You may have learned through social media, your friends and neighbors, or other sources, that Medicare Advantage plans come with extra benefits. They’re called extra benefits because they are not part of Original Medicare. Review your plan’s Summary of Benefits to see what extra benefits are offered. Let’s look at a some extra benefits that typically come with Medicare Advantage plans.
Vision: Most plans provide a routine eye exam at no charge and will provide an allowance to help pay for lenses, frames, or contacts. Let’s say the allowance is $300.00. If your lenses, frames or contacts cost more than $300.00 you pay the difference. Depending on the plan, the vision benefit may roll over every year or every two years.
Hearing: Most plans provide a routine hearing exam at no charge and offer financial assistance to pay for hearing aids. Some plans offer an allowance, say $2,000 for two hearing aids. If the cost of your hearing aids is more than the allowance, you pay the difference. Other plans offer a copay amount. Suppose your copay is $850 for one hearing aid. If you need two devices, your cost will be $1,700. Most companies use a third party vendor for this benefit.
Food Benefit: A frequent question from beneficiaries is whether their plan has a food benefit. Beginning in 2026, two things need to be in place to access food. First, your plan needs to offer the benefit. Second, you need to attest to a chronic heath condition. Conditions may vary among plans. If you have a chronic condition that fits the plan, a medical professional will need to confirm your attestation. The food benefit has a monthly allowance and needs to be considered healthy.
Transportation: Some insurance companies provide routine transportation, at no cost, to approved locations such as a doctor’s office. Plans contract with transportation companies to provide this benefit. You get a certain number of trips per year. If you go over this number, you are responsible for finding your own transportation. There may be mile limits on how far a transportation company will travel to pick you up, drive you to an approved location, or both. Ambulance service is not part of this benefit.
Dental: Most Medicare Advantage plans offer dental coverage. The amount of the allowance varies from one Medicare Advantage plan to another. Once your allowance is exhausted, you are responsible for finding an alternative resource for dental care. Two alternative resources are dental insurance and dental discount plans. Medicare Advantage plans will cover procedures at different percentage amounts. For example, a plan may cover preventative care at 100% and complex procedures at 70% or 50%. Look for frequency limits on procedures. Two routine cleanings a year. A crown per tooth every five years. Finally, every dental procedure has a code attached to it. It your dentist wants to perform a procedure with a code that is not supported by the insurance company, and you go forward with it, you will pay full price for the procedure.
Some Medicare Advantage plans offer additional money (called a ‘flex allowance’) for vision, hearing, dental and other benefits such as routine podiatry. Check your Summary of Benefits to see if your plan has such an allowance.
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If you have questions about the extra benefits on your plan, please call 725-227-6795, send an email to ken@deserthealthandlife.com, or fill out contact form on this website. I am a licensed insurance broker.
