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If you’re new to Medicare, you may be aware that you have coverage options. You can get your Medicare benefits from Original Medicare (Part A and Part B) administered by the federal government, or through Medicare Advantage, administered by private insurance companies. Rest assured that if you sign up for a Medicare Advantage plan, you will not have less coverage than if you had stayed with Original Medicare. Medicare Advantage plans are required to cover everything that Original Medicare covers. Medicare Advantage plans may also offer supplemental benefits not generally covered by Original Medicare. If you have Medicare Advantage, you’re still in the Medicare program and you still have Medicare rights and protections, including the right to appeal a coverage decision.
Medicare coverage is determined by federal and state laws, as well as national coverage decisions about whether something is covered.
Medicare Advantage plans cover medical costs covered by Medicare Part B, such as:
Medicare Advantage plans also cover hospital costs covered by Medicare Part A, such as:
If you have Medicare Advantage, hospice care is still covered by Medicare Part A.
All Medicare Advantage plans cover emergency and urgent care.
Medicare Advantage plans may offer benefits for services not generally covered by Original Medicare. Supplemental benefits may vary from plan to plan but this coverage could include:
|Coverage Category||Specific Services that may be covered|
|Prescription drugs||The coverage of specific prescription drugs may vary from plan to plan. To find out if your medications are covered, check the plan’s formulary or list of covered prescription drugs. Prescription drug types Medicare Advantage plans are required to cover include:
· certain vaccines including pneumococcal and influenza
· certain oral anti-cancer drugs
· hemophilia clotting factors
· immunosuppressive drugs
· some antigens
· Injectable drugs for osteoporosis.
|Routine Dental||· Cleanings
· Annual exams
· Root canals
· Gum disease treatment
· Crowns, bridges, dentures
|Routine vision||· Routine eye exams
· Contact lenses
· Eye glasses
· Lenses, frames, upgrades
|Inpatient hospital acute or psychiatric||Additional days|
|Skilled nursing facility||Additional days|
|Routine hearing||· Routine hearing exams
· Fitting evaluation for hearing aids
· Hearing aids
|Wellness benefits||· Gym memberships
· Fitness programs
If your Medicare Advantage plan denies
You have the right to appeal this decision.
Are you interested in finding a Medicare Advantage plan in your area? Just enter your zip code on this page to begin comparing plans.
eHealth's Medicare website is operated by eHealthInsurance Services, Inc., a licensed health insurance agency doing business as eHealth. The purpose of this site is the solicitation of insurance. Contact may be made by an insurance agent/producer or insurance company. eHealth and Medicare supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. We offer plans from a number of insurance companies.