Key Takeaways

  • Medicare began to cover opioid treatment program services in 2020.

  • Supplemental benefits under Medicare Advantage plans expanded beyond just health-related benefits.

Beginning in 2020, Medicare made several changes to coverage of certain services, benefits, and prescriptions.

These included:

  • Allowing Medicare Advantage plans to cover additional non-health related supplemental benefits for plan members with chronic illnesses
  • Enabling Part D prescription drug plans to utilize indication-based formularies, which means they can limit coverage of medication to specific conditions/diseases
  • Expanding Part B benefits to cover services at opioid treatment programs

The Center for Benefits Access has partnered with the Medicare Rights Center to develop one-page, consumer friendly fact sheets that explain these changes and how they affect Medicare coverage.

PDF File: https://assets-us-01.kc-usercontent.com/ffacfe7d-10b6-0083-2632-604077fd4eca/c482c04e-8efb-4493-88eb-3ccc5840d383/Medicare-Rights-Center-Fact-Sheet-MA-coverage-of-supplemental-benefits.pdf
PDF File: https://assets-us-01.kc-usercontent.com/ffacfe7d-10b6-0083-2632-604077fd4eca/1d7d8e79-7489-467b-b9b4-8cecdd3a835a/Medicare-Rights-Center-Fact-Sheet-Medicare-Part-D-indication-based-formularies.pdf
PDF File: https://assets-us-01.kc-usercontent.com/ffacfe7d-10b6-0083-2632-604077fd4eca/4b0e229e-eafc-4af4-a2df-0e8082f32cef/Medicare-Rights-Center-Fact-Sheet-Medicare-coverage-of-opioid-treatment-programs.pdf