What benefit standard must every Medicare Advantage plan meet?
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
A Medicare Advantage plan is required to provide at least the same range of benefits that Original Medicare covers, including Part A hospital coverage and Part B medical coverage. The plan may then add extra benefits beyond what Original Medicare provides, such as routine dental, vision, hearing, or fitness programs, and it must meet annual out-of-pocket limits for Part A and Part B services. Because the plan replaces Original Medicare for the enrollee, the beneficiary must still pay the Part B premium in addition to any plan premium. This parity requirement protects enrollees from plan designs that strip away core Medicare protections.
Why the other options are wrong
- B) MA plans cannot reduce benefits below the Original Medicare level; they must at least match Medicare's covered benefits.
- C) MA plans must cover emergency and urgent care, including out-of-network emergency services, as part of their benefit package.
- D) Long-term custodial care is not covered by Original Medicare, so it is not a required MA benefit, although some plans may offer related services.
Memory hook
Medicare Advantage must match Medicare's floor, then it may build upward with extra benefits.