Analysis: Medicare Advantage Supplemental Benefits
(2024–2025)
Medicare Advantage (MA) plans have increasingly used
supplemental benefits to attract and support enrollees, offering services
beyond original Medicare’s scope. Figure 1 illustrates the prevalence of key
supplemental benefits in 2024 and 2025, measured as the percentage of MA plans
that offer each benefit. Nearly all MA plans now include vision, dental,
hearing, fitness, and telehealth benefits, whereas fewer plans provide nutrition,
transportation, or in-home care support. This disparity raises questions about whether
MA plans prioritize benefits that reflect older adults' clinical, social, and
economic needs. In the sections below, I provide a detailed evaluation of which
benefits are prioritized and which are neglected, as well as how this mix
aligns with best practices in older adult care and the health outcome drivers
for older adults.
Figure 1. Percentage of Medicare Advantage plans offering
supplemental benefits in 2024 (light blue) vs 2025 (dark blue). While virtually
all plans cover vision, dental, hearing, and fitness, relatively few offer
services like transportation or in-home support (Source: industry data).
As Figure 1 shows, vision coverage is almost universal (≈99%
of MA plans in 2025), as are dental and hearing benefits (≈98%) and fitness
programs (≈98%). Telehealth benefits became nearly ubiquitous by 2025 (97%),
reflecting the pandemic-driven expansion of remote care. In contrast, only
about one-third of plans offer transportation assistance to medical
appointments (36% in 2025), and an even smaller share provides in-home support
services (just 9% of plans) for home care aide or caregiver support. Nutrition-related
benefits are also underrepresented – for example, only ~40% of plans offer
nutrition counseling or healthy food benefits, and ~72% cover meal delivery
(often only post-hospitalization). This stark difference between widely offered
vs. rarely offered benefits suggests a misalignment: the most prevalent
benefits tend to be those with high consumer demand (e.g., dental, vision) or
easy integration, while critical supports for chronic illness and aging in
place (like home care and transportation) remain scarce.
MA plans overwhelmingly prioritize certain supplemental
benefits – notably vision, dental, hearing, fitness, and, more recently,
telehealth. These benefits address essential aspects of older adults’ health,
but primarily focus on clinical preventive services and lifestyle perks that
are popular in marketing. Below, I provide an assessment of each benefit:
- Vision
and Hearing Services: Vision care (eye exams, eyewear) and hearing aid
benefits are offered by ~99% and ~98% of plans, respectively (Freed et
al., 2023). This near-universal coverage reflects recognition of how
prevalent vision and hearing loss are among older adults. Impaired vision
contributes to falls and injuries; uncorrected hearing loss can lead to
social isolation and cognitive decline. By including these benefits, MA
plans fill a notable gap in original Medicare (which does not cover
routine vision or hearing services). This high coverage is appropriate
from a needs perspective: regular eye and hearing exams are recommended
for older adults. However, the scope and utilization of these benefits may
be limited. Many plans cap their dental or vision coverage or require
cost-sharing, which can restrict access to more expensive treatments.
Indeed, a recent study found that although MA enrollees have far more vision/hearing
coverage than those in traditional Medicare, their actual use of these
services was similar, and many enrollees were not even aware they had such
coverage. Only 41% of MA members report using their vision benefits, and
7% use hearing benefits in a year (Cai et al., 2025). Despite clinical
guidelines advising annual eye exams and periodic audiology checks. This
suggests that offering a benefit is not enough — plans must also ensure
enrollees know how to use it and cover a meaningful portion of the cost.
Nonetheless, by prioritizing vision and hearing, MA plans are at least
addressing everyday clinical needs of aging (sensory impairments), which
aligns with older adult care recommendations to assess and manage these
impairments routinely.
- Dental
Benefits: Routine dental care is included by ~98% of MA plans, making it
as common as vision/hearing benefits (Freed et al., 2023). Poor oral
health in older adults is linked to nutrition problems, pain, and even
heightened risk of cardiovascular disease, and traditional Medicare covers
almost no dental services. MA plans have capitalized on this gap. The high
prevalence of dental coverage indicates that plans prioritize oral health
for older adults. However, the adequacy of this coverage is variable. Many
MA dental benefits are limited to cleanings, X-rays, and preventive care,
with annual dollar caps that may not cover extensive dental work. Thus,
while almost every MA enrollee has some dental benefit, it may not fully
meet the needs of those with severe dental issues. Regarding utilization,
about 42% of MA enrollees report using their dental benefit annually,
implying that a majority do not use it yearly (possibly those without
acute dental needs, or those deterred by limited coverage). Overall,
making dental care nearly universal in MA is a positive alignment with
older adults’ needs – addressing a crucial service tied to overall health
and quality of life – but the depth of coverage often remains insufficient
relative to the need (e.g., dentures or periodontal care may still incur
substantial out-of-pocket costs (Freed et al., 2023).
