# Medicare and Medicaid Behavioral Health Service Use Among Dual-Eligible Special Needs Plan Enrollees

**Authors:** Hyunjee Kim, Sara Edelstein, Angela Senders, Maanyatha Cheekati, Stephan R. Lindner, K. John McConnell, Jeah Jung

PMC · DOI: 10.1001/jamanetworkopen.2025.54246 · JAMA Network Open · 2026-01-15

## TL;DR

This study examines how often behavioral health services are used and who pays for them among people enrolled in dual-eligible special needs plans.

## Contribution

The study provides new insights into the use and funding of behavioral health services in dual-eligible special needs plans.

## Key findings

- Behavioral health services are commonly used by dual-eligible special needs plan enrollees.
- Medicaid primarily covers behavioral health services for these enrollees.
- Medicare's role in covering these services is limited.

## Abstract

This cross-sectional study investigates the prevalence of behavioral health services among Medicare and Medicaid enrollees in dual-eligible special needs plans and the distribution paid for by each program.

## Full-text entities

- **Diseases:** BH condition (MESH:D000071069), self-harm (MESH:D012652), mental illness (MESH:D001523), substance use disorder (MESH:D019966), BH (OMIM:603663)
- **Chemicals:** D-SNP (-)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

1 figure with captions in the complete paper: https://tomesphere.com/paper/PMC12809357/full.md

## References

6 references — full list in the complete paper: https://tomesphere.com/paper/PMC12809357/full.md

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Source: https://tomesphere.com/paper/PMC12809357