Medicare Advantage (MA) plans often provide supplemental benefits not typically covered by traditional Medicare, such as dental, vision, hearing, and over-the-counter (OTC) medication coverage. Despite their availability, many enrollees are not fully utilizing these benefits, often due to lack of awareness or barriers to access.
A 2024 survey by The Commonwealth Fund revealed that while 80% of Medicare beneficiaries across all plan types consider supplemental benefits important, the perceived value varies by plan type. Nearly 90% of MA enrollees valued these benefits, compared to 74% of traditional Medicare beneficiaries. Socioeconomic factors also play a role; individuals with incomes below $50,000, those with functional limitations, and Black or Hispanic beneficiaries are more likely to value supplemental benefits than their higher-income or white counterparts.
Despite recognizing their importance, actual utilization of these benefits is inconsistent. Approximately 40% of MA enrollees use dental or vision benefits, and only about 6.7% utilize hearing benefits. Conversely, 46% report using OTC medication benefits, with higher usage among lower-income individuals and those who highly value these benefits.
To address underutilization, the Centers for Medicare & Medicaid Services (CMS) implemented the Contract Year 2025 Medicare Advantage and Part D final rule. This rule mandates that MA plans inform beneficiaries about available supplemental benefits and provide personalized mid-year notifications of unused benefits.
By enhancing awareness and access, these measures aim to ensure beneficiaries fully benefit from the supplemental services offered by their MA plans.