Medicare Advantage is a fantastic program that’s been providing seniors with affordable and comprehensive medical care since its original legislation in the late 1990s. With typically lower premium rates than Medicare Supplement plans and the appeal of Medicare Advantage-Prescription Drug (MAPD) plans that conveniently roll medical, hospital, and drug coverage together, it’s no surprise that the MAPD option has soared in popularity over the past decade.
However, many Medicare-eligible folks don’t know about some of the extra perks that come with Medicare Advantage plans. Unlike Medicare Supplement plans that are standardized by the Federal government and have set and rarely changing benefits, Medicare Advantage plans are administered by private insurance companies and offer a number of extra benefits and incentives. These companies must offer no fewer benefits than what a person is entitled to under Original Medicare but are otherwise able to customize their plan’s coverage levels. Driven by market competition, these insurance companies often customize their plans with bigger and better benefits from year to year to vie for your business. The result is that Medicare Advantage members are able to access fantastic benefits like fitness programs, hearing and dental coverage, alternative care, and more at a very low (oftentimes as low as $0!) premium rate.
A common staple in the extra perks of Medicare Advantage plans are fitness programs. Programs like Silver Sneakers, Renew Active, and Silver & Fit all offer plan beneficiaries complimentary access to a network of local gyms. Lists and maps of the networked gyms are available online, and your insurance agent can help show you the different filters that can help you specifically look for locations with pools, group classes, resistance training and more!
Some plans will even sweeten the deal with added incentives to choose healthy habits. For instance, Go365 by Humana is a program that rewards members with gift cards for volunteering, regularly exercising, and doing preventative medical checks like wellness visits and cancer screenings.
Another set of benefits that have grown in popularity in recent years are enhanced dental, vision, and hearing coverage. Dental, vision, and hearing coverage have long been available as an optional, tacked-on benefit at an extra cost. However, many Medicare Advantage plans have begun adding these benefits into their main plans without charging for them!
The dental portion of these benefits typically focuses on the preventative side of dental health and usually offers little to no cost cleanings, X-rays, and basic fillings. Some plans go as far as to cover more advanced dental work like root canals, although the dental benefit will usually cap out with an annual maximum of around $500-$2,000. So, if you’re prone to cavities, you may want to ask your agent about coordinating Medicare Advantage plan benefits with a more comprehensive dental plan to ensure maximum coverage.
The vision portion of these benefits also usually focuses on the preventative side of eye care and tends to offer little to no-cost eye exams to make sure your vision is still in good shape. Many plans will also offer a set hardware allowance to help you with the cost of your glasses and contacts! Like dental benefits, you should also consider asking your insurance agent about coordinating your Medicare Advantage plan vision care with a stand-alone vision plan. These plans are usually less than $20 a month and can help you afford more advanced eyeglasses and can even give you discounts on things like prescription sunglasses!
Hearing care, also a very important benefit is available in most plans. These Medicare Advantage plans also will include a basic hearing exam and some will even cover hearing aids! However, do expect to share the cost of your new hearing aid with the insurance company. Although you’ll likely get it at a heavily discounted rate, you’ll probably still have to put some money down. Your insurance agent can help you look before you leap and assist you in finding a plan to maximize your coverage.
Medicare Advantage plans can also help with your medications. Even the Over-the-counter ones! A common client favorite is savings available for Over-the-Counter products. Many plans include an Over-the-Counter benefit that gives members a quarterly or monthly allowance to spend on things like antacids, aspirin, bandages, vitamins, and more! Every company has a different way of getting members their products, but most either allow you to order from an online or paper catalog or will give you a prepaid card to use at the store.
Many insurance companies also offer need-specific programs and special plans that can help folks with a variety of health and life obstacles. Some common programs devote care managers and extra resources to folks with chronic conditions, mobility issues, and other unique needs. Your eligibility for these programs is typically assessed after you submit your enrollment application. Additionally, there are plans called Chronic Special Needs plans for which you must have one of 15 Medicare designated conditions in order to qualify. An insurance broker can help you assess whether you are eligible. Finally, once the enrollment application is completed a Health Assessment can be done. These optional, brief questionnaires will typically ask you about your general health, how often you’ve stayed overnight in the hospital, your ease of mobility, and if you’re having any difficulty accessing needed doctors or medications. The answers will help your Medicare Advantage company determine if you are eligible for any extra programs and they will reach out to you directly after your plan starts.
With all the amazing extra benefits accompanying most Medicare Advantage plans, it’s no wonder why most seniors are strongly considering them. Remember no two plans are created equal, and it’s important to weigh a plan’s medical and prescription drug benefits along with the extra bells and whistles. A plan that may have enticing extras may not cover your specific medical needs. Talking to an agent can help you weigh all your important needs along with the extra bells and whistles.
This Annual Enrollment Period be sure to check out the wonderful benefits in Medicare Advantage plans! With all the great Medicare Advantage plans in Southwest Washington (as well as the rest of WA, all of OR, and 6 other states), we at Your Insurance Gal Agency are trained to help you find a great fit! Please call us today for a no-cost review of the plans available to you for your specific needs.