- Fitness
Programs: Approximately 96–98% of MA plans offer fitness benefits (e.g.,
gym memberships like SilverSneakers), and these benefits are extremely
popular as a marketing tool, encouraging healthy, active older adults to
choose MA. From a health standpoint, regular exercise in older age is
beneficial – it helps maintain mobility, muscle strength, and balance
(preventing falls). It can improve chronic disease control (like diabetes
and hypertension). By prioritizing fitness, plans align with preventative care
principles for older adults that encourage physical activity to reduce
frailty. The high uptake of fitness benefits indicates that plans view
this as a low-cost investment that attracts enrollees and potentially
keeps them healthier. However, one could question if this primarily serves
the already-active subset of older adults. It may not reach more
disadvantaged older adults who have mobility limitations or lack access to
fitness facilities (e.g., rural residents or those without
transportation). Still, widespread fitness benefits reflect a proactive
approach to healthy aging.
- Telehealth
Services: Telehealth has rapidly become a standard offering in MA. In
2024, 83% of plans offered supplemental telehealth benefits, down from 97%
in 2023 (a drop primarily due to reclassification of some telehealth
services into core benefits). However, by 2025, telehealth offerings
rebounded to roughly 97% of plans (Figure 1). The COVID-19 pandemic
demonstrated the value of telehealth for older adults, allowing remote
medical consultations and monitoring. Embracing telehealth aligns MA plans
with modern chronic disease management practices, enabling more frequent
check-ins for congestive heart failure or diabetes without requiring
travel. Telehealth directly supports older adults' care by improving
access for those who are homebound or distant from providers. Its
near-universal inclusion by 2025 is a strong positive in aligning with
clinical needs. The key caveat is the digital divide: not all older adults
have internet access or are comfortable with telemedicine technology.
Plans and providers must ensure that older patients can effectively
utilize telehealth (perhaps through caregiver assistance or providing
devices/training). Nonetheless, coverage of telehealth services positions
MA well for future care models, especially as studies show telehealth can
facilitate chronic disease monitoring and reduce barriers to care.
- Over-the-Counter
(OTC) Allowances: Another commonly offered benefit (about 85–86% of plans)
is an OTC stipend or allowance for health-related items (e.g.,
nonprescription medications, bandages, vitamins). This economic benefit
gives older adults a quarterly or monthly dollar credit to purchase
everyday health supplies. While not a clinical service per se, OTC
coverage acknowledges the financial strain many older adults face in
managing minor health needs. It somewhat addresses the economic needs of
older adults on fixed incomes by covering items that might otherwise be out
of pocket. This can indirectly affect health by enabling adherence to
over-the-counter therapies (for example, a plan might cover glucose test
strips or aspirin). Beneficiaries with lower incomes especially value OTC
benefits, and indeed, the usage of OTC cards is higher among low-income enrollees.
(Gupta et al., 2025). The widespread adoption of OTC benefits indicates MA
plans’ responsiveness to older adults’ economic needs, albeit on a small
scale (typically, these allowances are modest). It is a supportive
benefit, but not one that dramatically alters health outcomes; it enhances
the affordability of routine self-care.
The most prevalent supplemental benefits (vision, hearing,
dental, fitness, telehealth, OTC) generally correspond to services that older
adults want and that improve quality of life. They also tend to be relatively
low-cost for insurers to provide at a basic level (e.g., a gym membership
discount, a limited dental cleanings package) and serve as strong enrollment
incentives. From a needs perspective, these benefits are certainly not
frivolous – each addresses legitimate aspects of senior health (sensory impairments,
oral health, preventive care, access to providers). To a large extent, their
prioritization does reflect the real needs of the aging population. However,
the depth and effective use of these benefits may not always match the need.
For instance, having vision coverage on paper is only meaningful if older
adults get eyeglasses and vision issues corrected. Current research suggests that
many MA enrollees do not get recommended vision or dental care due to awareness
gaps or residual cost barriers. Thus, while the high offering of these benefits
is encouraging, a gap remains between availability and impact, an important
theme in evaluating alignment with health outcomes. (Cai et al., 2025).
