Medicare Advantage is a supplemental insurance plan that many seniors use to manage their Medicare benefits in a single, simple package. Medicare Advantage plans combine all the benefits of Original Medicare Part A, which pays for inpatient hospital care, and Part B, which provides for outpatient office care. Most Medicare Advantage plans also provide extra benefits, such as prescription drug coverage and vision care. Seniors who find a Medicare Advantage plan that suits their unique health needs often get the protection they want for a single monthly premium.
The purpose of this guide is to inform readers about how Medicare Advantage differs from Original Medicare in benefits and monthly premiums. It explains how Medicare Advantage works and what is typically covered by most plans. This guide is also meant to help seniors and their loved ones find a plan that meets their needs.
The Basics of Medicare Advantage
Medicare provides health insurance for eligible seniors in the United States. Coverage is split between several parts, according to what is being covered. Medicare Part A covers the cost for inpatient care given in a hospital setting. There is no premium for Part A coverage, and almost all costs are covered at the point of service. Because of this, Part A is automatically assigned to eligible seniors when they turn 65. Part B covers much of the cost of outpatient care, such as office visits and a limited number of medications. Part D is Original Medicare’s prescription drug benefit, which pays for most of the cost of self-administered medications.
Unlike Part A, Medicare Parts B and D are not free. As a result, seniors have the ability to opt-out of these plans in favor of a private insurance plan. These plans, which are often called Part C or Medicare Advantage, provide all of the benefits of Parts A and B, along with several extra features many seniors want included under a single monthly premium. Federal law requires all authorized Medicare Advantage plans to cover the same services as Parts A and B, though there is variety in the other features plans offer.
Beneficiaries can opt-in to a Medicare Advantage plan when they become eligible for Original Medicare benefits, or they can sign up for a plan during the annual open enrollment period that runs from October 15 to December 7 each year. Most Medicare Advantage plans charge a monthly premium that ranges between $0 and $300 a month, which varies with plan specifics and geographic area. The average Medicare Advantage plan in the United States costs participants $29 a month, plus any upfront costs that exist at the point of service.
How to Enroll in Medicare Advantage with Vision Coverage
Not every Medicare Advantage plan includes vision care, but the option is available under many plans in all 50 states. To get vision coverage under a Medicare Advantage plan, it is first necessary to be eligible for Original Medicare. To qualify for Medicare, U.S. citizens must be either aged 65 and older, be receiving Social Security Disability Insurance (SSDI) for at least the previous 24 months continuously for a medically diagnosed disability, or suffer from end-stage renal disease. Hospice patients are also eligible for Original Medicare Part A coverage.
If you meet the eligibility criteria for Original Medicare, you can choose to forego traditional coverage options and instead buy a Medicare Advantage plan from a private insurer. Every state has at least one authorized Medicare Advantage provider, and most states have more than one. Applications can be made directly through the company that offers the policy you’re interested in, or you can apply for a Medicare Advantage plan through your state’s online health insurance marketplace. While reviewing plans, be sure to look for the stated vision care options, which are not automatically included in all plans. If a policy you’re interested in does not specifically state it includes eye exams and prescriptions for glasses, call the company before you sign up to find out if you can get the coverage. Some insurers are willing to expand the coverage of a plan with a supplemental option if you ask. Other plans include vision care, which should be listed as a coverage option in the policy documents.
