Medicare Advantage has become an attractive alternative to traditional Medicare. New members are drawn to its benefits that go beyond regular Medicare (Parts A and B).
Private insurers, such as UnitedHealthcare and Humana, provide Medicare Advantage, also called Medicare Part C. About one-third of Medicare beneficiaries choose Medicare Advantage. That’s on the rise. Membership has increased by about 11 million over the past decade.
Medicare Advantage plans often offer prescription drug benefits, vision, hearing and chiropractic services. This year, the federal government is letting insurers expand benefits even further.
Insurers can now reimburse for meal delivery, gym membership, home safety, service dog coverage, rides to doctor appointments and enhanced preventative care.
Other Medicare Advantage plans offer specialized benefits related to a person’s health. For instance, about 300 plans will provide up to 1.3 million enrollees with benefits connected to diabetes and congestive heart failure care.
Cathryn Donaldson, director, Communications & Public Affairs, America's Health Insurance Plans (AHIP), said Medicare Advantage benefits and coverage vary by insurer, plan and local market.
"For instance, if an insurance provider is serving a market that is considered a food desert, they may work with a local organization to organize a meal delivery service for their members. Additionally, when you're talking about disease-specific plans, many plans are offering new benefits for those with chronic conditions, such as diabetes. For instance, an insurance provider may connect a member diagnosed with Type 2 diabetes with a nutritionist,” Donaldson said.
Bonnie Whalen, a senior services consultant for EHD Insurance in Lancaster, PA, said she finds Medicare Advantage members appreciate the add-ons, including dental, vision and hearing aids.
"(Original) Medicare does not cover hearing aids, so having an allowance for hearing aids is definitely appealing to members. The Advantage plans do not cover the total cost, but they have an allowance for hearing aids, which is very helpful since hearing aids are extremely expensive,” Whalen said.
Let’s take a look at some of Medicare Advantage’s supplemental benefits.
Some original Medicare plans include "necessary care" as it relates to vision. That means it only corresponds to serious situations, such as vision-related illness.
Medicare Advantage plans often go beyond that. Most offer eye exam and eyewear coverage. For instance, Fallon Medicare Plus Orange let members have one eye exam per year for a $40 co-pay and up to $150 each year for eyewear.
Several Medicare Advantage insurance companies offer free "on-demand" transportation to doctor appointments. These services usually work by providing an allotment to use for Uber or Lyft.
Alignment, Blue Shield of California, Humana and Anthem Blue Cross & Blue Shield are companies with this transportation benefit. Amerigroup provides its Medicare Advantage plan participants up to 60 one-way trips per year to health-related appointments or to obtain a service covered by the health plan. Anthem, too, boasts "services to help members get to doctor appointments and other healthcare visits."
Several healthcare companies added benefits to address food insecurity.
Alignment Healthcare is among the Medicare Advantage healthcare companies with this add-on. The option gives qualifying members a $10 to $20 per month grocery benefit to use at participating stores, such as CVS, Walgreens and Walmart.
Healthy Food Deliveries
A growing problem for many Americans is access to healthy food. Medicare Advantage insurers can include food deliveries to their plans.
Anthem said that its 2020 wellness services options include a prescribed meal plan of two meals per day for 90 days delivered to the home. It is "based on qualifying clinical criteria, health plan consumer receives a prescription for meals and periodic appointments with a registered dietitian."
Amerigroup announced that it'll add up to 16 delivered meals four times each calendar year to support members who are either discharged from an overnight stay at a hospital, have a Body Mass Index (BMI) more than 25 or less than 18 or has an A1C level more than 9.0.
Whalen said this benefit can especially help people who live alone.
Original Medicare doesn’t usually cover this holistic application to healing. However, some Medicare Advantage plans offer visits to the chiropractor as one of its supplemental benefits.
The SCAN plan, as an example, covers routine visits to the chiropractor through American Specialty Health MA option.
Social Visits/Help From the Younger Generation
Many Medicare Advantage plans are introducing coverage for a service that connects youth with those who would benefit from social interaction.
"Grandkids On-Demand" from Alignment is one such Medicare Advantage added benefit "to help solve the growing loneliness epidemic.” The program offers "companion care benefit on certain plans that connects college students with qualifying members who need assistance with non-medical services, such as light housekeeping, technology lessons and general companionship."
Vibra Health Plan is adding a similar Medicare Advantage plan benefit called "Papa Pals." The program connects college students with members who need assistance with light household chores and errands.
Similar to vision care, dental coverage has been a long-standing added benefit in Medicare Advantage plans. Original Medicare usually doesn’t offer dental care coverage except for emergency visits or complicated dental procedures.
This Medicare Advantage supplemental benefit varies greatly. Many Advantage plans include some level of dental care. That could consist of cleanings, oral exams, X-rays, root canals, extractions, fillings, crowns, bridges, implants and dentures.
Physical activity and exercise is a key component to Medicare Advantage supplement benefits. It is specifically addressed with the SilverSneakers benefit.
SilverSneakers promotes exercise. It often offers no-cost gym memberships, fitness classes and a fitness app.
"They will actually pay for your gym membership as long as your fitness center participates and is contracted with the Advantage plan," explained Whalen.
Most Medicare Advantage Plans include prescription drug coverage.
Alignment Healthcare reports that it offers nearly 500 commonly used generic drugs at no copay for most plans.
"One of the real perks to having an Advantage plan is that most plans wrap the prescription drug benefit with the medical benefits," said Whalen, "so the member is able to have a ‘one-stop-shop.’ The member is only required to carry one card, which provides them with their medical coverage and prescription drug coverage housed with the same carrier."
Personal Home Helper and House Calls
Many Medicare Advantage insurers are adding a benefit of a "personal home helper.” Anthem Blue Cross and Blue Shield in Connecticut is adding, "up to 124 hours of an in-home personal care aide for assistance with activities of daily living, such as dressing, grooming and bathing."
A similar benefit included in several Medicare Advantage plans is one that provides wellness visits. UnitedHealthcare already has HouseCalls, a program that offers people an annual health and wellness visit from the comfort of home. The program helps to make it easier to get needed care, tests and treatment. The company expects to complete 1.7 million HouseCalls for its members in 2019.
Compare Medicare Advantage plans
No matter what Medicare Advantage plan you choose, make sure you shop and compare before signing up.
Medicare Advantage plans vary widely in their coverage for additional supplemental benefits. While we provided 10 popular added benefits, there are dozens of others, including coverage for:
- Service dog support
- Smoking cessation programs
- Over-the-counter ordering and delivery
- Air conditioning
- Pest control
- Alternative medicine coverage, such as acupuncture or therapeutic massage