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Updates to Medicare Advantage services effective Jan 1
December 9, 2020

ATTENTION: This information has been updated in an article published at a later date. Please consult the latest News & Updates on our COVID-19 information page.

This article is for providers paid at the Medicare standard rate

Effective January 1, 2021, we are making the following changes to benefits and costs for Medicare Advantage members.

No member cost for these services

There will be no member cost (copayment or co-insurance) for the duration of the Public Health Emergency for the following services when they are related to treatment for COVID-19:

  • Ambulance services
  • Emergency room or urgent care visits
  • Inpatient services
  • Outpatient office visits


Medicare Advantage members will have coverage for telehealth services for PCP, specialist, urgent care, and outpatient mental health services. Member cost will be the same as an in-person office visit, and cost will not be waived for a COVID-19 diagnosis.

Please be sure to bill with the appropriate telephonic codes listed in our COVID-19 temporary payment policy when providing services by telephone (versus by telehealth).

Prior authorization

For Medicare Advantage members, prior authorization will be required for skilled nursing facilities, long-term acute care services, and rehabilitation services. In September we communicated that prior authorization is required for these services for our commercial members (HMO, PPO, POS and indemnity) in this article: COVID-19: Inpatient acute care auth requirements waived until Dec 31.