If you have a Medicare Advantage plan, you may have more benefits available than you realize.
Many people enroll in a Medicare Advantage plan and only use it when they visit the doctor or fill a prescription. It is important to understand that today’s plans often include a wide range of additional benefits designed to improve your health, lower out-of-pocket costs, and provide added value throughout the year.
At Yost Insurance Agency, we help clients understand how to maximize their Medicare Advantage plan benefits, so nothing gets left unused. Here are some helpful tips to ensure you get the full advantage of your advantage plan:
1. Start with Preventive Care
Most Medicare Advantage plans cover preventive services at little to no cost. These services are designed to catch health concerns early and help you stay well.
Common preventive benefits include:
• Annual wellness visits
• Routine screenings
• Vaccinations
• Lab work
• Mammograms and colonoscopies
Scheduling your annual wellness visit is one of the simplest and most important ways to use your plan effectively. Preventive care can reduce long-term medical costs and improve overall health outcomes.
2. Use Your Dental, Vision, and Hearing Benefits
Unlike Original Medicare, many Medicare Advantage plans include coverage for routine dental, vision, and hearing services.
Depending on your plan, you may have access to:
• Dental exams and cleanings
• X-rays and basic procedures
• Eye exams and eyewear allowances
• Hearing exams and hearing aid coverage
Many of these benefits have annual maximums that reset each year. If you do not use them, they typically do not roll over. Reviewing your Evidence of Coverage can help you understand exactly what is available.
3. Take Advantage of Over-the-Counter Benefits
Many Medicare Advantage plans now include allowances for over-the-counter health items. These benefits often provide a quarterly or monthly amount that can be used for:
• Vitamins and supplements
• Pain relievers
• First aid supplies
• Cold and flu medications
• Incontinence products
These allowances can total hundreds of dollars each year. If you are unsure how to access your over-the-counter benefit, it is worth reviewing your plan materials or contacting your agent for assistance. Keep in mind that with many plans, your quarterly OTC amount does not roll over and must be utilized each quarter.
3. Review Your Prescription Drug Coverage
Most Medicare Advantage plans include Part D prescription drug coverage. However, formularies, pharmacy networks, and tier pricing can change each year.
To help reduce prescription costs:
• Confirm your medications are on your plan’s formulary
• Use preferred pharmacies
• Consider mail-order options
• Review changes annually during the Medicare Annual Enrollment Period
Staying informed about your prescription benefits can prevent unexpected expenses and ensure your medications remain affordable.
4. Use Fitness and Wellness Programs
Many Medicare Advantage plans include gym memberships or structured wellness programs at no additional cost. These programs are designed to support mobility, heart health, balance, and overall well-being.
Benefits may include:
• Access to national gym networks
• Group fitness classes
• Online workout programs
• Wellness coaching
Using these benefits can improve quality of life and help maintain independence as you age.
5. Understand Your Provider Network
Medicare Advantage plans typically operate within provider networks. Depending on whether you have an HMO or PPO plan, your flexibility in choosing doctors and specialists may vary.
Before scheduling appointments or procedures, confirm that your providers participate in your plan’s network. This can help prevent unexpected out-of-network charges.
6. Schedule a Benefits Review
Medicare is not something you should set and forget. Your health needs may change, and plan details can change annually.
A Medicare plan review allows you to:
• Confirm you are using all available benefits
• Review prescription drug coverage
• Evaluate provider access
• Prepare for upcoming enrollment periods
Some agents only provide enrollment support and then you are on your own to navigate your plan throughout the year. At Yost Insurance Agency, our goal is to provide ongoing service and support because we believe that understanding your Medicare Advantage plan leads to better decisions, greater confidence, and most importantly, better health and care!
If you are unsure whether you are maximizing your Medicare Advantage benefits, we are here to help. A simple review can ensure you are getting the full value from your coverage.
Medicare is not just about having a card in your wallet. It is about knowing how to use it.