Medicare Advantage is a premium-based Medicare health plan. If you’re eligible, you can choose to enroll in a Medicare Advantage plan instead of Original Medicare, which covers Part A and Part B services only. There are many different types of plans available and each one offers different coverage. Here is a look at what you might expect as far as coverage goes with this type of program:
Medical Services
Medicare Advantage is a type of health plan that’s offered by private insurers. It works in conjunction with Original Medicare and offers an alternative to Original Medicare, as well as other types of insurance.
If you’re considering a Medicare Advantage Plan, you should know what it covers. Here are some answers to common questions about what the plans cover:
- Do they cover doctor visits? Yes, they do—but the coverage may vary depending on which plan you choose. Some plans offer more coverage than others, so be sure to look at your options before deciding which one is right for you.
- Do they cover drugs? Yes, but again, this will depend on which plan you choose. Some plans offer more drug coverage than others, so it’s important to compare all of your options before making a decision.
Prescriptions
Medicare Advantage Plans cover prescriptions, including the following:
- Medicare Part D prescription drugs. This includes brand-name drugs, generic drugs and mail-order pharmacy services. You pay a copayment for each prescription that you get filled.
- Medicare Part B drugs. These are non-formulary drugs that are considered medically necessary and approved by Medicare as covered services. They include medications such as cancer medications, antiretrovirals and injectable medications. If you’re in a Medicare Advantage Plan, you pay less than $6 per prescription for these kinds of medications under most plans (called “tier 3”).
Preventative Care
Preventative care is covered by Medicare Advantage Plans. This includes yearly check-ups and screenings, as well as immunizations and other treatments to help you stay healthy, such as:
- Annual physicals and checkups
- Immunizations (like flu shots)
- Blood pressure checks
- Screenings for cancer or diabetes, like mammograms and colonoscopies
Inpatient And Outpatient Benefits
Medicare Advantage plans cover inpatient and outpatient services that are medically necessary. This includes hospital stays, doctor visits, lab tests and more. It also includes skilled nursing care if you are hospitalized for at least three consecutive days or longer than two nights. In addition to these things, Medicare Advantage plans will also cover hospice care if you are terminally ill and need palliative care.
Dental And Vision
Dental is limited to preventative care, such as exams and cleanings. If you need more extensive treatment, you’ll need to pay out-of-pocket for those expenses. Vision is similar; it covers basic vision care like eye exams and glasses or contacts if they’re medically necessary, but not other options like contact lenses or laser eye surgery.
Conclusion
The Medicare Advantage plan is a great alternative to traditional Medicare. It provides more benefits and helps you get the care you need. If you are considering switching, contact us today. We can help guide you through this process so that everything goes smoothly.
