Medicare Advantage Can No Longer Cover These Items in 2026
By Marge | Published 2026-01-06T19:09:26.199+00:00
News
Health News -- January 6, 2026: Starting in 2026, the Centers for Medicare and Medicaid Services (CMS) has implemented new rules to tighten what Medicare Advantage (MA) plans can offer as "supplemental benefits." While these plans often provide extras that Original Medicare doesn’t, CMS is now excluding specific items that do not meet the "primarily health-related" standard.
In 2018, the Bipartisan Budget Act authorized Medicare Advantage Plans to provide more supplemental benefits to enrollees suffering from chronic illnesses. Specifically, Advantage plans were given authorization to cover Special Supplemental Benefits for the Chronically Ill (SSBCI). CMS classifies these as "non-primarily health-related" benefits, yet requires that they must still be "reasonably expected to improve or maintain the health or function" of the chronic illness sufferer. CMS is now imp