How can I compare benefits of different Medicare Advantage plans?
This article was updated on: 10/06/2018
Looking for a plan that covers eyeglasses? What about gym memberships? Want dental care? Medicare Advantage might have what you’re looking for. Because Medicare Advantage plans are provided by private insurers approved by Medicare, they may provide extra benefits that Original Medicare (Part A and Part B) don’t offer. However, note that Medicare Advantage plans costs and benefits can vary among plans. Other than these extra benefits, Medicare Advantage plans must cover all of the services that Medicare Part A (hospital insurance) and Part B (medical insurance) cover. (An exception is hospice care, which Medicare Part A continues to cover.) They also must cover emergency and urgently needed care.
Most Medicare Advantage plans offer Medicare Part D prescription drug coverage. If you are interested in one of these Medicare Advantage plans, be sure to check the formulary, or list of prescription drugs covered by the Medicare Advantage plan to make sure the medications you take are covered. Although a Medicare Advantage plan can make changes to its list of covered prescription drugs, the plan will notify you before it does so.
Here’s what you should know when comparing benefits of MA plans.
What are the extra benefits Medicare Advantage plans may provide?
Although Medicare Advantage plans aren’t required to offer extra benefits, many plans do offer one or more extra benefits. As you evaluate the Medicare Advantage plans available where you live, you’ll want to take into account extra benefits the plans may offer, in addition to comparing Medicare Advantage plan premiums, deductibles, copays, and provider networks. You must continue to pay your Medicare Part B premium.
- Medicare Advantage plans may offer extra benefits that expand on Medicare Part A or Part B coverage.
Examples of these types of extra benefits include:
- Additional inpatient hospital/skilled nursing facility days not covered by Medicare Part A
- Worldwide Emergency/Urgent Care
- Routine podiatric (foot) or chiropractic care not covered by Medicare Part B
- Comprehensive dental services
- Routine eye exams and eyewear not covered by Medicare
- Hearing exams, fitting and evaluation for hearing aids, and hearing aid devices
- Additional coverage for smoking cessation or nutrition counseling
- Medicare Advantage plans may offer benefits for alternative therapies Medicare does not cover under any circumstance, such as acupuncture.
- Medicare Advantage plans may offer benefits related to your safety that Medicare does not cover.
Examples of these benefits include:
- In-home safety assessments to help minimize the risk of falls and injuries in your home
- Bathroom safety devices
- Personal Emergency Response System (PERS) to notify emergency personnel if you experience a medical event or fall
- In-home medication counseling after discharge from a hospital or skilled nursing facility to ensure you are taking only the medications you need
- Nurse Hotlines or Telemedicine Services
Many Medicare Advantage plans provide a 24-hour nurse hotline free of charge to assist you when you have questions about health symptoms you are experiencing. Some Medicare Advantage plans may offer telemedicine services that allow you to consult a doctor by phone or video.
- Gym Membership and Fitness Programs
Many Medicare Advantage plans include access to fitness programs, such as SilverSneakers, at no additional cost or at a discounted cost. Medicare Advantage plans may provide coverage for other programs, such as weight management or yoga classes, which support a healthy life style as well.
- Counseling and Education Programs
Some Medicare Advantage plans provide coverage for medical nutrition therapy or counseling to manage life changes, for example. They may also offer educational programs related to stress management, living with a specific health condition, and similar topics delivered by qualified experts.
- Over-the-counter (OTC) products
Some Medicare Advantage plans may provide coverage for specified health-related OTC products that are not covered by the plan’s Part C (medical) coverage or Part D (prescription drug) coverage.
You can typically find information about any extra benefits in the Medicare Advantage plan’s Summary of Benefits. This information includes both a description of the coverage and any applicable premium or cost-share amount you may have.
Are you looking for more information about Medicare Advantage plans that offer extra benefits?
Would you like help comparing benefits between MA plans available where you live? Please feel free to contact me by using the links below. If you wish to compare some of the Medicare plans where you live, use the Compare Plans button on this page.
Benefits, premiums and/or copayments/co-insurance may change on January 1 of each year.
The Formulary, and/or provider network may change at any time. You will receive notice when necessary.