Choose perks and premiums for your lifestyle in your Medicare Advantage plan
We've all heard of
Medicare, the sweeping, government-backed health system for older
Americans. But less is known about Medicare Advantage. Despite what you
may have heard, it's not just doctor visits or hospital coverage.
The main difference between original Medicare and Medicare
Advantage is that Medicare offers the ability to choose your physicians
and other health care providers, as long as those providers accept
Medicare, and a vast majority of providers do, according to the Centers
for Medicare & Medicaid Services.
Medicare Advantage plans are
Health Maintenance Organizations (HMOs) that provide the same essential
services as original Medicare but offer benefits beyond original
Medicare coverage. Consumers get care from specific networks of
providers that have agreed on how much to charge for each service.
Keeping costs down allows plans to offer more benefits.
Most
know that Advantage plans have vision coverage and lower prices for
prescription drugs. But there are a lot more perks. Here are some
examples from Long Beach-based nonprofit SCAN Health Plan, which has
provided Medicare Advantage plans for over 30 years.
Fitness technology:
Active SoCal seniors can get a free Fitbit from SCAN. This device is
worn around the wrist like a watch and tracks physical activity. A
popular feature counts daily steps, which motivates wearers to improve
their numbers.
Hearing aids: Hearing
aid coverage is available again in 2020 - and at an even lower cost. It
includes a yearly hearing test by an audiologist associated with SCAN,
and a low copay for high-tech wireless hearing aids that deliver more
clarity and can be programmed via app.
"The advancement in hearing
aid technology has greatly improved the functions of hearing aids, but
as a result, hearing aids can run several thousand dollars," said Jill
Selby, the vice president of product development for SCAN. This is why,
she said, SCAN lowered hearing aid copays in 2020.
Emergency response:
Wearable alert devices are often available. If you've seen the
commercials showing elderly people in frightening fall situations, you
know that a safety pendant can save lives.
"This system is not just
for use at home," Selby said. "Some of our more active seniors will want
to wear it when they go for a walk or a bicycle ride, just as a safety
precaution."
In-home fall prevention inspection: A licensed
occupational therapist will do a free inspection of your home. "Many of
us live with safety hazards and don't even realize it," said Selby. They'll ensure your home is set up for your safety, recommending grab
bars or better lighting, for example, and identifying slip hazards. "It
can be very simple things," she said.
In-home caregiving and meal delivery: After
a hospital stay, you might need a little help around the house. "A
caregiver can assist you taking that first shower, for example." Selby
said. "Our members just out of the hospital get up to 28 days of
home-delivered meals."
Transportation: Members can have a car pick them up at home and take them to medical appointments. This benefit isn't just for seniors
who have stopped driving. The service is available for people who need a
ride after eye examination with dilation, for example. Selby recalled
that one member was frequently late for her appointments because she
could never get a parking spot. The car service dropped her off at the
doctor's door.
Telehealth: If you
are considering urgent care, you can call and be connected to a doctor
for medical advice. Maybe that trip won't be needed, after all.
The
most popular SCAN plan, the SCAN Classic (HMO), has a full suite of
benefits that will meet the needs of a great many seniors, Selby said.
There are also specialized plans for chronic conditions like diabetes,
heart disease or kidney disease.
Available in L.A. and Orange
counties is the Prime plan, which is targeted at younger, newly retired
people who want more lifestyle benefits as opposed to coverage for
things like in-home care.
Whichever you choose, Selby recommends taking a good look at your health requirements and goals.
"The
idea is to find a plan that meets your needs," Selby said. "Don't sign
up for things you won't use. Maybe you think a free gym membership
sounds great, but will you ever go to the gym? Maybe you prefer to play
tennis and go on hikes."
"Check
every year to make sure a benefit you want is still covered," Selby
said. "It is important that while you are reviewing what you had this
year, you think about benefits you didn't need before, but do now. A
senior's needs change from year to year."
– CATHERINE GAUGH
Custom Publishing Writer
