Medicare Part C – Understanding Medicare Advantage (Medicare replacement plans)
Get to know your options!
Private insurance companies may offer Medicare-approved programs called Medicare Part C, or Medicare Advantage plans (MA Plans). Sometimes known as Medicare replacement plans, Medicare pays certain approved companies to cover Medicare benefits. These plans provide Medicare Part A and Medicare Part B coverage and add to it additional coverage. Medicare Advantage Plans are only available to people who have Medicare Parts A and B.
Individuals can choose from various types of Medicare Advantage Plans:
- Private Fee-for-Service (PFFS) Plans — As with Medicare, you can see any doctor or healthcare provider if they accept the plan. Individual plans decide how much you pay when you get care.
- Preferred Provider Organization (PPO) plans — This insurance generally offers in-network and out-of-network care options.
- Health Maintenance Organizations (HMOs) — Generally limited to providers who are in-network only, you may need a referral from a primary care provider for hearing-related and other coverage. You may add out-of-network care by using a HMO Point-of-Service (HMOPOS) plan.
- Special Needs Plans (SNPs) — Specifically for people with special needs, these plans often are designed for people who carry both Medicare and Medicaid, live in a nursing facility or have serious/chronic medical conditions.
- High-deductible, Medical Savings Account Plans (MSAs) — These plans combine a high-deductible healthcare plan with a special medical-related bank account. Generally for these plans, Medicare will deposit money into an MSA account from which you use the funds to cover healthcare-related expenses.
Medicare Advantage Plan coverage varies widely. Even within the same company, people may have different coverage. Sometimes this covers hearing-related visits, and some MA plans include hearing aids (or a portion of the cost of hearing aids).
Coverage varies widely, and your policy may cover hearing aids completely, include a portion of the cost of hearing aids, or only cover up to a certain dollar amount.
Which Medicare Advantage Plans offer hearing aid coverage?
Unfortunately, this isn’t a straight-forward answer.
Coverage varies widely, even within the same insurance company. Therefore, when choosing plans, you may want to select one that includes hearing-related coverage.
If you already have a plan in place, HearingLife can check with your insurance on your behalf to see what services are covered.
Medigap and hearing aids
Another additional supplement for Medicare Parts A and B recipients are Medigap policies. Each state requires insurance companies that offer Medigap coverage to follow the same standardized, basic benefits, no matter which insurance company sells them. Individuals may elect to add additional benefits to meet specific needs. In other words, you may need to buy separate coverage for supplemental coverage that includes hearing aids and hearing tests.
Please note that Medigap insurance is not for individuals who have a separate Medicare Advantage Plan.