Are There Specific Questions I Should Ask About Supplemental Benefits?Before signing up for a Medicare Advantage Plan that includes supplemental benefits or before receiving services that are covered by these benefits, ask the following questions to better understand the available coverage:

  •  Is this definitely a supplemental benefit? Or is this service covered under Original Medicare?
    •  Sometimes, plan marketing materials can make it seem as though they are covering additional services, when these services are actually covered by Medicare. To find out if a service is already covered by Original Medicare, you can call 1-800-MEDICARE.
  •   If I am signing up for a Medicare Advantage Plan because it contains this benefit, have I also made sure that the plan’s other coverage will work for me?
    •   For example, are all my providers in this plan’s network? Are my drugs on this plan’s formulary?
  •  Is this benefit offered to all enrollees in this Medicare Advantage Plan?
    •  Is it an optional benefit that I need to sign up for?
    •  Is it a benefit that is only offered to plan members with chronic conditions? Do I meet the plan’s criteria for coverage?
    •  Is the benefit only available if medically necessary? Does my situation meet that standard?
  •  Is there a cost associated with this benefit?
    •  Is there an additional premium that I must pay in order to access it?
    •  Are there copays or coinsurances for these services?
    •  Is this Medicare Advantage Plan’s premium higher than comparable plans that do not offer this benefit?
  •  Are there limits to how much I can use this service—for example, a set number of rides under a transportation benefit or a dollar limit on eyeglasses?
  •  Are there restrictions on where and how I can access these services? For example, do I need to see in-network providers, receive a referral, or participate in a care management program?
  •  Are there some excluded services within this category of benefits?
  •  Is this the most cost-effective way for me to access these services?
    •  Is separate insurance or private payment for that benefit available? Does that insurance offer more benefits or is it less expensive than the premium difference?

Read More: Are There Additional Ways I can Access Similar Services?
Learn About: What is Considered a Supplemental Benefit?
Return to: Medicare Advantage

Are There Specific Questions I Should Ask About Supplemental Benefits?Before signing up for a Medicare Advantage Plan that includes supplemental benefits or before receiving services that are covered by these benefits, ask the following questions to better understand the available coverage:

  •  Is this definitely a supplemental benefit? Or is this service covered under Original Medicare?
    •  Sometimes, plan marketing materials can make it seem as though they are covering additional services, when these services are actually covered by Medicare. To find out if a service is already covered by Original Medicare, you can call 1-800-MEDICARE.
  •   If I am signing up for a Medicare Advantage Plan because it contains this benefit, have I also made sure that the plan’s other coverage will work for me?
    •   For example, are all my providers in this plan’s network? Are my drugs on this plan’s formulary?
  •  Is this benefit offered to all enrollees in this Medicare Advantage Plan?
    •  Is it an optional benefit that I need to sign up for?
    •  Is it a benefit that is only offered to plan members with chronic conditions? Do I meet the plan’s criteria for coverage?
    •  Is the benefit only available if medically necessary? Does my situation meet that standard?
  •  Is there a cost associated with this benefit?
    •  Is there an additional premium that I must pay in order to access it?
    •  Are there copays or coinsurances for these services?
    •  Is this Medicare Advantage Plan’s premium higher than comparable plans that do not offer this benefit?
  •  Are there limits to how much I can use this service—for example, a set number of rides under a transportation benefit or a dollar limit on eyeglasses?
  •  Are there restrictions on where and how I can access these services? For example, do I need to see in-network providers, receive a referral, or participate in a care management program?
  •  Are there some excluded services within this category of benefits?
  •  Is this the most cost-effective way for me to access these services?
    •  Is separate insurance or private payment for that benefit available? Does that insurance offer more benefits or is it less expensive than the premium difference?

Read More: Are There Additional Ways I can Access Similar Services?
Learn About: What is Considered a Supplemental Benefit?
Return to: Medicare Advantage

Clicking third-party links will open a new tab and will take you away from YourMedicare.com. YourMedicare.com, LLC does not control the linked sites’ content or link.

This content was created and copyrighted by the Medicare Rights Center ©2019. Medicare Rights Center is a national, nonprofit consumer service organization that works to ensure access to affordable health care for older adults and people with disabilities. These materials are presented here with support from YourMedicare.com and may not be distributed, modified or edited without Medicare Rights’ consent.

YourMedicare.com takes pride in providing you as much information as possible concerning your Medicare options, but only a health insurance broker licensed to sell Medicare can help you compare your plan options from various insurance companies. When you’re ready, we recommend you discuss your needs with a YourMedicare.com Licensed Sales Agent.