I’m sure you’ve seen the television commercials where you’re urged to call an 800 number to find out about the free extra benefits that come with a Medicare Advantage plan.
You may be led to believe that extra benefits have no limits and will never cost money. This is not the case. Vision, hearing, meal delivery, transportation and dental care typically come with Medicare Advantage plans. Let’s look at them in some detail.
Vision: Most plans provide a routine eye exam at no charge. They help pay for glasses or contacts with a designated allowance. Let say your allowance is $300.00. If your glasses or contact cost $300 or less, you don’t pay anything. If they cost $500, you may have to pay the difference. Some plans offer an optional supplement, with a monthly premium, for better vision coverage. See my note about Flex Allowances at the bottom of the page.
Hearing: Most plans provide a routine hearing exam at no charge. They help pay for hearing devices with designated allowance or a copay amount. Suppose your plan comes with a $3,000 allowance for two hearing devices. If the devices cost $5,000, you may have to pay $2,000. Let’s say your plan comes with an $900 copay for one hearing aid ($1,800 for two). If the cost of two hearing aids is $5,000, you may have to pay $1,800. See my note about Flex Allowances at the bottom of the page.
Meals: This benefit is available after being discharged from the hospital or a skilled nursing facility. Meals come from a third-party vendor. How many meals depends on the plan. These meals may not compete in quality to Hello Fresh, Daily Harvest, or Freshly, but it’s a nice benefit to have.
Transportation: Most plans offer routine transportation, at no cost, to approved locations such as a doctor’s office or an outpatient surgical facility. You set up transportation with a third-party vendor in advance. There may be mile limits on how far the company will travel to pick you up or deliver you to a location. How many trips depend on the plan. Ambulance is not part of this benefit.
Dental: Some plans offer preventive and comprehensive dental procedures at $0 copay up to a certain amount of money. Other plans offer $0 copay on certain procedures but charge for others. Still others will offer minimal dental coverage with an optional supplement that you can purchase to increase your monetary allowance and the number of covered procedures. See my note about Flex Allowances below.
Note: Your Medicare Advantage plan may come with a ‘Flex Allowance.” A “Flex Allowance” is an extra pot of money that can be used to pay for specified extra benefits or certain medical procedures. What it covers depends on the plan but, generally speaking, this is how it works. Let’s say your plan provides $300.00 toward the purchase of eyewear. If your flex allowance covers eyewear, you can use all or a portion of it to cover anything over $300.00. If your dental benefit is $2,500, you can use a portion or all of your allowance to cover more dental charges. Once you exhaust your flex allowance, you pay out of pocket.
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If you have questions about the extra benefits on your plan, please call 725-227-6795, send an email to [email protected], or fill out contact form on this website. I am a licensed insurance broker.
