Paying for Senior Care Logo
Our goal is to help families find the means to pay for senior care by providing objective information and interactive tools on our ad-free, easy-to-use and comprehensive website.  Read More

What Do Medicare Advantage Plans Cover?

Page Reviewed / Updated - August 17, 2020

Medicare Advantage plans, also known as Medicare Part C, are alternatives tMedicare Advantage plans are offered by private insurance companies, so the level of coverage may vary from one plan to another. This type of plan provides an alternative to traditional Medicare coverage. With Original Medicare, enrollees receive hospital coverage under Part A and outpatient services, including preventive care, under Part B. Medicare Advantage combines both types of coverage into a single plan, with many insurers also offering prescription coverage, which is usually provided under Medicare Part D.

Medical Care

Medicare Advantage plans cover the same services as Original Medicare, provided those services are deemed medically necessary. If a service isn't medically necessary, the insurance company that administers the Medicare Advantage plan may choose to deny coverage. Enrollees have the right to find out if a service or piece of medical equipment will be covered in advance. If there's any question of whether something is covered by a Medicare Advantage plan, requesting this information can help seniors avoid unexpected out-of-pocket costs.Medicare Advantage plans cover all Part A and Part B services. Part A services include hospital care, home health care and care provided by a nursing home or skilled-nursing facility on a short-term basis. Part B services include preventive care, immunizations, durable medical equipment, ambulance services and mental health services.

Extra Services

Although Original Medicare may cover glaucoma testing or surgery to remove cataracts, it doesn't cover eye exams for contact lenses and glasses. Medicare Advantage plans, on the other hand, may provide vision coverage and other services that aren't covered by traditional Medicare. Regular Medicare also doesn't cover routine dental care, such as cleanings, fillings, dentures or extractions. Because Medicare Advantage plans are provided by private insurers, each insurance company can choose whether to offer dental coverage to its subscribers. Comprehensive plans may also cover gym memberships and other wellness services, adult day care, transportation to medical appointments and over-the-counter medications.