most complex conditions, like mental illness, are not discriminated against. It also ensures they have access to a range of treatment options that meet their individual needs.
Medicare’s “six protected classes” policy is a key part of the success of Medicare Part D because it established critical medication access protections for many of the most vulnerable Medicare beneficiaries and must be maintained.
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