How to Maximize Your Medicare Advantage Plan in 2025

As we begin the new year, chances are you've already had the opportunity to experience your Medicare Advantage plan in action. Now is an ideal moment to take stock of all the benefits your plan offers, ensuring you maximize its value.

We've compiled five essential tips to help you make the most of your Medicare Advantage plan in 2025

1. Verify Your Provider Network

While it may not be the most glamorous advice, paying attention to your provider network can lead to significant savings.

Depending on your specific Medicare Advantage plan, you'll have a designated provider network. Health Maintenance Organizations (HMOs) typically offer no coverage outside this network except in emergencies. Preferred Provider Organizations (PPOs), however, provide some coverage for non-contracted providers, albeit at a higher cost.

Using out-of-network providers generally results in increased expenses. Even with a PPO, you'll face higher cost-sharing responsibilities and possibly elevated deductibles.

To ensure cost-effective care, it's essential to confirm the network status of all your healthcare providers, including specialists and other members of your healthcare team.

2. Review Your Summary of Benefits

Understanding your plan's coverage is extremely helpful. Upon enrollment, you will receive a detailed booklet outlining your Medicare Advantage plan's benefits. This comprehensive resource specifies covered procedures and outlines your financial responsibilities.

Having this information is invaluable when evaluating treatment options and can help you avoid unexpected medical bills later on. While it's important not to forego necessary treatment recommended by your doctor solely due to coverage limitations, being aware of potential costs allows you to plan accordingly.

Moreover, your plan might include benefits beyond what you expect, such as dental, vision, and hearing services. Unlike Original Medicare, which offers limited coverage in these areas, Medicare Advantage plans often provide more comprehensive benefits. Take advantage of these additional services to maximize your healthcare coverage.

3. Activate Spending Cards

A significant advantage of Medicare Advantage plans is their inclusion of perks not typically found in Original Medicare or Medigap plans. One such perk gaining popularity in recent years is the flexible spending card.

Many Medicare Advantage plans now offer these cards, which can be used for expenses related to dental, vision, and hearing care. Depending on your plan, you may have allocated funds for each category or a lump sum to use as needed throughout the year. It's important not to overlook these benefits, as they can range from $250 to $750 or more annually.

Don't miss out on maximizing your healthcare coverage with these flexible spending opportunities!

4. Purchase Over-the-Counter Items

Many Medicare Advantage plans also offer an over-the-counter (OTC) stipend as an additional benefit. This stipend is typically distributed monthly or quarterly, depending on your plan. While specific details vary, these funds can generally be used to purchase a variety of items commonly found in drugstores.

Examples of eligible items include over-the-counter medications, first aid supplies, incontinence products, sunscreen, vitamins, supplements, and more.

It's important to note that unused amounts usually cannot be carried over to the next period, so it's a "use it or lose it" benefit. Familiarize yourself with how your OTC benefit operates—some plans allow in-store purchases, while others offer an online catalog for ordering. Taking advantage of this benefit can help you save on everyday healthcare essentials.

5. Explore Extra Perks and Incentives

Finally, take the time to discover any extra perks your Medicare Advantage plan may offer. Many plans provide benefits like access to local gyms simply by presenting your Medicare Advantage ID card. It's worthwhile to check your plan details to see which gyms participate in your area.

Moreover, some plans offer further incentives and rewards. These can include gift cards for completing wellness checks, engaging in volunteer activities, or maintaining an active lifestyle. These incentives are designed to encourage you to prioritize your health and well-being.

Be sure to take advantage of these additional perks and rewards offered by your Medicare Advantage plan. They can enhance your overall healthcare experience while promoting a healthier lifestyle.

Get Your Medicare Advantage Questions Answered

Medicare Advantage plans present a compelling choice for many beneficiaries, offering affordable monthly premiums and a wide range of benefits that surpass those of Original Medicare. While these plans come with their own set of advantages and considerations, knowing how to leverage your plan effectively can lead to significant benefits.

If you would like assistance in reviewing your current plan or have questions regarding your coverage, don't hesitate to reach out to the dedicated team of Medicare advisors at Local Medicare Specialists today. We are ready to provide personalized guidance to help you make informed decisions about your healthcare coverage.