Document ID: ./input/supremecourt_opinions/opinions/21pdf/20-1641_3314.pdf
Page Number: 9

Cite as:  596 U. S. ____ (2022) 

7 

Opinion of the Court 

wants to create such a system going forward, Congress of
course may do so.

In sum, the Marietta Plan does not “differentiate in the 
benefits it provides” to those with end-stage renal disease 
and those without end-stage renal disease. 

B 
DaVita  also  contends  that  a  plan  that  provides  limited
coverage for outpatient dialysis impermissibly “take[s] into 
account” the Medicare eligibility of plan participants with 
end-stage renal disease in violation of the statute.  To reit-
erate, that statutory provision states that a plan “may not
take into account that an individual is entitled to or eligible 
for” Medicare.  42 U. S. C. §1395y(b)(1)(C)(i); see also §426– 
1.  For example, a plan may not terminate coverage, limit 
coverage, or charge higher premiums for an individual who 
has Medicare coverage due to end-stage renal disease.  See 
42 CFR §§411.108(a)(3), (5)−(6).

As already discussed, the Marietta Plan’s terms, includ-
ing its terms of coverage for outpatient dialysis, are uniform
for all individuals.  Because the Plan provides the same out-
patient dialysis benefits to all Plan participants, whether or 
not a participant is entitled to or eligible for Medicare, the
Plan cannot be said to “take into account” whether its par-
ticipants are entitled to or eligible for Medicare. 

* 

* 

* 
Because the Marietta Plan’s terms as relevant here apply
uniformly to all covered individuals, the Plan does not “dif-
ferentiate  in  the  benefits  it  provides”  to  individuals  with
end-stage renal disease or “take into account” whether an
individual is entitled to or eligible for Medicare.  We there-
fore reverse the judgment of the U. S. Court of Appeals for
the Sixth Circuit and remand the case for further proceed-
ings consistent with this opinion. 

It is so ordered.