Big Benefits, Small Premiums: Medicare Advantage Extras 2025

If you’re a Medicare beneficiary living on the South Shore of Long Island, chances are you’ve seen the commercials. You know the ones—“Call now to get dental, vision, a free gym membership, and a pony!” (Okay, maybe not the pony.) But with all the hype, it’s hard to know what’s real, what’s fluff, and what actually matters to you.

So let’s break it down—warmly, clearly, and honestly—because you deserve real answers, not a sales pitch.

What is a Medicare Advantage Plan, Really?

Medicare Advantage Plans (also called Part C) are offered by private insurance companies, but don’t let that scare you off—they’re approved and regulated by Medicare.

Here’s the important part:

• They must cover everything Original Medicare covers—as good or better.

• Most plans also include Part D prescription drug coverage, so you’re not stuck buying a separate plan.

• And unlike Original Medicare, they come with an annual out-of-pocket maximum to protect you from runaway costs. (No such protection exists under Original Medicare.)

Think of it as a bundled deal—hospital, medical, and prescription drug coverage, all rolled into one tidy little package. Some plans even throw in perks that make the whole thing feel like an upgrade.

What Extras Can You Get in 2025?

Depending on your plan—and your ZIP code—you might have access to some great “extras” like:

• 🦷 Dental coverage (think cleanings, x-rays, dentures)

• 👓 Vision benefits (eye exams and glasses)

• 🔊 Hearing aids & hearing tests

• 💪 Fitness memberships (like SilverSneakers or Renew Active)

A Quick Word of Caution:

Some of the splashiest benefits—like Over-the-Counter (OTC) allowances, transportation services, and Flex Cards—are usually reserved for those who qualify for both Medicare and Medicaid (dual-eligible folks). If you don’t qualify for Medicaid, your available perks may be more limited—but still valuable!

Why Are These Plans So Affordable?

If it sounds too good to be true, you might be wondering, “What’s the catch?” The truth is, there isn’t one—as long as you understand how the system works.

• Medicare Advantage plans are funded on a per capita basis, meaning Medicare pays the plan a fixed amount each month to manage your care.

• That’s why you’ll see those ads asking for your ZIP code—benefits and plans vary based on location.

• To manage costs, these plans use networks and tools like prior authorization for certain services. (And by the way, Original Medicare is adding prior authorization in 2026, too.)

Plans differ in how they handle prescription drugs—some use tiered copays, some offer preferred pharmacies, and some just plain do it better. In fact, Medicare Advantage plans often offer more competitive drug coverage than stand-alone Part D plans.

Is Medicare Advantage Right for You?

Here’s when a Medicare Advantage Plan might be a great choice:

1. ✅ You want convenience – one card, one plan, one monthly premium (maybe even $0).

2. ✅ You live in a strong network area – like Nassau or Suffolk County, where top-tier doctors and hospitals often participate.

3. ✅ You want predictable costs – many plans limit your out-of-pocket spending.

4. ✅ You value extras – dental, vision, hearing, wellness benefits? Yes, please.

5. ✅ You like coordination – some plans offer chronic care teams or help managing conditions.

6. ✅ Your doctors are in-network – this is the big one. If your doctors are covered, it can be a fantastic value.

7. ✅ You want drug coverage included – most Advantage plans do this well.

Still wondering? That’s exactly what I’m here for.

Don’t Leave Benefits on the Table

A lot of people stick with what they know—even if it’s not the best fit anymore. But here in New York, you’ve got options most folks in other states don’t.

🗽 Medicare Switching Rules on Long Island: What Most People Don’t Know

Fact #1: New York is a guaranteed issue state for Medigap.You can apply any time—no health questions, no pre-existing condition penalties.

Fact #2: First-time on an Advantage plan? You have a 12-month “trial right.”Didn’t love your plan? You can switch back to Original Medicare and get a Medigap plan without underwriting.

Fact #3: Special Enrollment Periods (SEPs) are more common than you think.Moved? Lost Medicaid? Left an employer plan? Misled by a commercial? These all qualify you to make changes.

Why this matters:

Many Long Island seniors get overwhelmed by flashy ads promising “free everything,” but don’t understand their rights or options. That’s where a local broker—like me—can make all the difference.

Let’s Talk—No Pressure, No Gimmicks

Choosing between a Medicare Advantage Plan and a Medicare Supplement isn’t about which one is “better”—it’s about which one is better for YOU.

That depends on:

• Your doctors

• Your prescriptions

• Your lifestyle

• Your budget

As a licensed Medicare broker serving the South Shore of Long Island, I’ll help you find the right fit without any confusing jargon, pushy sales tactics, or gimmicks.

📞 Ready to talk it through?Call me at 631-337-3625

🌐 Visit www.ABCMPB.com

📧 Or email me directly at Diane@ABCMPB.com

Let’s make Medicare easier—together.

Medicare Advantage Extra Benefits