In contrast to the near-ubiquitous benefits above, several
supplemental services that could significantly impact older adults’ health and
independence are comparatively neglected by MA plans. These include nutrition
support (meals and diet), transportation assistance, and in-home support
services. Also in this category are benefits like caregiver support and home
safety modifications. These services address key social and functional
determinants of health for older adults – areas strongly linked to outcomes
like hospitalization, institutionalization, and mortality – yet only a minority
of plans offer them. Here we critique the limited prioritization of these
benefits:
- Meal
and Nutrition Benefits: Proper nutrition is fundamental for older adults,
particularly those with chronic illnesses or post-hospital recovery needs.
Some MA plans have started to cover meal delivery (for example, pre-cooked
meals delivered to a patient’s home after discharge from a hospital or for
those with certain chronic conditions). By 2025, about 72% of MA plans
offer a meal benefit (usually limited in duration or specific situations).
Additionally, around 40% of plans offer nutrition-related benefits such as
dietary consultations, healthy produce subsidies, or cooking classes
(often as part of newer flexibility for chronically ill members) as of
2025 (Figure 1). While these percentages are higher than a few years ago
(nutrition benefits were under 30% of plans in 2020), they still indicate
that over half of MA plans do not address nutrition support. This is
problematic given that malnutrition in older adults is a serious health
concern associated with increased morbidity, frailty, and even mortality.
For example, inadequate nutrition can exacerbate chronic diseases (poor
diet control worsening diabetes or heart failure) and contribute to muscle
wasting and immune dysfunction. Meal delivery programs have shown positive
impacts – studies have found that medically tailored meal programs can
reduce hospital readmissions and improve diet-sensitive outcomes in
high-risk patients (e.g., reducing heart failure exacerbations by ensuring
low-sodium meals). The relatively modest uptake of robust nutrition
benefits suggests a gap between what older adults' best practice would
recommend (ensuring food security and dietary support for older adults)
and what MA plans typically provide. Many plans limit meal benefits to
short-term post-discharge periods, which is beneficial for recovery, but
ongoing food insecurity or chronic nutritional needs often remain
unaddressed. Given that a sizable fraction of older adults face
difficulties in grocery shopping or cooking (due to mobility issues or
cognitive impairment), more comprehensive nutrition benefits (like regular
grocery allowances or partnerships with Meals on Wheels) would better
align with senior needs. Only a minority of plans (generally Special Needs
Plans) offer a monthly healthy food stipend for chronically ill enrollees.
The neglect of broader nutrition support in most MA plans is a notable
shortcoming relative to its importance for health outcomes in aging (Gupta
et al., 2025).
- Transportation
Assistance: Transportation is often the linchpin for healthcare access –
without a ride, an older patient may miss medical appointments, therapy
sessions, or even the chance to socialize and obtain groceries. Nevertheless,
in 2025, only about 36% of MA plans cover any transportation services for
medical needs. This represents a decrease from 2023, when 43% offered
transportation help, suggesting some plans pulled back this benefit. For
the majority (~64%) of MA enrollees, their plan offers no rides to the
doctor. Although many older adults cannot or should not drive due to
health conditions, public transportation can be impractical for those with
mobility limitations. The low prioritization of transportation benefits
indicates a misalignment with a critical social determinant of health.
Research consistently shows that transportation barriers lead to missed
appointments, delayed care, and poorer management of chronic conditions. One review concluded that a lack of transportation
often results in delayed medical interventions and ultimately worse health
outcomes for chronic disease patients. In older adult practice, ensuring
patients have transportation to their primary care and specialist visits
is essential for continuity of care. Some MA plans recognize this –
notably, Dual-Eligible SNPs (special plans for low-income
Medicare-Medicaid patients) typically include transportation (88% of SNPs
cover transport vs only 36% of standard plans). That disparity suggests
that insurers value providing rides when targeting high-need, low-income
populations (perhaps because Medicaid programs also emphasize it). However,
for the broader MA population, transportation remains under-provided. This
neglect disproportionately affects those who are just above Medicaid
thresholds – older adults who may be low-income or rural and have no
reliable transportation, yet are in a regular MA plan without this
benefit. The result can be untreated conditions or reliance on emergency
services when issues worsen. Regarding equity and need, transportation is
a prime example of MA benefits not keeping pace with what older adults
truly require to obtain care.
