With a Medicare Advantage Plan, every benefit under Original Medicare will be covered, including additional benefits that Original Medicare lacks.
You will have access to benefits such as hospital and medical insurance and coverage for health-related services, such as prescription drugs, vision, and dental.
Are you new to Medicare?
Medicare has many coverage options. You can choose to get your Medicare benefits from Original Medicare (Medicare Part A and B), which the federal government administers, or you can go the route of Medicare Advantage, administered by private insurance companies.
Medicare Advantage Plans do not offer you less coverage than Original Medicare. Medicare Advantage covers everything that Original Medicare covers.
With Medicare Advantage Plans, you may have access to supplemental benefits not generally covered by Original Medicare. With Medicare Advantage, you’re still in the Medicare program, but you still have Medicare rights and protections. You also have the right to appeal a coverage decision.
What your Medicare Advantage plan covers
Medicare coverage is not only determined by federal and state laws but national laws as well. All Medicare Advantage Plans cover emergency and urgent care, but below are other medical costs covered by Medicare Advantage:
Medicare Part A:
- Hospital care
- Skilled nursing facility care
- Nursing home care (if custodial care isn’t the only care you need)
- Home health services
- Hospice care
Medicare Part B:
- Laboratory tests and doctor visits
- Emergency ambulance services
- Durable medical equipment, such as wheelchairs and walkers
- Inpatient and outpatient mental health services
- Preventative care, including vaccines
- Rehabilitative services, such as physical therapy, occupational therapy, and speech-language pathology
Prescription Drug Coverage:
The coverage of specific prescription drugs may vary depending on the plan, but you can check the plan’s formulary to see if your prescriptions are covered. The prescription drugs that are required to be covered include:
- Certain vaccines including pneumococcal and influenza
- Certain oral anti-cancer drugs
- Hemophilia clotting factors
- Immunosuppressive drugs
- Some antigens
- Injectable drugs for osteoporosis
Routine Dental Coverage:
- Cleanings
- X-rays
- Annual exams
- Extractions
- Fillings
- Root canals
- Gum disease treatment
- Crowns, bridges, dentures
Routine Vision Coverage:
- Routine eye exams
- Contact lenses
- Eyeglasses
- Lenses, frames, upgrades
Routine Hearing Coverage:
- Routine hearing exams
- Fitting evaluation for hearing aids
- Hearing aids
Wellness Benefits Coverage:
- Gym memberships
- Fitness programs
Other coverage includes:
- Additional days for inpatient hospital acute or psychiatric care
- Podiatry care
- Routine care
What if my Medicare Advantage Plan doesn’t cover what I need?
Should your Medicare Advantage Plan deny you the coverage you need, you can:
- Request an appeal for a health care service, item, or prescription drug you think you should get
- Request an appeal for payment for a health care service, item, or prescription drug you already got
- Request an appeal to change the amount you must pay for a health care service, item, or prescription drug
At Hitcho Insurance, we work with you to find the best Medicare policy that suits your needs, goals, and finances. Give us a call today at (610) 694-9435 and receive a free consultation.
