Telehealth (or telemedicine) allows you to get care from your doctor without leaving your home. Learn all about how it works and the care you can receive.
The transition from traditional health insurance to Medicare can be... complex. With so many different Parts (literally), your coverage will undoubtedly come with a bit of a learning curve.
But if you’d still prefer an all-inclusive structure to your healthcare (rather than pay for the individual Medicare Parts you need), there is another option out there. It’s similar to health insurance you might have had in the past, with added benefits too. You guessed it: Medicare Advantage (also known as Medicare Part C).
And that’s right — we said added benefits. What are they (and how much more do they cost), you ask? Keep on reading to find out. Our answers might surprise you!
What is Medicare Advantage?
If you’re not totally clear on what Medicare Advantage is, let’s back up and break it down first. Medicare Advantage (or Medicare Part C) is privatized, all-in-one health insurance. These benefits are the alternative to Original Medicare, bundled together with Parts A, B, and usually D. So if you opt for a Medicare Advantage plan, you’ll have all your emergency care, urgent care, and almost all medically necessary care covered — just like you would with Original Medicare.
These benefits also sometimes cover dental care, vision, over-the-counter items, and other specialized health needs, to round out your coverage. (More on that later.)
Where can you enroll in a Medicare Advantage plan?
Medicare Advantage plans are offered by private insurance companies and approved by the Centers for Medicare & Medicaid Services (CMS). You can enroll in a plan through a concierge enrollment service to get tailor-made Medicare recommendations and all your coverage questions answered — free of charge! But before you enroll in Medicare Advantage, you must have Medicare Parts A and B and live within the service area of your Medicare Advantage plan. What’s a service area? It’s essentially your geographic location. Your Medicare Advantage plan’s doctor network will primarily be close to where you live. (Yay for not having to drive too far!)
What are the extra benefits that come with a Medicare Advantage plan?
Generally speaking, many Medicare Advantage plans offer the convenience of all-in-one healthcare under one simple plan. Things like prescription drugs, dental care, routine vision care, and routine hearing services are typically covered in most Medicare Advantage plans. Long gone are the days that your vision and dental care are separate from your health insurance!
This holistic approach is unique to Medicare Advantage, and it's why 37.5% of all Medicare enrollees choose a Medicare Advantage plan — with that number expected to grow annually.
After all, health and wellness aren’t just about doctor’s visits — it’s a lifestyle, and a Medicare Advantage plan can help make those healthier habits an integral part of your daily life. Some of the most common benefits include:
Wellness services: gym memberships and fitness programs are usually covered, so you can stay active.
Clinical services: these are things like routine acupuncture and chiropractic services, because even the slightest joint pain can have a big impact on your daily life.
Support services: while home meal deliveries and non-emergency transportation might not be a priority when comparing your health plan options, these benefits provide peace of mind — and make your recovery time after a hospital stay or surgery that much easier.
There are also some Medicare Advantage plans with extensive additional benefits, too. (Again, these benefits vary by plan.)
Here are a few more benefits to look out for when comparing Medicare Advantage plans:
Transportation to medical appointments
Over-the-counter supplies and medications
Nicotine replacement therapy
Adult daycare services
In-home support and personal care services
Social worker teleservices
Caregiver support services
Expanded telehealth services
Transportation for non-medical needs
Indoor air quality monitors
Structural modifications to your home such as grips to accommodate mobility issues, or ramps or widened doorways to accommodate wheelchairs
Home safety evaluations and maintenance services
Just like healthcare plans, it’s a good idea to compare Medicare Advantage plans each year to determine which plan will meet your needs for the next calendar year. For example, if you anticipate having a major surgery, enrolling in a plan with meal delivery and structural home modifications might be something to take advantage of — not to mention making your recovery a whole lot easier.
How much does a Medicare Advantage plan cost?
You might be thinking — with all these additional benefits, it must cost a fortune to enroll in a Medicare Advantage plan! The truth is, it can cost you as low as $0 extra a month. (You read that right.) Let’s explain.
If you decide that Medicare Advantage is right for you, you’ll still have to pay your monthly Medicare Part B premium (which depends on your income, but is usually around $148.50). But most Medicare Advantage plans will have a monthly premium of $0, so it’s no additional cost to you.
What you need to pay attention to is the way you pay for your care. In many cases, you’ll need to use doctors and providers who are in your plan’s network and service area for the lowest possible cost, similar to how this works for health insurance. Some plans won’t cover services from providers outside of your network and service area, so pay extra attention while you’re making your routine appointments. Your out-of-pocket costs may vary — meaning some plans may have lower out-of-pocket costs for certain services than others. You’ll also have a MOOP, or maximum out-of-pocket, for the year. Once you reach your plan’s limit, you’ll pay nothing for services that Part A and Part B cover for the rest of the calendar year.
This gives you the freedom to choose which plan makes the most sense for your health needs and budget.
How can you learn more about Medicare Advantage plans?
Making your Medicare decision is a big undertaking — but we’re here to guide you through it. There’s a lot more to learn about Medicare Advantage’s cost, coinsurance, out-of-pocket expenses, and network of doctors, and we’ve broken it all down here.
Plus, if you decide that Medicare Advantage isn’t right for you, there are alternative options. To compare Medicare Advantage to, say, Original Medicare with Medigap, click here. Our best piece of advice? It all comes down to what you value in a health plan — there’s no such thing as the “better” choice.
Are you surprised at the additional benefits a Medicare Advantage plan can provide? For those that want more from their Medicare plan — and believe that health isn’t just about your routine visits to the doctor — consider Medicare Advantage during the next Annual Election Period, your Initial Enrollment Period, or during a qualifying life event.