- In-Home
Support Services: One of the clearest gaps in MA supplemental coverage is
in-home support for daily living. Only about 9% of MA plans 2025 offer
in-home support services for enrollees – personal care aides to help with
bathing, dressing, homemaker services, or respite care for caregivers.
This percentage declined from 14% of plans in 2023, showing that uptake
has been tepid and retreating. In-home support is foundational for aging
in place, a goal for many older adults and a priority in older adults'
care policy. Frail older adults often need assistance with activities of
daily living (ADLs) to remain safely at home and avoid
institutionalization. Such support can prevent falls (through supervision
or home hazard mitigation), ensure medication adherence, and reduce
caregiver burnout. Despite these benefits, most MA plans have not
incorporated home-care services into their benefits, likely because they
can be expensive and were not historically allowed as “primarily
health-related” benefits until recently. In 2019, CMS expanded the
definition of allowable supplemental benefits to include non-medical
services for chronically ill members. However, insurers have been slow to
adopt them, citing a lack of evidence for return on investment. The extremely low prevalence of in-home
support in MA indicates a significant misalignment with senior needs: this
is arguably an area of greatest need for the most vulnerable elders (those
with functional impairments), but it is scarcely available unless one
qualifies for Medicaid home care or is in a special chronic illness MA
plan. Only 25% of SNPs (which target high-need groups) offer in-home
support, versus 9% of general plans, highlighting even within MA, this
benefit is reserved for a subset of enrollees. From an older adult's best
practice standpoint, this is a significant gap – supporting ADLs and
caregivers at home is known to improve outcomes like delaying nursing home
entry and reducing hospitalizations for frail patients. The neglect of
in-home services in MA supplemental benefits is thus a critical area where
the plans’ priorities diverge from the aging population's real health and
social needs.
- Other
Neglected Supports: Additional rare benefits include caregiver support
(only ~5% of plans provide services like respite care or caregiver
training in 2024) and home modification benefits (e.g., bathroom safety
devices were offered by just 22% of plans in 2024). Caregiver support is
an often overlooked need – many older adults rely on informal caregivers
(family or friends), and supporting those caregivers (with training,
respite breaks, or counseling) can directly impact the senior’s health
outcomes and ability to age in place. However, besides a tiny fraction of
the population experimenting with it, hardly any MA plans offer a
caregiver benefit. Home safety modifications (like grab bars, ramps,
shower chairs) are directly tied to fall prevention – a cornerstone of older
adults care – and while it is encouraging that plans offering such devices
more than doubled from 10% in 2023 to 22% in 2024, it is still only one in five plans. Again, these
benefits have become more common in specialized plans: for example, nearly
one-third of SNPs cover bathroom safety devices. The slow adoption of
these supports in standard MA plans likely reflects uncertainty among
insurers about costs and logistics, and perhaps a lack of immediate demand
from healthier enrollees. However, their absence represents a lost
opportunity to address key risk factors (like falls and caregiver burnout)
that drive hospitalizations and institutional care.
The comparatively neglected benefits – nutrition support,
transportation, in-home care, and caregiver/home support – correspond to some
of the most significant determinants of older adults’ health outcomes. These
are areas strongly emphasized in older adults and gerontological literature as
necessary for managing chronic illness and enabling independence. The limited
availability of these services in MA plans suggests that current plan offerings
do not fully align with an aging population's complex social and functional
needs. The following section examines this alignment more broadly, in light of older
adults' care best practices and health equity considerations. Modern older
adult and chronic care models stress a holistic approach: managing medical
conditions while addressing functional abilities and social circumstances. Key
pillars include effective chronic disease management, facilitating aging in
place, addressing social determinants of health, and ensuring equity in access
to care. Here, I evaluate how well Medicare Advantage’s supplemental benefit
priorities align with these principles:
Chronic Disease Management: Older adults typically have
multiple chronic conditions (hypertension, diabetes, arthritis, heart disease,
etc.) that require continuous management. Best practices for chronic care
(e.g., the Chronic Care Model) highlight the importance of regular monitoring,
patient education, medication management, and care coordination. Some MA
supplemental benefits support these aims, notably, telehealth services and
emerging remote monitoring tools. The widespread adoption of telehealth (97% of
plans) is a positive alignment, as telehealth enables more frequent follow-ups
and management of issues before they escalate. For instance, a diabetic senior
can have tele-visits to adjust insulin, or a heart failure patient can report
weight changes remotely. However, beyond telehealth, few supplemental benefits
directly target chronic disease management. Remote patient monitoring, which
could greatly benefit conditions like heart failure (through daily weight/BP
tracking) or COPD, is offered by only ~3% of plans as a supplemental service in
2024. This indicates that despite technology enabling it, MA plans have not
widely embraced providing devices or services for telemonitoring vital signs
(unless one counts general telehealth, which many use for check-ins). Some
plans likely have disease management programs as part of their care management
(internal plan operations rather than member-facing “benefits”), but these are
not transparent or guaranteed. Additionally, MA plans have the flexibility to
offer disease-specific benefits in Chronic Condition SNPs – e.g., a
diabetes-focused plan might offer extra podiatry visits or nutrition classes –
but these remain niche and not part of the general MA landscape. Overall, while
MA supplemental benefits cover some tools useful for chronic care (telehealth,
pharmacy home delivery in some cases, OTC meds), there is room for better
alignment. Medication management programs (like enhanced Part D medication
therapy management) and care coordination services could be considered part of
chronic care best practice; MA plans do have case managers for high-risk
patients, but again, that is not a supplemental benefit advertised to members.
