Main points
-
Medicare Advantage expanded in 2018 to provide supplemental benefits for people with chronic conditions.
-
The supplement would allow Medicare to cover expenses not directly related to health.
-
The government has now placed limits on those benefits, which could affect more than 4 million older Americans.
Medicare Advantage plans are alternatives to traditional Medicare that offer coverage for more services. Bipartisan Budget Act of 2018 Allows Advantage Plans to Cover Matters That Would Otherwise Be no directly related to health if They help maintain or improve function in people with chronic conditions.
In response, Medicare Advantage plans submitted proposals to the Centers for Medicare and Medicaid Services (CMS) to cover different supplemental services, some of which CMS believed should not be covered. In fact, CMS has compiled a non-exhaustive list of Advantage program services cannot Covers and includes some common procedures.
Image source: Getty Images.
CMS vetoes Medicare Advantage plans’ efforts to expand coverage
Medicare Advantage plans have submitted requests in the past to cover certain procedures under new CMS rules that take effect in 2026, but CMS says it will no longer consider them. The new rules provide:
Some plans offer cosmetic services for cosmetic purposes only, such as Botulinum toxin injections for fine lines and wrinkles. CMS previously rejected the proposals during bid review because purely cosmetic procedures had no health relevance.
CMS has now made clear that such coverage is not allowed under the 2018 expanded rule because the required procedures do not create a “reasonable expectation of improving or maintaining the enrollee’s health or overall functioning.”
Common procedures no longer covered by Medicare
Now, CMS has a new rule package addressing the issue. The agency has revised § 422.102 to prohibit:
-
Cosmetic surgery, including plastic surgery
-
Facial line beauty treatment
-
Cosmetic treatments for collagen and lipoatrophy
-
Cosmetic surgery to treat bone loss caused by aging
According to the American Society of Plastic Surgeons, cosmetic surgery is on the rise, with more than 4.1 million people aged 55 and older undergoing cosmetic surgery (a 28% increase from 2010). Because Medicare Advantage plans no longer cover these treatments as a benefit after this rule change, retirees who want these treatments must make sure they save and invest wisely to get the care they need.
$23,760 Most retirees completely ignore Social Security bonuses
If you’re like most Americans, you’re a few years (or more) behind on your retirement savings. But there are some lesser-known ones “Social Security Secrets” Can help ensure increased retirement income. For example: One simple trick can make you $23,760 more…each year! Once you learn how to maximize your Social Security benefits, we think you’ll be ready to retire with the peace of mind we all seek.
Many Americans leave money behind when they retire. Learn more about these retirement strategies and what you can get when you join stock advisor.
View “Social Security Secrets” »
The Motley Fool has a disclosure policy.
New Medicare Advantage rules ban coverage for procedures used by more than 4 million seniors Originally published by The Motley Fool
