Seven Medicare Advantage Benefits To Consider

Victoria Burke by Victoria Burke | Licensed since 2011
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This article was updated on: 11/21/2018

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If you get a Medicare Advantage plan, you may get extra Medicare Advantage benefits not typically provided by Original Medicare (Part A and Part B). Not all benefits are covered in the same way by all plans. Here are seven benefits to consider.

1. Medicare Advantage prescription drug coverage

According to research for the Mayo Clinic, nearly 70 percent of Americans take at least one prescription drug and 20 percent take five or more prescription drugs. Original Medicare generally doesn’t cover most prescription drugs you take at home.

However, most Medicare Advantage plans include coverage for prescription drugs you take as an inpatient, outpatient, and at home. There is no separate premium for your Medicare Advantage prescription drug coverage; you pay for it in your general monthly Medicare Advantage premium.

You may pay a separate prescription drug deductible, for example, $250 a year. You also will generally pay something when you fill a prescription, for example a $15 copayment for a generic medication and a $47 copayment for a preferred brand medication.

2. Medicare Advantage dental coverage

Original Medicare generally doesn’t cover dental care, except in certain extreme and emergency situations. However, you may be able to find a Medicare Advantage plan that covers routine dental care such as cleanings, x-rays, fillings, and dentures. A Medicare Advantage plan is the only way to get routine dental care through Medicare.

3. Medicare Advantage vision coverage

Unlike Original Medicare, many Medicare Advantage plans cover routine vision coverage, such as eye exams, eye glasses, and contacts. Original Medicare only covers eye exams related to certain conditions such as diabetes, glaucoma, and macular degeneration.

4. Medicare Advantage hearing coverage

According to the National Institutes of health, hearing loss is one of the most common conditions affecting older adults. Despite this, Original Medicare generally doesn’t cover routine hearing coverage. A Medicare Advantage plan may cover routine hearing exams, fittings for hearing aids, and hearing aids. There may be a limit on how much the plan will pay for hearing aids, for example $1,000 every three years for hearing aids for both ears combined.

5. Medicare Advantage fitness benefits

One Medicare Advantage fitness program is called SilverSneakers. which may provide you with unlimited access to gyms in your area as well as fitness classes. According to the U.S. National Library of Medicine, exercise for seniors can help you build strength, avoid falls, and keep your body limber.

6. Medicare Advantage out of pocket maximums

Original Medicare has no out of pocket maximum. That means that if you get a complicated surgery, have a prolonged hospital stay, or need frequent outpatient procedures or doctor visits, you may be billed for tens of thousands of dollars. All Medicare Advantage plans, on the other hand, have an out of pocket maximum.

In 2018, the upper limit for the Medicare Advantage out of pocket maximum was $6,700 for covered medical services. Many Medicare Advantage plans set lower out of pocket maximums, for example $4,900. An out of pocket maximum can give you the security of knowing that no matter how much medical care you need, your personal financial resources will only be drained so much.

Certain things generally don’t count towards your out of pocket maximum, such as prescription drug copayments and out of network care.

7. Medicare Advantage copayments

The Medicare Advantage cost sharing structure is usually copayments rather than coinsurance.

A copayment is a set dollar amount, for example $10, that you pay to visit your primary care physician. On the other hand, the cost sharing structure of Original Medicare is coinsurance, making you responsible for example of 20% of the Medicare approved amount for a service. With a copayment, you know what you will pay when you receive a medical service. With a coinsurance, you won’t know the dollar amount until you receive the bill. The Medicare Advantage copayment structure may make it easier to budget your medical expenses.

Now that you know about these seven benefits of Medicare Advantage plans, you can compare and find a Medicare Advantage plan in your area by entering your zip code on this page.

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