Some Medicare Advantage Plans may have supplemental benefits. These are services that Original Medicare cannot cover. But not all supplemental benefits are the same! Let’s review what you should know about these extra benefits.

What are supplemental benefits?

A supplemental benefit is an item or service covered by a Medicare Advantage Plan that is not covered by Original Medicare. Common supplemental benefits include:

• Dental Care
• Vision Care
• Hearing Aids
• Gym Membership

Supplemental benefits can be:

• Optional: They are offered to everyone enrolled in the plan. You can choose to purchase coverage if you want. For example, an optional dental benefit for which you can pay an extra premium.
• Mandatory: They are covered for everyone enrolled in the plan. For example, a gym membership benefit that’s included in the plan. You don’t pay an extra premium, and you can’t decline or opt out of the benefit. Mandatory doesn’t mean you need to use it, though.

Supplemental benefits must be primarily health related. There are some exceptions, though, for people with chronic conditions.

 

Supplemental benefits for chronic conditions

Plans can cover supplemental benefits that are not primarily health-related for enrollees who have chronic illnesses. These benefits can address social determinants of health for people with chronic disease. A social determinant of health is a part of someone’s life that can affect their health in some way. Examples of the kind of benefit that plans can cover are:

 

• Meal delivery
• Transportation for non-medical needs
• Home air cleaners
• Pest remediation
• Heart-healthy food or produce

 

To be eligible, you must be chronically ill. If you meet the criteria, a Medicare Advantage Plan may offer you one of these benefits.

Note that not every member of a plan will have access to the same set of benefits. For example, a plan might cover services like home air cleaning and carpet shampooing for its members who have serious asthma. A member of that plan who doesn’t have asthma, or whose asthma is not as severe, will not have access to this coverage.

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