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Medicare Advantage Plans: What Is the Coverage?

Medicare Advantage plan next to stethoscope

In 1997, the Balanced Budget Act introduced Medicare Part C (Medicare Advantage) as a plan that offered added benefits to the original Medicare. However, nowadays, the original Medicare consists of two parts: Medicare Part A (Hospital Insurance) and Part B (Medical Insurance). While original Medicare provides extensive coverage for inpatient and outpatient care, it lacks coverage for some daily medical necessities.

Additionally, the original Medicare does not cover deductibles, coinsurance, and copayments. Medicare Advantage is coverage offered through private insurers which provide supplemental funds for Medicare recipients in need.

What Is a Medicare Advantage Plan?

Medicare Advantage is an extension of Medicare that features missing benefits of the original Medicare. Medicare Advantage plans operate similarly to an HMO or PPO plan. With Medicare Advantage, Medicare recipients utilize the local doctors and facilities in their area that will accept their insurance coverage.

What Are the Coverages?

Medicare Advantage plans provide additional supplemental coverage. Furthermore, Medicare Advantage aims to benefit those who have an underlying need for the various products and services not covered under the original Medicare.

Prescription Drug Coverage

Depending on your location, Medicare Advantage plans may offer coverage for prescribed medication under certain conditions. Medicare Advantage offers coverage for almost 300 prescription drugs through prescription drug coverage, also known as MAPD. This plan will reduce the expensive costs normally associated with purchasing your prescription drugs. We recommend working with your doctor to determine which prescription drugs does your Medicare Advantage plan cover.

Hearing Coverage

According to Medicare, over 88% of Medicare Advantage plans in the US offered coverage for hearing aids. In fact, nearly 30 million adults in the US who require hearing aids could benefit from their qualifications for original Medicare and an additional Medicare Part C plan.

Vision Coverage

Medicare Advantage plans may offer coverage for routine exams, upgraded frames, eyeglasses and contact lenses, and preventative exams. Also, certain Medicare Advantage plans depending on your location will even cover specific retailers.

Dental Coverage

Medicare Advantage plans provide Medicare recipients with additional benefits not available in original Medicare such as access to networks of qualified dentists, price protection, cost-sharing, and out-of-pocket spending limits. Dental insurance coverage under a Medicare Advantage plan includes routine dental exams, routine teeth cleanings, X-rays, tooth extractions, fillings, root canals, and more. 

Physical Fitness Coverage

Membership fees and costs associated with maintaining physical health may be covered depending on your service location and your underlying need.

Do You Have Questions?

Choosing the right Medicare Advantage plan for you is best done with the assistance of licensed insurance professionals. Moreover, licensed insurance agents can provide the proper insight and costs associated with choosing a Medicare Advantage plan. It is worthwhile to understand the coverages and plans offered in your area, especially if your original Medicare does not cover the expenses you need. 

Begus Insurance Group helps Medicare recipients choose which Medicare Advantage plan is best for them. If you would like more information about Medicare Advantage plans or would like to speak to an agent, contact Begus Insurance Group today for a free consultation!