Learn more about the latest Medicare Advantage updates, benefits and changes.
Medicare Advantage Plans can offer extra benefits beyond the coverage provided by Original Medicare. These supplemental benefits can improve access to coverage offered through traditional Medicare plans, such as by providing lower deductibles or copays, or they can extend coverage to include extra benefits not offered by traditional Medicare, such as dental and vision coverage.
Each year in October, the new benefits being added to Medicare Advantage Plans for the following year are released. All of the various insurance company plans for the next year are available for review starting October 1, says Sonia Jensen, an Independent Medicare Agent at Sonia Jensen Insurance Agency located in Orange County, California, who works with clients in various states. Beneficiaries can change their Medicare Advantage Plan election during the annual Open Enrollment Period from January 1 to March 31 of each year.
Medicare.gov is supposed to provide all of the updated information for beneficiaries to review, but it isn’t always the most complete or accurate, Jensen says. For the most accurate information, she recommends speaking to the insurance companies themselves or with a local licensed insurance broker who contracts with all of the plans.
Medicare Advantage supplemental benefits fall into one of two categories: enhanced coverage of a Medicare-covered service, such as a lower deductible or copay, or a non-Medicare covered benefit, such as dental or vision coverage. In 2022, the most widely offered extra benefits in Medicare Advantage Plans according to KFF analysis are:
Other common benefits in 2022 include over-the-counter items in 81% of plans, meal benefits in 67% of plans and transportation benefits in 38% of plans. Only 8% of plans offer bathroom safety and 10 % in-home support benefits, according to KFF analysis.
Another exciting addition to Medicare Advantage plans in 2022 is the ability of individuals with End-Stage Renal Disease (ESRD) to enroll in Medicare Advantage Plans as of January 1, 2021, says Cynthia Pruemm, investment advisor and founder and CEO of SIS Financial Group in Hoffman Estates, Illinois.
The expanded telehealth benefits can allow seniors who can’t get to a doctor’s office to meet via video conference, which can be safer and more convenient, Pruemm says.
“There have also been additional benefits added to some Medicare Advantage plans for long-term care services,” she says. “Look for plans that cover adult day care, home safety modifications, meal delivery service and transportation service just to name a few.”
Even within plans offering the same benefit, the way they provide the benefit can vary from plan to plan. For instance, while 95% of plans offer hearing aid coverage in 2022, Jensens says this benefit can range from $400 to $2,000 based on the company. Likewise, while most of these plans require you to use the insurance company’s third party vendor. “So it’s not like you can go to Costco,” she says. But Aetna offers a Direct Member Reimbursement (DMR) option that allows you to see any hearing provider. Beneficiaries pay up front and then submit information to get reimbursed. This is the only provider Jensen knows of who includes such a benefit.
Similarly, Scan Health Plan offers a unique in-home benefit after you’ve been discharged from the hospital where the insurance company will cover 40 hours of in-home caregiving services to help with activities of daily living, she says. “And they’ll provide home-delivered meals for breakfast, lunch and dinner for 28 days,” complete with a menu for you to choose from.
Plan providers may also restrict who has access to these extra benefits, such as by restricting benefits for beneficiaries with certain conditions. So the same provider may offer different benefits to different enrollees.
Note that “benefits are county and zip code specific,” Jensen says. So these benefits may not be available in all areas.
Medicare Advantage plans can also offer Special Needs Plans (SNPs) to serve high-need beneficiaries. There are more 1,156 SNP plans available in 2022, a 19% increase over 2021. SNPs are more likely to offer over-the-counter items, transportation benefits and meal benefits than standard Medicare Advantage Plans. SNPs are also more likely to offer bathroom safety devices and in-home support.
How can you get the latest Medicare Advantage Plan benefits?
Nearly all Medicare beneficiaries have access to at least one Medicare Advantage Plan with extra benefits not available through Original Medicare, KFF reports. Around 99% of beneficiaries can also access telehealth and over-the-counter items, 98% can get a meal benefit and 95% of beneficiaries can get transportation assistance.
To learn about the latest benefits being offered by Medicare Advantage plans, you can go to Medicare.gov. “On Medicare’s website, you can enter in your zip code, county, doctor’s names and medication and you’ll be matched up with the best plan options in your area,” Pruemm says. “Each Medicare Advantage plan has a summary of benefits that will explain what you will pay for each procedure and what your copays will be when picking up your medication.”
“For individuals that would like more personalized information from a licensed and certified professional, there are agencies in your area that specialize in these types of plans,” she says.
If you choose to work with a professional, Jensen says it’s important to use a local agent because plans are county-specific. A national representative may not be as familiar with all the plans offered in your area.
If you do work with an independent broker, be sure to do your due diligence. Look for an active broker who works with all of the plans so they won’t have an incentive to put you into one plan over another.
A great way to find a local broker can be through your own network, Jensen says. Ask friends and neighbors if they use anyone for help navigating their Medicare coverage.
What should I consider when looking for a Medicare Advantage Plan?
Medicare Advantage Plan supplemental benefits can be an important factor when choosing between plan providers as the benefits and degree of coverage offered by each plan will vary. It’s important that you understand the pros and cons of the Medicare Advantage plan you are considering since you can only enroll and disenroll during the annual enrollment period.
That said, the extra benefits are not the only things to consider. When looking for Medicare Advantage Plans there are several things to keep in mind. First, make sure the plan offers coverage for the medications you use and contracts with your doctor, Jensen says.
You should also keep in mind that while the majority of Medicare Advantage Plans are HMOs, some plans are available as PPOs or HMO-POS, Jensen says. HMOs typically have a network of doctors and medical facilities that are covered under the plan. To get insurance coverage, you generally must use one of these in-network providers. With an HMO-POS, you have the option of paying more for an out-of-network provider.
PPOs give more flexibility in seeing specialists and out-of-network doctors, but they often have higher premiums than either HMO or HMO-POS plans. Jensen doesn’t normally recommend PPOs because of their higher out-of-pocket costs.
“If somebody wants to consider a PPO Medicare Advantage Plan, they should really be looking at Medicare Supplement plans as well,” she says. A Medicare Supplement plan can offer flexibility and is worth a comparison.
These experts were consulted for insight into Medicare Advantage Plan benefits for 2022.
LeRon Moore has guided Medicare beneficiaries and their families as a Medicare professional since 2007. First as a Medicare provider enrollment specialist and now a Medicare account executive, Moore works directly with Medicare beneficiaries to ensure they understand Medicare and Medicare Advantage Plans.
Moore holds a bachelor’s degree from Southern New Hampshire University and is A+ Certified with a Medical Records Clerk Certification and Medical Terminology Certification from Midlands Technical College.
He’s passionate about educating, informing, and resolving issues concerning Medicare and Medicare Advantage Plans, and considers it imperative that he does all he can to educate and inform the senior community as much as possible about Medicare.