Summary: Medicare Advantage plans cover Original Medicare (Part A and Part B) benefits – and more, in many cases. These plans are offered by private insurance companies and vary in terms of benefits and cost. If you compare Medicare Advantage plans, you might find the plan that works best for your needs and budget.
Medicare Advantage plans are offered by private insurance companies that contract with Medicare to deliver your Medicare Part A and Part B benefits. Most of these plans cover prescription drugs. Many Medicare Advantage plans have provider networks. You might have to see doctors within the network, or you might pay more if you go outside the network.
Original Medicare covers many of your hospital and medical expenses. If you want certain additional benefits, a Medicare Advantage plan might be a better option for your needs. When you compare Medicare Advantage plans, you might find coverage for things like eyeglasses, routine dental care, gym memberships, and more.
Comparing Medicare Advantage plans: what is Medicare Advantage?
The Medicare Advantage (Medicare Part C) program gives you an alternative way to get your Medicare Part A and Part B benefits. Private, Medicare-approved insurance companies offer these plans.
Medicare Advantage plans can also offer extra benefits. Common additions include routine dental and vision services, and prescription drug coverage. Other possible extra benefits might surprise you. Some plans might cover bathroom safety devices, enhanced disease management, meal delivery, remote access technology, and acupuncture. You may have to meet certain criteria to qualify for these benefits.
When you compare Medicare Advantage plans, keep in mind that costs and extra benefits can vary between plans.
How to compare Medicare Advantage Plans
When you compare Medicare Advantage plans, there are several things to think about.
If you compare Medicare Advantage plans that offer prescription drug coverage, be sure to check the formulary. This is a list of the medications covered under the plan. You want to know the plan you choose will cover the medications you take. Sometimes, Medicare Advantage plans change their formulary. You will receive notification if it does, so you can look for another plan if necessary.
What extra benefits may be included?
Medicare Advantage plans are not required to offer extra benefits. However, most do offer at least a few. Examples of additional benefits might include:
- Additional days in a hospital or nursing center
- Urgent care when you are out of the country
- Podiatric (foot) care or chiropractic services
- Comprehensive dental services
- Hearing services, including hearing aids
- Smoking cessation or nutrition counseling
- Alternative therapies like acupuncture
Some Medicare Advantage plans also offer safety-related benefits. These might include:
- In-home safety assessments to minimize your risk for falls or injuries at home
- Bathroom safety devices
- Personal Emergency Response System (PERS) to notify emergency personnel if you need help
- In-home medication counseling after a hospital or nursing facility stay
Additional Medicare Advantage benefits
When you compare Medicare Advantage plans, be aware that Medicare Advantage plans can offer even more benefits that you might find helpful. Keep in mind not all plans will offer these services. In some cases, you might have to qualify for certain services or items with the plan’s approval.
Nurse hotlines or telemedicine services
Some Medicare Advantage plans provide a nurse hotline that is available 24 hours a day, seven days a week. You can call this free service to ask questions about your health. Plans may also 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. Other programs, such as weight management or yoga classes, might also be covered.
Counseling and education programs
Some Medicare Advantage plans offer counseling and education to help you adopt a healthier lifestyle. You might receive nutrition therapy or counseling to manage life changes. You could also have educational programs related to stress management, living with a specific health condition, and similar topics.
Over-the-counter (OTC) products
When you compare Medicare Advantage plans, you might find coverage for OTC medications, such as pain relievers and cold medicines.
Medicare Advantage plans can also cover some support services for members. These might include transportation to doctor visits or adult daycare services. In specific situations, cleaning services might also be available.
Compare Medicare Advantage plans: where to find information
Every Medicare Advantage plan has a Summary of Benefits, listing the benefits included with the plan. This information includes both a description of the coverage and any cost you might have to pay out of pocket for the benefit.
Comparing Medicare Advantage plans: different types of plans
Before you compare Medicare Advantage plans, you’ll want to be familiar with the different types of plans available. For example, some Medicare Advantage plans are Health Maintenance Organization HMO) plans, and some are Preferred Provider Organization (PPO) plans. Read about the various types of Medicare Advantage plans.
When you compare Medicare Advantage plans, make sure you look at the cost of the plan as well as the benefits. Some of the costs might include a monthly premium, yearly deductible, copayments, or coinsurance. These costs can also vary, so make sure you find a plan that meets your budget as well as your needs.