Medicare Advantage plans, also known as Medicare Part C, offer recipients a choice in what kind of healthcare they receive by bundling Original Medicare with additional benefits. Medicare Advantage plans are offered by private insurance companies that contract with Medicare to provide your Part A and Part B benefits, but many Medicare Advantage plans include additional coverage at little to no extra cost. Each Medicare Advantage insurer determines what additional benefits are included in each plan, so choosing a plan that will save you money requires careful evaluation of your needs and a comparison of plans available in your area.
Common Benefits Offered by Medicare Advantage Plans
In order to be eligible as a Medicare Part C plan, Medicare Advantage insurers must provide the same benefits recipients get through Original Medicare Part A and Part B. Medicare Advantage providers typically offer a variety of plans that may offer a wide range of additional benefits to help recipients save money and receive comprehensive healthcare.
The additional coverage addresses common gaps in coverage with Original Medicare, such as routine dental and vision care, hearing exams, and prescription drug coverage. Some Medicare Advantage carriers may include an allowance for over-the-counter supplies, but what can qualify as covered supplies can vary by each plan. Some Medicare Advantage plans provide wellness programs and gym memberships through SilverSneakers.
Annual changes can occur that impact the additional benefits a plan covers. Once enrolled in a plan, you will be notified by your plan of any changes. It’s important to stay up-to-date on any changes to your Medicare Advantage plan and consider any changes you experience in your own healthcare needs. If you are enrolled in a Medicare Advantage plan with prescription drug coverage (MA-PD), you should check the plan’s drug formulary each year to make sure your current needs are still being met.
Evaluating Your Healthcare Needs
A Medicare Advantage plan may not be a suitable choice for every Medicare recipient, but they can provide valuable benefits. For instance, Medicare recipients with a need for dental or vision care may prefer to enroll in a Medicare Advantage plan rather than paying the full cost of care without insurance.
Medicare Advantage plans can also prove beneficial for recipients who anticipate the need for monthly prescription drug costs to factor into their overall budget. Life can be unpredictable, and an unexpected medical crisis can threaten your financial security if you require long-term use of medications for a chronic or acute condition. Additionally, a Medicare Advantage plan may include benefits that offset the premiums, copayments and deductibles associated with Medicare Part B, which helps recipients who have frequent doctor’s appointments throughout the year.
Savings Associated with Medicare Advantage Plans
Generally, recipients experience healthcare savings through a Medicare Advantage plan when they choose plans that help cover the costs associated with out-of-pocket expenses. Part C plans have their own monthly premium that is paid separately from the Part B premium, but some plans will pay the Part B premium as part of the benefits offered. Copay and coinsurance amounts, as well as deductibles, may also be included, in part, through Medicare Advantage coverage.
A Part C plan may also place a yearly limit on a recipient’s cost obligations, which means that once the limit is reached, recipients receive full coverage for qualifying healthcare services for the rest of the year. Original Medicare does not have a yearly limit on out-of-pocket expenses for recipients, so this can prove to be a very valuable savings opportunity for recipients.
The dental and vision benefits that many Part C plans offer also present another effective way to save on the costs of healthcare. Regular exams may help detect disease and damage early on, which then helps you prevent more serious conditions from worsening and costing more to repair at a later date.
Because each Part C plan can be different depending on the insurer and the location, you should compare the list of benefits carefully and consider what healthcare services you need the most in order to help you decide if a Medicare Advantage plan can save you money.