What Does Medicare Advantage Cover? – Frequently Asked Questions

Last Updated : 10/29/20183 min read

Original Medicare includes Part A (hospital insurance) and Part B (medical insurance). Medicare Advantage (also called Medicare Part C) is an alternative way to get Medicare Part A and Part B benefits through a private Medicare-approved insurance company. Medicare Advantage combines all your Medicare benefits into one convenient plan except for hospice care, which is still covered by Part A.

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You’re still enrolled in Medicare when you have a Medicare Advantage plan and you still have Medicare rights and protections. According to the Kaiser Family Foundation, about 1 in 3 Medicare beneficiaries are enrolled in a Medicare Advantage plan.

What are the basic benefits that Medicare Advantage covers?

Medicare Advantage plans must cover at a minimum, all the services that Original Medicare covers. This includes:

  • Hospital care
  • Skilled nursing facility care
  • Nursing home care (as long as custodial care isn’t the only care you need)
  • Home health services
  • Ambulance services
  • Durable medical equipment
  • Mental health services (inpatient and outpatient )
  • Certain vaccines

What are extra benefits that Medicare Advantage covers?

  • Prescription drugs: While Original Medicare does not cover most prescription drugs, most Medicare Advantage plans do cover prescription drugs.
  • Over the counter medications: Some Medicare Advantage plans include a supplemental benefit for over-the-counter medications
  • Dental care: Original Medicare generally does not cover routine dental care. However, Medicare Advantage may cover routine dental services, diagnostic services such as X-rays, and oral surgery.
  • Vision care: Original Medicare generally does not cover routine vision care. Medicare Advantage may cover routine eye exams and eye wear such as contact lenses, eye glasses, lenses and frames.
  • Hearing care: Original Medicare generally does not cover routine hearing care. Medicare Advantage may cover routine hearing exams and fittings for hearing aids.
  • Additional inpatient days: Medicare Advantage may cover additional days in acute hospital care and skilled nursing facility care

What are other benefits of a Medicare Advantage plan?

  • Some Medicare Advantage plans may offer a $0 monthly premium. However, you still have to pay your Part B premium.
  • Unlike Original Medicare, Medicare Advantage plans have maximum out-of-pocket limits. That means there is a ceiling on how much you will pay each year before the plan covers all your health care costs.

Do you want more information about Medicare Advantage plans?

I can help you understand your options and get enrolled. I’m happy to set aside time for a phone discussion or send you an email containing plans that could work for you; the links for those are below, too. To start comparing Medicare Advantage plans now, click the Compare Plans buttons on this page.

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Medicare has neither reviewed nor endorsed this information.

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