If you’re a new Medicare beneficiary, or someone considering making a switch during open enrollment, you may be considering a Medicare Advantage plan. Medicare Advantage, also known as Medicare Part C, is simply an alternate way of getting your benefits under Original Medicare (Part A and Part B).
There are many different Medicare Advantage benefits available depending on the plan you choose. Because these plans are offered by private companies approved by Medicare, they can offer extra benefits not available under Original Medicare.
Here’s a look at the Medicare Advantage benefits that may be available with the plans offered in your area.
What are the Medicare Advantage benefits that are different from Original Medicare?
Under federal law, all Medicare Advantage plans must include, at a minimum, all the benefits included in Original Medicare, except for hospice care, which is still covered under Medicare Part A. You do not lose any benefits if you enroll in or switch to a Medicare Advantage plan.
However, you may be able to enroll in a plan that also includes additional Medicare Advantage benefits, such as:
- Part D coverage for prescription drugs. Most Medicare Advantage plans include Part D prescription drug coverage, but be sure to read your plan documents to understand what medications are covered, if any, and your financial responsibility for covered medications, since this can vary greatly from plan to plan. Some plans may also include benefits for certain over-the-counter medications and treatments.
- Vision care. Original Medicare does not cover routine eye exams or prescription eye glasses except in certain limited situations. However, depending on where you live, you may have Medicare Advantage benefits for routine vision care, prescription eyewear, and contact lenses.
- Dental care. Many Medicare Advantage plans cover teeth cleaning (prophylaxis) and routine dental exams twice a year; some may even include benefits for restorative dentistry, such as fillings, root canals, and crowns or bridgework.
- Hearing care. Routine hearing exams and hearing aids are generally not covered under Original Medicare, but some plans include Medicare Advantage benefits for these services.
- Wellness. Your Medicare Advantage benefits may include discounted gym memberships, yoga classes, weight management counseling, and other routine wellness services not covered under Original Medicare.
Keep in mind that there may be annual limits and restrictions on these additional Medicare Advantage benefits, and that you may need to pay a deductible, copayment, or coinsurance amount when you access them. If these benefits are important to you, check your plan documents before you enroll in a Medicare Advantage plan.
What are other Medicare Advantage benefits?
In some cases, you may be able to enroll in a Medicare Advantage plan that covers alternative therapies such as chiropractic care and even acupuncture. In addition, your plan may include other comprehensive benefits such as:
- Counseling to manage life changes, conflict resolution, and grief in both individual and group sessions that would not otherwise be covered under Original Medicare.
- Enhanced disease management services for people with serious or chronic medical conditions such as heart disease, diabetes, and Alzheimer’s and related dementias.
- Bathroom safety devices and safety counseling for individuals at risk for falls. Your plan may also cover a comprehensive in-home safety assessment to help minimize the risk of injury and falls at home.
- Temporary home meal delivery for up to four weeks following surgery or inpatient hospital stay
- Personal emergency response system to notify emergency personnel in the event of fall or other medical event.
- Telemedicine or other remote health services, including a nursing hotline; in some cases, you may also qualify for remote monitoring devices.
- Transportation assistance to get you to and from covered health care appointments.
- Wigs for hair loss following chemotherapy for cancer.
It’s important to note that not all plans offer all benefits and not all plan types may be available in all locations. You also need to pay your routine Part B premium plus any additional premium required by your plan while you are enrolled in a Medicare Advantage plan. There may be deductibles, copayments, and/or coinsurance amounts required before your plan benefits apply.
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