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.