Summary of Medicare Updates in the Medicare Plan Finder (MPF)

Currently, in the “Extra Benefits” section, MPF presents a more detailed display of benefit information for a limited set of supplemental benefits:

• • Hearing
  • Preventive and comprehensive dental
  • Vision

In the “More Extra Benefits” section, MPF displays 30 additional supplemental benefits using “some coverage” and “no coverage” labels. These benefits include, but are not limited to, health education, fitness benefits, over-the-counter drug benefits, and health-related emergency response devices.

On October 1, 2025, MPF enhanced the display of MA supplemental benefits for CY 2026 as follows:

• • CMS updated the 30 supplemental benefits in the “More Extra Benefits” section to replace the “same coverage” and “no coverage” labels with in-network and out-of-network cost sharing and messaging on authorization requirements and plan limits. This approach mirrors the current handling of the hearing, preventive and comprehensive dental, and vision benefits.

• • CMS added the following 6 new supplemental benefits with in-network and out-of-network cost sharing and messaging on authorization requirements and plan limits:
    • Wigs for Hair Loss related to Chemotherapy (PBP 14c15)
    • Weight Management Programs (PBP 14c16)
    • Home-Based Palliative Care (PBP14c20)
    • Re-Admission Prevention (PBP14c14)
    • Post Discharge In-Home Medication Reconciliation (PBP14c13)
    • Adult Day Health Services (PBP14c19)

The new rule will require Medicare Advantage organizations for plan years beginning on or after January 1, 2026, to:

• • Make the provider’s information available to CMS for publication online
  • Submit the information in a format determined by CMS
  • Update the provider data within 30 days of learning of a change
  • Ensure the accuracy of the provider directory information in an annual attestation

Medical Records

This brings us to a very IMPORTANT notification: North Carolina requires medical records for adult patients to be kept for a minimum of 11 years following their last contact with the provider or the date of service.

So, if you are retiring, or relocating, or even taking temporary leave, please keep this in mind as there are frequent government audits required of health plans. This information is for general guidance only and is not a substitute for legal advice. You should consult the specific North Carolina General Statutes and regulations, such as N.C. Gen. Stat. § 90-411, or seek advice from a legal professional to ensure full compliance with the law for your specific circumstances.

Providers must also adhere to relevant federal laws, which may require longer retention periods for certain types of records. The most stringent requirement should always be followed.

One final note, if you are retiring, happy retirement and congratulations. After years of caring for others, it’s time to look after yourself!

Just in case you were wondering, CMS has recently decided to audit records for dates of service from 2018 through 2025 and all insurance companies annually starting with 2026. It has come to our attention early in this process that some providers have moved or retired without following proper procedure for access to their records.