Non-Medicare Covered Additional Benefits With Medicare Advantage
Almost every Medicare Advantage plan comes with some form of additional benefits that are not covered by Original Medicare or your Medicare Supplement policy.
Additional Health Benefits: Below are the most common additional health benefits that some plans may have.
• Dental: Typically some Preventative and sometimes Comprehensive dental coverage. It is always best to use the In-Network dentists to maximize the dental benefit.
• Vision: While Medicare covers Diagnostic Exams for your eyes, they do not cover Routine Exams that include refraction. These are the basic exams when you need to update your glass or contact lenses.
• Hearing: Similar to Vision, some Medicare Advantage plans cover Routine Hearing Exams and may include some coverage for hearing aids…which Medicare does not cover at all.
• Transportation: Non-Emergency transportation to and from plan providers (doctors, hospitals, clinics, pharmacies). Not all plans offer transportation.
• Fitness Memberships: Fitness or gym memberships like Silver Sneakers. This gives you access to “local” health clubs and fitness centers.
• Over-The-Counter Wellness Products: Many plans give you a certain dollar amount per month or quarter that can be used for over-the-counter items from a catalog. I call these drug store items—things like: vitamins, over-the-counter medicines, first-aid supplies, personal care items and more.
While all these extra benefits are nice, in most cases, you should not base your decision on whether or not to enroll in a plan because of them or the lack of them. The most important part of determining which plan is in your best interest should come down to:
1. The plans network of doctors and hospitals. Are all of your preferred providers and hospitals In-Network? Which plan has the most doctors and hospitals In-Network? And maybe which plan is most flexible for travel?
2. Your prescription coverage: As mentioned elsewhere, you could have a lower priced plan with more additional benefits, but the prescription coverage is inferior to another plan. This could end up costing you hundreds, if not thousands, of dollars per year extra.
3. How well the plan or insurance company is at helping you manage your healthcare.
What I can tell you is—if you call some 800 number, go Online or deal with an agent that only sells for one or limited companies…then you are running the risk of ending up with the wrong plan and inferior coverage or benefits.
Optional Supplemental Benefits: Optional Supplemental Benefits are additional benefits that you can add on to the plan for an additional premium. Dental and Vision are the most common ones. When considering these Optional Supplemental Benefits, always be sure to see if your dentist or vision center is In-Network or that you are willing to use the plan’s In-Network dentists and vision centers. The reason is simple—you get a better deal when you use their providers which will make enrolling in the plan it worthwhile.
Value Added Benefits: These are benefits that are not allowed to be disclosed to you at the time of the sale or the time of your enrollment. You find out about them after the fact. They are nice to have, but not worth considering when it comes to choosing your plan.
