Must Medicare Advantage Plans Cover Maintenance Therapy

August 1, 2022
Rick Gawenda

Must Medicare Advantage plans cover maintenance therapy in the same manner that traditional Medicare covers maintenance therapy?


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  1. How do you force Optum to cover this? You have to fight with them on just regular visits.

  2. Thank you for the clarification Rick. Out of curiosity – what is your opinion on how the prior authorizations and limit visits MA plans place on patients and clinicians align with “same level of service” as traditional Medicare?

    1. Same level of service refers to services that are covered by the Medicare program and not authorizations, co-pays, etc.