Medicare Benefits 101

medicare benefits 101

Original Medicare 101

Original Medicare is offered by the federal government and is often referred to as Medicare Parts A and B. It covers things like:

  • Hospital care.
  • Follow-up care after you leave a hospital
  • Visits to you primary care physician (PCP)
  • Mental Health services.
  • Certain kinds of therapies.

Original Medicare also covers some additional services, which you can learn about here . Still, it doesn’t cover everything. In fact, its benefits don’t include dental, vision, hearing, and long-term services. It also doesn’t provide a ceiling or cap on out-of-pocket costs for eligible services, which could potentially create a financial burden for you.

Why Medicare Advantage (MA)

Medicare Advantage plans are supplemental plans to Original Medicare and are sometimes referred to as Medicare Part C. These plans cover everything that parts A and B cover and, usually, offer many benefits in addition to original Medicare, including convenient coverage, multiple plan options, and long-term savings.

Medicare Advantage plans also roll your coverage into one plan, enabling you to make just one decision. They also add extra perks like case managers who can help you manage a chronic condition and support your wellness goals. Monthly premiums are typically low and they’re the same for every person, regardless of age or health history. Keep in mind, every Medicare Advantage plan is different so be sure to do your homework to find a plan that’s right for you.

Here are some additional perks you’ll receive with Medicare Advantage plans.

Dental coverage

Medicare Advantage plans cover basic dental care, such as exams, cleanings, and fillings. Some plans also cover more extensive procedures, including X-rays, root canals, extractions, crowns, and dentures.

Eyeglasses and eye doctor appointments

This includes contacts, eyeglasses, and specialty eyewear not covered by Original Medicare. Choosing a Medicare Advantage plan that includes vision coverage could save you a lot of money out of pocket.

Hearing aids

If you think you might need a hearing aid down the road, you may want to check out plans that can reduce your out-of-pocket costs on exams and high-quality hearing aids. These plans can end up saving you thousands of dollars on the equipment you need.

Over-the-counter medications

Cold medicine, cough drops, aspirin — when you’re on a fixed income, these costs can really add up. Some Medicare Advantage plans give allowances for these expenses. They can even help cover vitamins.

Extra help staying fit

Physical activity plays a huge role in living your best life. Some Medicare Advantage plans offer free fitness programs that cover the costs of memberships to health clubs and local gyms, as well as instructional programs for exercising at home.

Clinical care teams

When you need care, you want to know you can count on your Medicare provider. Some companies that offer Medicare Advantage provide members with clinical care teams. These experts know your unique health needs, can help you coordinate care, manage expenses, and so much more. If you want to know more about what clinical care teams do, click here.

Rewards programs

Some health insurance companies also offer rewards programs to their members. These programs give discounts or gift cards in exchange for making healthy decisions like getting checkups and attending preventive screenings — because if you have to go to the doctor, you may as well get rewarded for it.

Find the right plan for you

If the extra benefits that Medicare Advantage plans offer are of interest to you, contact Highmark to learn more about our options. Our licensed Medicare experts can help you find the right Medicare Advantage plan that fits your needs. You can meet up online, inperson, or over the phone —whatever works for you.

Let Highmark help with finding your Medicare plan

Schedule a personal consultation with a Highmark Medicare advisor or call 866-320-8359 , 7 days a week, 8 a.m. - 8 p.m. (ET), (TTY users call 711)

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Highmark Choice Company, Highmark Senior Health Company, and Highmark Senior Solutions Company are Medicare Advantage plans with a Medicare contract. HM Health Insurance Company is a PDP plan with a Medicare contract. Enrollment in Highmark Choice Company, Highmark Senior Health Company, Highmark Senior Solutions Company, and HM Health Insurance Company depends on contract renewal.

Health benefits or health benefit administration may be provided by or through Highmark Blue Cross Blue Shield, Highmark Choice Company, Highmark Senior Health  Company, Highmark Senior Solutions Company, or Highmark Health Insurance Company, all of which are independent licensees of the Blue Cross Blue Shield Association.  All references to “Highmark” in this document are references to the Highmark company that is providing the member’s health benefits or health benefit administration.