Getting the Most Out of Your Medicare Advantage Plan
Chances are, you’ve seen a commercial starring Joe Namath while he speaks about a Medicare plan that costs nothing, covers everything and includes all this extra stuff like dental and gym memberships. Joe isn’t selling some hot ticket Medicare add on, he’s selling Medicare Advantage plans, also called Part C.
Medicare Advantage plans are sold by private insurance companies and they combine your Medicare Part A (Inpatient) + Medicare Part B (Outpatient) with your drug coverage (Part D). Essentially, they are combining all the different parts of Medicare into one, low cost plan. They also typically include extra benefits like dental and gym memberships among other things. While Advantage plans are not always the right fit for everyone, they are a very popular option for a lot of folks. In this blog we are going to take a look at some of the common “extra stuff” these plans include so you can take advantage of these additional benefits. Please note the following explained benefits do not reflect any one particular plan.
Dental - One of the biggest benefits to Medicare Advantage plans is that they may include dental coverage. Unfortunately, not all dental plans are made the same. Some may be an actual plan that covers up to a certain amount per year with set rates (copays) for dental services. You may need to see an “In Network” dentist to be covered. Other plans may include a dental reimbursement plan. With this you typically pay full cost at the time of service and submit claims to the insurance company for reimbursement.
Key things to pay attention to with dental coverage are:
Is the plan Dental Insurance or a Dental Reimbursement plan.
Benefit Max - This is the most your dental plan will pay towards care per year. Even if your copays are $0, the full cost of the service will count towards your Max.
What’s covered by the plan? Ie: does it only cover cleanings, exams and X-Rays or is it a comprehensive plan that covers major services like root canals. Also, how much will you have to pay for those services
Is the dental embedded in the plan ie: no cost or is it an optional rider ie: opt in for a cost.
Do you need dental? If you only go for a cleaning and check up, you might not even need a dental plan.
Vision - Another popular benefit to Medicare Advantage plans is vision coverage. When you see vision included in a plan it really only means “routine” vision. If routine vision is included with your plan, it typically only covers your 1 annual eye exam. The plan may also include a hardware reimbursement to help cover the costs of lenses, frames, contacts etc. Medicare covers conditions/disease of the eyes (cataracts, glaucoma, etc.) under Medicare Part B.
Gym membership - One of the strategies Medicare Advantage plans utilize to keep the costs of the plan down is encouraging members to be proactive with their own health. Most advantage plans we see will include a gym membership benefit. Basically, this benefit allows you to become a member of a gym through a program like SilverSneakers at little or no cost to you.
OTC (Over the Counter) - A benefit that is becoming more common with Medicare Advantage is an over the counter benefit. This is typically a quarterly credit that you can use to purchase over the counter items (cough medicines, aspirin etc) from vendors like a Wal-Mart or CVS. This can be a great way to save some additional money on items you might already be purchasing at a cost.
Hearing Aids - Most Advantage plans will cover a routine hearing exam once per year. In addition to that many plans also offer a discount on hearing aids. Depending on the plan, there are typically different brands and models you can choose from a vendor service. The plan will set rates that you pay per ear for the hearing aids you choose. Hearing aids are expensive so even with a discount you could still pay in the thousands, but still a savings from the full retail amount.
Discounts and Reimbursements - There really are a lot of variety in the ancillary benefits commonly included with Medicare advantage plans. Many plans include various types of reimbursements for things like wellness, fitness equipment, meal delivery and many more. It’s always a good idea to take a look and see what might be beneficial to you.
While we never recommend picking a Medicare Advantage plan based solely on the extra benefits (at the end of the day, you are purchasing Health Insurance), these extra benefits can be a great way to save money and improve your mental and physical health at the same time. If you, a family member or a friend is getting ready for Medicare we’re happy to help walk them through the options and explain how these plans work. Call us today at 401-404-7373 or email help@doctorschoiceusa.com to schedule a no cost consultation. Thanks for reading!