Aging in Place and Functional Support: A core goal in older adults'
healthcare is to enable them to live safely and independently in their homes
for as long as possible, rather than in institutions. Achieving this goal
involves supporting ADLs (activities of daily living), modifications to the
home environment, and coordination of community services. This is precisely
where the MA supplemental benefits show the most significant shortfall. As
discussed, in-home support services (personal care aides, chore services) are
extremely limited in MA (offered by <10% of plans). This contrasts with older
adults' best practice guidelines, which advocate for home-based interventions
(like occupational therapy home visits, home safety assessments, and help with
daily tasks for those with functional impairments). The lack of in-home care
benefits means MA enrollees must navigate state Medicaid waivers or private pay
options to get such support, unless in a special plan or demo program.
Caregiver support, another pillar of aging in place, is virtually absent in MA
plans – yet family caregivers are often essential for keeping an elder at home
and out of a nursing facility. Home modifications and safety – partial progress
with ~22% plans covering some equipment, still leaves most older adults without
financial help to make their homes safer (e.g., installing grab bars to prevent
falls). Older adults' care practice would call for routinely addressing fall
risks and supporting ADLs; MA plans’ offerings only sporadically address these,
showing misalignment. It is worth noting that some innovative MA plans and
demonstrations have begun to provide comprehensive home-based care (for
example, the VBID model or PACE programs outside MA). However, aging-in-place
supports are not a priority benefit in the mainstream MA market. This
represents a disconnect between what the healthcare community identifies as
crucial for older adults’ well-being and the commonly available insurance
benefits. Many older adults in MA may not realize that these supports could be
part of their insurance because historically Medicare never covered them; now
that MA could, most plans still do not. Therefore, aligning with aging-in-place
ideals is weak in current MA benefits, with a few notable exceptions (e.g., 9%
of plans offering in-home services likely target specific high-need
populations).
Social Determinants of Health: Increasingly, the healthcare
field acknowledges that medical care alone accounts for only a portion of
health outcomes – factors like nutrition, social connection, housing, and
transportation significantly influence older adults’ health and longevity. Best
practices in older adults' care include screening for social needs and
intervening (e.g., connecting patients to meal programs, transportation, social
support groups). Medicare Advantage, thanks to policy changes in 2019 and 2020,
gained the flexibility to address these social determinants through new
supplemental benefits (especially the Special Supplemental Benefits for the
Chronically Ill (SSBCI), which allow non–primary medical services for
qualifying chronically ill enrollees). However, the adoption of SDOH-related
benefits has been slow. Plans have hesitated to invest heavily in non-medical
services, partly due to limited evidence and potentially limited short-term
return on investment. For example, benefits like pest control, home cleaning,
or help with bills (utilities) – all permissible under SSBCI to address
determinants of health – are exceedingly rare in general MA plans (well under
10% offer such benefits). Only ~6% of plans provide transportation for
non-medical needs (like going to a grocery store), and ~8% offer general
support for living expenses, as SSBCI benefits. Food and produce benefits under
SSBCI are slightly higher (~14% of plans), indicating some recognition of food
insecurity issues. The greater uptake in SNPs (for instance, 60% of SNPs offer
food/produce support reinforces that when dealing with socioeconomically
disadvantaged groups, addressing SDOH becomes more pressing. Regarding
alignment, Medicare Advantage is still catching up with older adults' best
practices regarding social determinants. While the traditional Medicare program
historically focused narrowly on medical care, older adults' care models have
long integrated community services and social support. MA’s new benefits are a
step in that direction, but mainstream plans in 2024–2025 only lightly touch
these areas. The gap is evident in outcomes: an MA member might have coverage
for a new pair of glasses (important, but perhaps less urgent than having
regular nutritious meals or a ride to the doctor). On a positive note, some
early evidence suggests that when social needs benefits are used, they can
improve outcomes. For instance, case studies from MA plans offering meal
benefits have reported improved patient satisfaction and even reduced acute
care utilization. The alignment will likely improve as more data becomes
available. If studies demonstrate that investing in meals and transportation
yields lower hospitalization rates, plans may be more willing to reallocate
resources to these benefits. However, the alignment with social health needs is
partial at best.
