What Do Medicare Advantage Plans Cover?


Quick Answer

Medicare Advantage plans are required to cover all of the same services that Original Medicare covers with the exception of hospice care, according to Medicare. In addition, Advantage plans may offer extra services, such as hearing, vision, dental, and health and wellness programs. Most offer Medicare prescription drug coverage.

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Full Answer

A Medicare Advantage plan may choose not to cover services that are not deemed medically necessary under Medicare, according to Medicare. All Medical Advantage plans cover members for emergency and urgently needed care. If unsure if a service is covered, an individual can check with the plan provider before receiving the service.

Participants in the plan usually pay a monthly premium for the Medicare Advantage plan in addition to the Medicare Part B premium. As of 2015, the Medicare Part B premium is $104.90 per month for most individuals. Medicare Advantage Plans include Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-For-Service plans and Medical Savings Account plans. Individuals can join a Medicare Advantage Plan if they currently have Medicare Part A and Part B, don't have end-stage renal disease and live in the service area of the plan they wish to join, states Medicare. If one lives in a different state for part of the year, he can check with the plan to see if it offers coverage there as well.

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