Are You Getting the Most Out of Your Advantage Plan?
Medicare Advantage (MA) plans often include valuable supplemental benefits that go beyond what Original Medicare covers — but the data shows that many beneficiaries never use them. These extra benefits vary by plan and can include services like dental care, vision exams, hearing aids, gym memberships, transportation, and allowances for over-the-counter (OTC) health products. Some plans even offer meal delivery after a hospital stay.
In some cases, these benefits are included at no additional cost as part of the plan. Others may require an additional premium, depending on the specific Medicare Advantage plan. Despite their potential value to Medicare beneficiaries, research shows these benefits are frequently underused.
Common Supplemental Benefits in Medicare Advantage Plans
Medicare Advantage plans have flexibility to offer a wide range of benefits designed to support overall health and wellness. Common offerings include:
Dental care
Coverage may include preventive services such as exams, cleanings, and X-rays. Some plans also provide limited coverage for procedures like fillings or dentures.
Vision care
Many plans cover routine eye exams and may provide allowances for eyeglasses or contact lenses.
Hearing services
Coverage may include hearing exams and benefits toward hearing aids.
Fitness programs
Many plans include gym memberships or fitness programs designed for older adults.
Meal delivery services
Some plans offer temporary meal delivery after a hospital stay to help support recovery.
Over-the-counter (OTC) allowances
Many MA plans provide quarterly allowances that can be used to purchase eligible health items like vitamins, pain relievers, toothpaste, and other everyday health products.
Transportation benefits
Some plans provide non-emergency transportation to doctor visits, pharmacies, or other medical appointments.
How Often Are These Benefits Used?
A study by The Commonwealth Fund found that while nearly 90% of Medicare Advantage beneficiaries say supplemental benefits are important, actual usage rates are much lower.
For example:
- Dental and vision benefits: used by about
42% of enrollees
- Hearing benefits: used by about
7% of enrollees
- OTC allowances: used by about
46% of enrollees
The study also found that people with lower incomes or functional limitations often value these benefits highly — but they still may not use them more frequently.
Why Many Benefits Go Unused
Several factors contribute to the underuse of supplemental benefits.
Lack of awareness
Many beneficiaries simply don’t realize what benefits their plan offers.
Access challenges
Some services may require using specific providers or following certain plan procedures.
Perceived need
Some beneficiaries may not feel they need certain services right now and postpone using them.
To help address this issue, the Centers for Medicare & Medicaid Services (CMS) now requires Medicare Advantage plans to send
mid-year notifications to members.
These notices inform beneficiaries about:
- Supplemental benefits included in their plan
- Benefits they have not yet used
- Instructions on how to access them
The goal is to make sure beneficiaries are aware of the resources available to them.
Your Action Plan
If you are enrolled in a Medicare Advantage plan, it’s a good idea to review your plan summary to see which supplemental benefits are available. You may be missing out on valuable services already included in your plan.
Also watch for your
mid-year benefits notification, which will show any unused benefits and explain how to access them.
If you have questions about what your Medicare Advantage plan includes, reviewing your benefits now can help ensure you’re getting the most value from your coverage.