Equity and Access in Care: Health equity is a critical
component of best practices, ensuring that individuals of all races,
ethnicities, and income levels can achieve their highest health potential. In
the context of Medicare Advantage benefits, equity considerations encompass
whether disadvantaged subpopulations can access and utilize the supplemental
benefits equitably. This includes various aspects: who enrolls in MA, what
benefits they receive, and how they utilize them. Medicare Advantage enrollment
has grown strongest among racial and ethnic minority groups over the past
decade. Black and Hispanic Medicare beneficiaries have increasingly enrolled in
MA at higher rates; one analysis found that MA enrollment growth was greatest
among Black and Hispanic enrollees from 2010 to 2019. These groups are also
more likely to be low-income. Surveys indicate that Black and Hispanic older
adults, as well as those with lower incomes or functional limitations, place a
high value on supplemental benefits, often stating these benefits are
“significant” to their coverage decision. This is understandable: a low-income
senior or one from a historically underserved community may lack the means to
pay for dental care or transportation out-of-pocket, making the extra benefits
in MA appealing. 90% of MA enrollees affirm that supplemental benefits are
important to them, with this sentiment even higher among Black (95%) and
Hispanic (89%) beneficiaries than White beneficiaries.
From an equity perspective, MA’s offering of benefits like
vision, hearing, and dental has helped improve access to services these groups
might otherwise struggle to afford. For example, dental coverage in MA leads to
slightly lower out-of-pocket costs for enrollees (MA members paid ~9% less for
dental care than those in traditional Medicare). However, disparities can still
arise in who uses the benefits. Suppose awareness is lower among certain
groups, as evidence suggests that many MA enrollees did not know they had a
particular benefit. In that case, simply having the benefit does not translate
to equitable use. There is also disparity by plan type: many minority and
low-income older adults are enrolled in Dual-Eligible SNPs or other SNPs,
which, as noted, tend to provide more robust social benefits (transportation,
food, etc.) than regular MA plans. This is positive for those who qualify, but
those who are not dual-eligible yet still have high needs might be left in a
standard MA plan with fewer supports. Geography can play a role too: MA plan
availability varies by region, and rural areas (which may have higher poverty
and a greater proportion of White older adults) have fewer plan choices on
average. Suppose only one or two MA plans operate in a rural county. In that
case, the scope of supplemental benefits might be limited, potentially leaving
those beneficiaries with less access to extras like meal programs or telehealth
specialists (though telehealth is effectively available everywhere now).
Another equity concern is the digital divide and telehealth:
while telehealth is widely offered, lower-income and minority older adults may
have less internet access or device capability, meaning they cannot equally
benefit from this service. Plans offering telehealth need to ensure language
access, technology support, and alternatives (like phone visits) to make it
truly equitable. Similarly, while common, fitness benefits might not be usable
by those who live in neighborhoods without safe exercise options or who have
disabilities; plans could consider adapted fitness programs or home exercise
equipment for those who cannot use a gym. Notably, Medicare Advantage
supplemental benefits have the potential to advance health equity by providing
services that vulnerable older adults need (and might not afford otherwise).
