How Can Medicare Advantage Members Maximize Benefits?

The rising cost of medication can be a significant concern for many health care consumers. Still, Medicare Advantage members can take advantage of the savings that come with using a Medicare Advantage plan. But how can members maximize the benefits of their medication coverage? Let’s take a closer look at how you can get the most out of a Medicare Advantage plan and your medication benefits.

What is the Medicare Advantage Plan?

A Medicare Advantage plan is a type of health insurance that provides coverage for Medicare services, including prescription drug coverage. This type of plan is sometimes referred to as a “Part C” plan because it is a type of “compliment” to the traditional “Part A” and “Part B” coverage provided under traditional Medicare.

Unlike traditional Medicare, which is partially financed through federal tax dollars, Medicare Advantage plans are privately run and paid for through premium dollars, much like other types of private health insurance. They offer comprehensive coverage, and in most cases, enrollees enjoy more significant benefits and lower costs than those provided under traditional Part A and Part B Plans.

How do Medicare Advantage Plans Work?

Most Medicare Advantage plans are managed care plans, meaning that they provide health services to members through a network of contracted physicians, hospitals, and other providers.

They also typically offer comprehensive coverage for prescription drug costs, with lower out-of-pocket costs than those generally associated with traditional Medicare.

As with other types of health insurance, it is essential to learn about the specific details of your plan, including the benefits, exclusions, and limitations, as well as the costs associated with both primary and specialty care. This will allow you to make the best possible decisions concerning your health care needs and maximize the value of your coverage.

What Medications Does the Medicare Advantage Plan Cover?

Most Medicare Advantage plans offer comprehensive prescription drug coverage, including the most commonly prescribed medications for cholesterol, high blood pressure, diabetes, and other conditions.

As with other types of private health insurance, the specific medications covered under your medication plan will vary depending on the specifics of your plan. In most cases, this will include the most commonly prescribed drugs, with coverage for all other medications determined on a case-by-case basis.

This means that you should always double-check with your plan administrator to determine the specific medications covered under your plan’s drug list.

How Does Clear Spring’s Medicare Advantage Plan Compare to Others?

Clear Spring Health has worked hard to provide the highest level of benefits and value for our members, and our Medicare Advantage plans are no exception. Not only do we offer Medicare Advantage and stand-alone Medicare Part D products, but we also offer Medicare Advantage Prescription Drug (MAPD) plans that allow you access to all your Medicare benefits, plus extra no-cost programs and services in a single, convenient plan.

This means that our MAPD plans include prescription drug coverage with both HMO and PPO plans. This provides you with the additional benefits and savings associated with a Medicare Advantage plan without purchasing separate prescription drug coverage.

With HMO and PPO options, you have the flexibility to choose the coverage that gives you the best possible value for your needs and preferences. In most cases, this will mean that you can select a plan with the highest level of prescription drug coverage that also provides the greatest level of value for your premium dollars.

How Medicare Advantage Members Can Maximize their Medication Benefits

As a Medicare Advantage member, you have access to all of your Medicare benefits and services, including prescription drug coverage. Your plan may offer a wide variety of prescription drug coverage options, which will provide you with the opportunity to maximize your medication benefits.

While familiarizing yourself with your drug list and what is covered and what isn’t is the first step in maximizing your medication benefits, you also want to become familiar with your extra benefits.

Depending on your unique plan, your extra benefits could entitle you to such things as free vision, hearing, and over-the-counter medications. By taking advantage of these additional benefits, you can maximize the value of your plan and ensure that you are taking full advantage of your coverage.

Of course, you can also consider adding a stand-alone Prescription Drug Plan (PDP) to your current benefits. With Clear Spring, we offer both a Value and Premier PDP that can help you maximize your medication benefits:

Value: Offers comprehensive coverage with low copays and deductibles.
Premier: Offers affordable premiums, no deductibles for Tier 1 and 2 medications, and low copays for generic drugs

Note: Each plan can and will vary by patient and location. To get the most accurate information, complete our online enrollment form or call 1(877)364-4566 for more information.

Clear Spring Health Medicare Advantage Plans

As a Medicare Advantage member, you have access to all of your Medicare benefits and services, including prescription drug coverage. Your plan may offer a wide variety of prescription drug coverage options, which will provide you with the opportunity to maximize your medication benefits. So, make sure you are taking the time to familiarize yourself with all your options and reach out to your provider should you have any questions or concerns.