Dear Marci,
I currently have a Medicare Advantage Plan and learned that it has supplemental benefits. Can you explain what these are?
Elena (San Diego, CA)
Dear Elena,Ā
A supplemental benefit is an item or service covered by a Medicare Advantage Plan that is not covered by Original Medicare.Ā These items or services do not need to be provided by Medicare providers or at Medicare-certified facilities.Ā Most supplemental benefits are health-related. Some examples include:Ā
- Dental careĀ
- Vision careĀ
- Hearing aidsĀ
- Gym membershipsĀ
These benefits must be available to everyone enrolled in the plan. Other supplemental benefits ālike meal delivery services, transportation services, or home air cleanersā usually may only be provided for members that have a particularĀ chronic illness.Ā These benefits can address specific risks related to their chronic illness or social determinants of health for people with chronic disease. A social determinant of health is a part of life that can affect health in some way, such as not having access to transportation to attend doctorās appointments or not having access to healthy foods. Special Needs Plans (SNPs) may also offer different supplemental benefits.Ā Ā
Supplemental benefits that are not specific to those with a chronic condition or offered in a SNP can be either optionalāoffered to everyone enrolled in a plan, but individuals can choose to pay an additional premium for that coverageāor they can be mandatory. A mandatory benefit is covered for everyone enrolled in the plan.Ā Ā
Before choosing to enroll in a plan that offers supplemental benefits or before electing an optional supplemental benefit, youāll want to review the planās coverage rules. A planās supplemental benefits are often less comprehensive than you may assume. For example, a plan may cover routine dental cleanings but not fillings or other services, or it may have restrictions like how often you can use your dental benefits. If a Medicare Advantage Plan advertises its supplemental benefits, remember to ask questions, get answers in writing, and read coverage rules to know exactly what to expect.Ā
To find out how to access your supplemental benefits, contact your plan directly.Ā Ā
Good luck!Ā
-MarciĀ