The data suggests mixed success on this front. On one hand, MA is popular among
and valued by historically underserved groups, indicating that the benefit
offerings are relevant to them. On the other hand, the benefits most crucial to
mitigating disparities (like transportation for those without cars, or
extensive home care for those with disabilities) are not widely available to
all enrollees. This can perpetuate inequities: for instance, an economically
advantaged senior could hire help or pay for an Uber to appointments if their
plan does not cover it, but a poor senior cannot – if their plan lacks a
transport benefit, they miss care. Thus, the limited adoption of certain
benefits may disproportionately harm those in lower socioeconomic strata.
Encouragingly, when plans invest in supplemental benefits aimed at social
needs, dual-eligible and minority populations reap significant gains in access.
Some analyses have found even greater positive effects of benefit use in
dual-eligible groups (e.g., supplemental benefits were associated with improved
healthcare utilization, especially for dual-eligibles, in one insurer study).
Ensuring equitable alignment means MA plans and regulators should focus on expanding
those high-impact benefits (nutrition, transport, in-home services) and
improving awareness and usability of all benefits among diverse enrollees.
The landscape of Medicare Advantage supplemental benefits in
2024–2025 reveals a clear contrast between marketable, commonly covered
services and foundational supports for healthy aging that remain scarce. MA
plans have nearly universal coverage of vision, hearing, dental, fitness, and
telehealth benefits – offerings that address genuine needs (preventive care,
sensory health, access to providers) and are highly valued by older adults. In
those areas, MA has arguably improved the standard of coverage for older
adults, closing long-standing gaps in Medicare (for example, now almost every
MA member has some dental coverage, whereas in traditional Medicare, they would
have none). However, the comparatively low provision of benefits like nutrition
assistance, transportation, and in-home support services indicates a
misalignment with the actual drivers of health outcomes in older adults. These
underprovided benefits correspond to social and functional needs that, if
unmet, often lead to poorer health: malnutrition is linked to higher morbidity,
lack of transportation leads to missed care and worse chronic disease control,
and absence of home support can precipitate falls or nursing home placement.
The fact that most MA plans do not offer these supports suggests that current
plan priorities are skewed toward benefits that are easy to advertise and
include rather than those that are complex but crucial for vulnerable older
adults.
From an older adult care perspective, this gap highlights
the need for MA plans to evolve. As the U.S. population ages and more older
adults have multiple chronic conditions, supplemental benefits should
increasingly focus on enabling effective chronic disease management and aging
in place. Some progress is being made – policy changes have opened the door for
non-medical benefits, and a subset of plans (especially Special Needs Plans)
have embraced food, transport, and home care benefits for high-need individuals.
Furthermore, early evidence indicates that expanding these benefits can improve
patient experiences: MA plans adopting new preventive and social benefits saw
modest increases in their enrollee satisfaction ratings. Such findings may
encourage more plans to invest in these areas. Additionally, the intense
interest and value placed on supplemental benefits by minority and low-income
beneficiaries means expanding these services could advance health equity,
helping to reduce disparities in care access among older adults. While Medicare
Advantage has made supplemental benefits a hallmark of its appeal, there
remains a discrepancy between benefit availability and the real health needs of
older adults. Vision, dental, and hearing benefits are important and widely
available – a positive but somewhat expected development. The actual test of
MA’s commitment to senior health is whether it will substantially expand the
currently neglected benefits that address nutrition, mobility, and home
support, which have proven links to better health outcomes. Aligning plan
offerings with older adults' best practices will likely require continued
regulatory encouragement, robust evaluation of innovative benefits, and perhaps
rebalancing resources towards services that keep older adults healthier outside
traditional clinical settings. Bridging this gap can ensure that the promise of
Medicare Advantage – more comprehensive, integrated care for older Americans –
is fully realized equitably, delivering not just ancillary perks but tangible
improvements in health and well-being for our aging population.
Sources:
Freed, M., Damico, A., Fuglesten Biniek, J., & Neuman,
T. (2023, November 15). Medicare Advantage 2024 spotlight: First look. KFF. https://www.kff.org/medicare/issue-brief/medicare-advantage-2024-spotlight-first-look/
Gupta, A., Jacobson, G., & Leonard, F. (2025, February
20). How much do Medicare Advantage enrollees value and use their supplemental
benefits? The Commonwealth Fund. https://doi.org/10.26099/4m5m-d976
Cai, C. L., Iyengar, S., Woolhandler, S., Himmelstein, D.
U., Kannan, K., & Simon, L. (2025). Use and costs of supplemental benefits
in Medicare Advantage, 2017-2021. JAMA Network Open, 8(1), e2454699. https://doi.org/10.1001/jamanetworkopen.2024.54699
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