Medicare Advantage Plans with Benefits Beyond Original Medicare in 2026
Medicare Advantage Plans include benefits beyond Original Medicare which may include important services that many people may need every year. Original Medicare covers hospital and medical care. Medicare Advantage Plans may include benefits such as dental, vision, hearing, prescription drug coverage, transportation, or over-the-counter allowances. Medicare Advantage Plans may be a better fit for your healthcare needs.
Do Medicare Advantage Plans Include Benefits that Original Medicare Doesn't Cover?
Original Medicare includes Medicare Part A and Part B benefits. Many people choose Medicare Advantage Plans because they include Medicare Part A and Part B benefits and may also include additional benefits beyond Original Medicare.
What Preventive Services Does Medicare Cover?
Medicare preventive services include annual wellness visits, cancer screenings, diabetes screenings, vaccines, and other essential preventive care. These services may help detect health problems early, improve treatment outcomes, and reduce long-term healthcare costs. Many preventive services covered by Medicare are available at low or no cost, making it easier to stay healthy year-round.
In addition to screenings, Medicare may also cover health monitoring, counseling, and education programs to support ongoing wellness and disease prevention.
Medicare Chronic Care Management Services
Medicare Advantage Chronic Condition Special Needs Plans (C-SNPs) may include specialized support for people on Medicare with qualifying chronic conditions through (C-SNPs). These Medicare Advantage plans are designed for individuals living with ongoing health conditions such as diabetes, heart disease, and other cardiovascular disorders.
C-SNPs may provide coordinated care, chronic disease management programs, and personalized treatment plans to help improve long-term health outcomes and reduce complications.
Many Medicare C- SNPs may also include valuable extra benefits, such as one or more of the following:
- Care coordination services
- Over-the-counter (OTC) allowances for plan approved items
- Healthy food and allowances
These additional benefits make it easier for beneficiaries to manage chronic conditions, stay on track with treatment, and maintain a better quality of life.
For UnitedHealthcare, the healthy food benefit is a special supplemental benefit available only to chronically ill enrollees with a qualifying condition, such as diabetes, chronic heart failure and/or cardiovascular disorders, who also meet plan criteria indicating they are at high risk for hospitalization and eligible for intensive care coordination.
Prescription Drug Coverage: Medicare Part D and Medicare Advantage Plans
Part D prescription drug coverage may be an important benefit not covered by Original Medicare. Medicare Part D and many Medicare Advantage plans may help cover the cost of prescription medications.
While some drugs are not covered, these plans can significantly reduce out-of-pocket costs and help beneficiaries access covered medications.
Dental, Vision, and/or Hearing Benefits in Medicare Advantage Plans
Many Medicare Advantage plans include routine dental and/or vision care. Original Medicare does not usually cover these benefits.
| Medicare Advantage Plans may include one or more of the following benefits | Original Medicare | Medicare Advantage |
|---|---|---|
| Dental | No routine dental | Cleanings, X-rays, dentures |
| Vision | No exams or glasses | Exams, glasses, contacts |
| Hearing | No exams or hearing aids | Exams & hearing aids |
| Prescription Drugs | Separate Part D required | Usually included |
| Transportation to Approved Locations | Not covered | Limited rides included |
Medicare Advantage Plans with Transportation, OTC, and/or Healthy Grocery Benefits
Some Medicare Advantage plans offer extra benefits such as transportation to doctor appointments, and/or OTC allowance for plan approved everyday health items. For Medicare beneficiaries
with qualifying chronic conditions, some Medicare Advantage Chronic Condition
Special Needs Plans (C-SNP) may include a healthy food allowance benefit.
These benefits can help reduce out-of-pocket healthcare costs. Coverage and eligibility vary by plan and location, so it’s important to compare Medicare Advantage plans to find the benefits that best fit your healthcare and lifestyle needs.
Medicare Advantage Fitness Benefits: Free Gym Memberships and Wellness Programs
Many Medicare Advantage plans include fitness benefits such as gym memberships. These fitness benefits are designed to help improve strength, balance, and overall wellness, while supporting an active and healthy lifestyle.
SilverSneakers
SilverSneakers is a health and fitness program for seniors that is often included with some Medicare Advantage plans and some Medicare Supplement plans. It may offer access to a nationwide network of gyms and fitness centers, along with group fitness classes and online workout programs.
Silver & Fit
Silver&Fit is a fitness program provided by American Specialty Health and included with some Medicare Advantage plans. It may offer access to a nationwide network of gyms and fitness centers, along with home fitness kits that may include Pilates and other workout equipment. Members may also connect with healthy living coaches and coaching resources.
How Medicare Advantage Protects You from High Out-of-Pocket Costs
Medicare Advantage plans include an annual out-of-pocket maximum, which limits how much you pay for covered healthcare services each year. Once you reach this limit, your plan may pay 100% of covered services for the rest of the year, providing important financial protection against high medical costs.
In addition to out-of-pocket limits, many Medicare Advantage plans may offer predictable healthcare costs through low or $0 monthly plan premiums, fixed copayments, and all-in-one coverage that may include hospital, medical, prescription drug, and extra benefits.
These features make Medicare Advantage a popular option for individuals looking to manage healthcare expenses while maintaining comprehensive coverage.
Frequently Asked Questions About Medicare Advantage Plan Coverage Beyond Original Medicare
What extra benefits do Medicare Advantage Plans offer beyond Original Medicare?
Medicare offers preventive services, prescription drug coverage, and wellness programs. Medicare Advantage plans may also include dental, vision, hearing, and/or OTC benefits.
Does Original Medicare cover prescription drugs?
No, but Standalone Part D plans or Medicare Advantage Prescription Drug Plans provide Part D prescription drug coverage.
Does Medicare cover dental and vision in 2027?
Original Medicare does not usually cover routine dental and vision care, but many Medicare Advantage plans include one or more these benefits.
What is the out-of-pocket maximum for Medicare Advantage?
Medicare Advantage plans include an annual out-of-pocket maximum, which limits how much you pay for covered services each year.
What is an OTC allowance in a Medicare Advantage Plan?
An OTC allowance may be given each month or quarter to buy plan approved health items.
Do Medicare Advantage include transportation to doctor appointments?
Many Medicare Advantage plans include transportation benefits for medical appointments and/or pharmacies.
Choosing the Right Medicare Coverage for You
Exploring Medicare Advantage Plans and their benefits beyond Original Medicare can help you make smarter healthcare decisions and reduce overall costs.
Medicare Advantage Plans may offer a wide range of benefits, including preventive care, prescription drug coverage, dental, vision, hearing, and/or fitness benefits. By understanding your Medicare coverage options, you can choose a plan that best fits your healthcare needs and helps you get the most value from your benefits.
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