Starting in 2025 we saw many changes to Medicare Advantage plans. In 2025 Premera BCBS exited the MA marketplace and BCBS of MA discontinued specific plans. This year BCBS of VT is also completely discontinuing offering Medicare Advantage plans. California saw Anthem BC reduce offerings in certain counties including El Gorado, Placer and Stanislaus. We are also seeing health systems and hospitals dropping MA plans.
Also in 2025, we’ve seen plans that previously covered 20 visits for chronic low back pain, as well as plans with additional acupuncture benefits, (known as routine coverage) no longer offer routine as well as no longer process for chronic low back pain unless the treatment was supervised by an MD.
WHY is this happening?
In short, insurance companies are under a lot of pressure with new laws, (the Inflation Reduction Act), stricter healthcare rules (Medicare added stronger protections for patients and safeguards around hospital stays, which cost money. Finally, prescriptions and supply costs covered under these plans have risen.
However, not all is lost…
What I am hearing are offices are assuming that ALL Medicare Advantage plans will no longer offer acupuncture benefits, and are telling patients acupuncture is no longer covered by any MA plan, this is not true.
While many plans are no longer covering, there still are plans that cover routine acupuncture. Carefirst BCBS still offers a PPO plan with both regular and routine benefits for 2026 for one. I reached out to my contact at Optum/UHC to inquire about their plans and was told that UHC continues to offer some Medicare Advantage plans with routine benefits to their members. I requested a list of plans, but they haven’t gotten back to me, so I continued to research, as I had an assumption.
Two Types Of Medicare Advantage Plans
First understand carriers that SELL MA plans also administer plans for employer groups that offer MA insurance to their retirees. These are people who retired and included in their retirement package was the employer group’s Medicare Advantage plan. Because it is self-funded it can decide to continue to offer routine benefits. I then checked two MA plans here in California administered by UHC, both ID cards show the same Group health-plan but a different Group number – CalPERS, (The CA Public Employees Retirement System) and UC Retiree plan (University of CA – 10 Campuses). CalPERS no longer has routine benefits, the UC plan has both. Kinda makes sense as I know CA has a multi-billion dollar deficit.
Bottom line – there are plans out there and most likely they will be retiree plans administrated by the carriers. So don’t assume there is no coverage before you confirm.