Additional benefits beyond original Medicare

Medicare Advantage insurers continue to add more supplemental benefits to their plans each year.

Medicare Advantage, also called Part C, is an alternative to Original Medicare and is offered by private insurance companies. 

Meanwhile, Original Medicare comprises Parts A and B. Part A is for inpatient care, such as hospital, skilled nursing facilities, hospice care and home health care in some instances. Part B overs doctor visits, outpatient care, medical supplies and preventive services. In most cases, the federal government provides Parts A and B coverage. Part D is optional, and Parts A and B do not include prescription drug coverage. A penalty may be added if a consumer elects to enroll in Part D later. 

Most people with Medicare have Parts A and B. However, that’s been changing over the past decade.The Centers for Medicare and Medicaid Services in April 2022 said more than 27 million beneficiaries were enrolled in Medicare Advantage. 

Medicare Advantage plan benefits

Medicare Advantage combines coverage that people with Original Medicare get in Parts A and B and usually combine it with prescription drug coverage and other benefits.

One reason for its increased popularity is Medicare Advantage’s supplemental benefits. The plans often offer dental, vision and prescription drug coverage. In recent years, Medicare Advantage insurers have expanded benefits further to include services that go beyond a person’s medical care. 

Medicare Advantage can now offer expanded services, such as meal delivery, home safety, rides to doctor appointments and preventative care.

Below are some of the expanded supplemental benefits available. But you should see the plan details for plan benefits and restrictions. 

• Nearly all Medicare Advantage plans offer telehealth benefits. 
• Hundreds of plans offer help with non-medical care services for people with chronic conditions, such as help with housekeeping, grocery shopping and meal delivery. 
• Plans may help with money for healthy food, meals and transportation. 
• Some plans have expanded adult day health services, caregiver services, in-home support services and home-based palliative care. 
• There are plans geared to help people with certain chronic conditions, such as diabetes. These plans may offer lower copays and expanded benefits, such as help with meals and transportation. 

Cathryn Donaldson, director, Communications & Public Affairs, America’s Health Insurance Plans (AHIP), said the offerings vary by plan. 

“The supplemental benefits offered are really going to depend on the plan, the insurance provider and the population/market they serve,” stressed Donaldson. “For example, if they serve a more rural area, they may be investing in transportation for doctor’s appointments… Or if they serve an area that is considered a food desert, they may help their members access fresh produce and groceries.” 

7 Medicare Advantage supplemental benefits

It’s critical to dig into plan information when comparing Medicare Advantage options. One plan may offer specialized benefits to someone with diabetes, while another might focus more on fitness. 

Here are seven Medicare Advantage benefits that you may not know about: 

1. Monthly Grocery Benefit: Alignment Healthcare is among the Medicare Advantage insurers that has a benefit to address food insecurity. Alignment has a $10 to $20 per month grocery benefit for qualifying members. Certain plans will partner with stores, such as CVS, Walgreens and Walmart.
2. Healthy Food Deliveries: Amerigroup provides up to 16 delivered meals four times each calendar year (64 total) for qualifying members. To qualify, Medicare Advantage members must either be discharged from an overnight stay at a hospital, have a Body Mass Index (BMI) more than 25 or less than 18 or have an A1C level of more than 9.0. Many other Medicare Advantage plans, including Zing, are providing similar healthy-food delivery type benefits.
3. Personal Home Helper: Some Medicare Advantage insurers have expanded “wellness” packages. Anthem Blue Cross and Blue Shield in Connecticut is one example. The insurer provides up to 124 hours of an in-home personal care aide to help with daily activities, such as dressing, grooming and bathing for qualifying individuals.
4. Transportation Services via Uber and Lyft:  Some Medicare Advantage insurers offer free “on-demand” transportation to doctor appointments using Uber and Lyft. Alignment, Blue Shield of California, Humana and Anthem Blue Cross & Blue Shield are among those with the benefit. Amerigroup, for instance, gives 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.
5. “Grandkids On-Demand”: This Medicare Advantage added benefit is “to help solve the growing loneliness epidemic,” according to Alignment. The benefit offers “companion care” that “connects college students with qualifying members who need assistance with non-medical services.” These services could be light housekeeping, technology lessons and general companionship. Vibra Health Plan has a similar Medicare Advantage plan benefit called “Papa Pals.” The program is an arrangement that links college students with members who need assistance with light household chores and errands.
6. House Calls: UnitedHealthcare, which is the largest Medicare Advantage insurer, has a program called HouseCalls. The program offers people an annual health and wellness visit from the comfort of home, helping make it easier to get needed care, tests and treatment. 
7. Service Dog Support: Several Medicare Advantage insurers include service dog support. Anthem provides a wellness option of up to $500 annual allowance to help pay for items used to care for a member’s service dog. The dog must be certified under the Americans with Disabilities Act.

When comparing benefits, it’s important to put a magnifying glass to the fine print. They vary by insurer. For instance, while Amerigroup offers a slew of new health care coverage options, several are for those with the “Everyday Extras” package. These participants can select only one of the 10 “extra” services. So, do you pick food or a ride? That’s the kind of thing you’ve got to make sure you understand.

Medicare Advantage vs. Medicare supplemental insurance plans

People with Original Medicare can get a Medicare supplement insurance plan called Medigap. Medigap helps people pay for their out-of-pocket Medicare costs, such as copays and deductibles. 

Medicare Advantage members don’t qualify for Medigap. Instead, people with Medicare Advantage have to pay out-of-pocket costs themselves. 

A benefit of getting Original Medicare and Medigap is that some Medigap policies will help cover international medical costs. Original Medicare doesn’t cover you if you’re out of the country, but Medigap plans may help pay for health care costs abroad. 

How to buy a Medicare Advantage plan

The open enrollment period to make changes to your Medicare plan is October 15 through December 7. Consumers must already be enrolled in Original Medicare to enroll in a Medicare Advantage plan. Qualified individuals may not join a Medicare Advantage plan during the Annual Enrollment Period if they do not already have Original Medicare. In that case, they need to wait for their Initial Enrollment Period, or if they missed it, wait until the General Enrollment Period, or wait for a Special Enrollment Period. Individuals about to turn 65, or who are otherwise eligible due to a disability, should visit medicare.gov or call 1-800 Medicare.

Donaldson said many Medicare Advantage plans offer no premiums. Nearly half of enrollees who stay with their current Medicare Advantage plan will have a $0 premium, she added. 

Also, those eligible can select a plan using the Medicare Advantage Star Ratings program to assess the different quality measures. 

For the first time in a decade, the Centers for Medicare & Medicaid Services recently launched a modernized and redesigned Medicare Plan Finder. On the Medicare Plan Finder, you can shop and compare Medicare Advantage and Part D plans. That can help you find the right Original Medicare or Medicare Advantage plan for you.  

Disclaimer:

Insure.com is not affiliated with or endorsed by the government or Federal Medicare program. Plans are insured or covered by a Medicare Advantage organization with a Medicare contract and/or a Medicare approved Part D sponsor. Enrollment in the plan depends on the plan’s contract renewal with Medicare. We do not offer every plan available in your area. Currently we represent 10 organizations which offer 100 products in your area. Please contact Medicare.gov, 1800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options. Not all plans offer all of these benefits. Benefits and availability may vary by carrier and location. Limitations and exclusions may apply. Every year, Medicare evaluates plans based on a 5-star rating system. Part B Premium give-back is not available with all plans. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply. Enrollment in the described plan type may be limited to certain times of the year unless you qualify for a Special Enrollment Period.

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