Medicare Advantage Plans

Medicare Advantage Plans (Medicare Part C) are offered by private insurance companies that are contracted by the federal government to administer them.

Medicare Advantage Plans cover the same healthcare services as original Medicare Part A and B, with the exception of hospice care. (Hospice services are covered under Original Medicare Part A and B, even if you’re enrolled in a Medicare Advantage Plan.)

4 Advantages of Medicare Advantage Plans

1. Cost Savings

• Medicare Advantage Plans are subsidized by Medicare so they usually have a very low or no premium at all.
• There are no extra premiums for prescription drug coverage with most plans.
• All preventative services are covered with no copay.
• Out of pocket costs are based on usage instead of a monthly premium so most members with average healthcare usage save more money with a Medicare Advantage Plan than a Medicare Supplement.
• Some Medicare Advantage Plans have Rx benefits that allow for generic prescriptions with no copay.
• Medicare Advantage plans are required to have a maximum out-of-pocket limit to restrict how much financial responsibility the beneficiary is exposed to.
• Medicare Advantage Plans may have additional benefits not covered under Medicare Part A or B, such as dental, vision, and hearing aid coverage.

2. Convenience

• Medicare Advantage Plans generally have the benefits of original Medicare parts A, B, and D all wrapped up into one coverage plan, administered by one company. This makes it easier for the beneficiary because they only need to use one card for all of their health services.
• Medicare Advantage Plans generally have a set schedule of copays for services. Most of the time, a beneficiary will know what the cost of care will be before that service is provided.
• There are no referrals to see specialists for most plans.

3. Extra Benefits

• Some Medicare Advantage Plans offer comprehensive dental, routine vision, eyeglasses, contact lenses, routine hearing exams, and hearing aid coverage.
• Benefit allowances for “over the counter” items you would normally buy from the pharmacy (vitamins, cold medicines, band-aids, incontinence pants, etc.).
• Some Medicare Advantage Plans cover home health aides, medical transportation, and the installation of in-home safety devices.
• Meals may be provided after a hospital or skilled nursing stay to help maintain nutrition levels during recovery.
• A 24-hour nurse hotline is available for medical advice.
• Telemedicine opportunities offer virtual doctor visits.

4. Healthy Lifestyle Perks

• Many Medicare Advantage Plans offer a cost-free membership to a local fitness center with access to classes designed to help you stay active.
• Gift card reward programs to encourage beneficiaries to complete their preventative services and stay physically active.