You’ve seen television commercials where you’re urged to call an 800 number to find out about the extra benefits that come with a Medicare Advantage plan. You may be under the impression these extra benefits are unlimited and never cost money. This is not true. 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. They will also 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. Some plans offer an optional supplement, with a separate monthly premium, for enhanced coverage.
Hearing: Most plans provide a routine hearing exam at no charge and offer financial help to pay for hearing aids. Financial aid comes in two forms. Some plans offer a set monetary allowance, say $4,000 for two hearing aids. If the cost of the devices, recommended by your audiologist, exceeds the allowance, you are responsible for paying the remainder. Instead of a set monetary allowance, some plans offer a copay for one or two devices. Let’s say the copay is $900 for one advanced hearing aid. If you need two hearing aids, you will pay $1,800.00. Most companies use a third party vendor for hearing devices and only certain ones are available at these prices.
Grocery Benefit: A frequent question from beneficiaries is whether their plan has a grocery benefit. Beginning in 2026, two things need to be in place to receive groceries. First, your plan needs to offer the benefit. Not all plans do. Check your plan’s Summary of Benefits to find out. Second, you need to attest to a chronic heath condition. Conditions may vary among plans and fall under the title of Special Supplemental Benefits for the Chronically Ill (SSBCI). Check your plan to find out what conditions are covered. A medical professional will need to confirm your attestation.
Transportation: Some insurance companies provide routine transportation, at no cost, to approved locations such as a doctor’s office. You get a certain number of trips per year. You will typically find mile limits on how far the third party vendor will travel to pick you up and drive you to a location. Ambulance is not part of this benefit.
Dental: Most Medicare Advantage plans offer dental coverage. A set monetary allowance pays for a variety of procedures authorized by the American Dental Association. Sometimes, procedures are limited to preventive care. Other times, your plan covers comprehensive procedures, such as crowns, root canals, bridges and dentures. A limited number of plans cover implants. If comprehensive procedures are not part of your plan, you may be able to pay a separate premium for enhanced coverage. An increasing number of plans are adding coinsurance charges for comprehensive procedures. For example, if you need a crown, your responsibility may be 20% of the cost. If the crown costs $2,000, your share is $400.00. The remaining amount of money ($1,600) is deducted from your dental allowance. Once you exhaust your allowance, you will need to find other ways to fund dental coverage. Two of the most popular options are separate dental insurance and a dental discount program.
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.
