Medicare Advantage Plans can sometimes provide broader coverage than traditional Medicare.
However, some changes were made in 2026 that will restrict certain services Advantage Plans have been able to cover for years.
Here’s why the changes are happening, along with a list of things that can no longer be covered.
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Why are Medicare Advantage rules changing in 2026?
Medicare Advantage Plans are changing in 2026 because the Centers for Medicare and Medicaid Services (CMS) created a new rule, changing one put in place in 2018.
- In 2018, the Bipartisan Budget Act of 2018 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, which aren’t directly related to health but which improve or maintain the health or function of chronic illness sufferers.
- CMS is now imposing new limits on some of these services in 2026 to restrict the kinds of coverage that are allowed.
In a statement announcing the change, CMS stated, “We believe that codifying a nonexhaustive list of examples of items or services that do not meet these standards will provide transparency and greater certainty for MA organizations and enrollees about the rules that govern these benefits.”
What is Medicare Advantage no longer allowed to cover?
The specific listed services Medicare Advantage is no longer allowed to cover under the new CMS rule include:
- Alcohol
- Cannabis
- Cosmetic surgeries, including treatment for facial lines, facelifts, and treatments addressing collagen and fat that has atrophied
- Funeral costs
- Hospital indemnity insurance
- Life insurance
- Tobacco products
- Unhealthy foods
Medicare Advantage members should know the new rules
Medicare Advantage plan members should understand coverage changes. Because neither traditional Medicare nor Advantage plans cover all that retirees need, it’s important to save and invest dedicated funds for healthcare services. Wisely investing to pay for care as a senior helps you ensure you can afford the services you require.