MW Use them or lose them: Time is running out to use your Medicare Advantage benefits
By Jessica Hall
The Centers for Medicare and Medicaid Services just proposed vacating a rule that would have alerted beneficiaries about their unused benefits
Three in 10 Medicare Advantage beneficiaries reported not using any supplemental benefits in the past year, the Commonwealth Fund said.
December is a time of nonstop errands: shopping for gifts, planning holiday travel and meals, and trying to beat year-end deadlines. Medicare Advantage beneficiaries have one more thing to add to their to-do lists: booking last-minute appointments for benefits they're entitled to, such as dental, hearing and vision care, gym memberships, or over-the-counter medication allowances.
Medicare Advantage plans heavily market these perks to woo new customers, but subscribers often don't use them, recent studies show. These insurance plans put the onus on the beneficiary to investigate benefit details, learn what benefits remain available to use, and track down providers to find out who accepts their plan, said Mary Johnson, an independent Social Security and Medicare analyst.
"Rarely do any of us know what all the supplemental benefits are. When they go to the doctor, they just hope they can afford the copay," Johnson said. "That leaves it to the enrollee to call customer service to discuss what they need and to find out what, if any, benefit their plan can offer. Then once we do learn about a supplemental benefit [comes] finding a participating provider, such as a dentist or optician."
The Centers for Medicare and Medicaid Services $(CMS)$ paid plans $39 billion in 2025 to provide such extra benefits, and 1 in 4 Medicare Advantage enrollees reported choosing their plans over traditional Medicare because of them, according to research by the Commonwealth Fund.
Yet, in 2024, 3 in 10 Medicare Advantage beneficiaries reported not using any supplemental benefits in the past year. Less than half used dental, vision, gym memberships, or over-the-counter medication benefits, and less than 10% used benefits like hearing, grocery allowance or meal delivery, the Commonwealth Fund found.
If the benefits are not used, the insurers that provide Medicare Advantage coverage can keep any unspent funds, according to the Commonwealth Fund.
Another study also found low utilization of benefits. As of 2021, nearly 18 million Medicare Advantage consumers had access to over-the-counter medicines and other covered healthcare products, with an average of $400 in allowances per enrollee. Of a total of $7.1 billion in total allowances, only about 30% of benefits were used, according to the Consumer Healthcare Products Association.
Medicare Advantage, the private-plan alternative to traditional Medicare, has become increasingly popular and has covered more than half of eligible beneficiaries since 2023, according to KFF, a healthcare research group. Yet Medicare Advantage is more costly for the federal government than spending on beneficiaries in traditional Medicare. In 2025, payments are 20% more per person for those on Medicare Advantage, which translated into an additional $84 billion in federal spending this year, KFF said.
The pressure to use benefits before the end of the year comes as beneficiaries also have only a few more days to make healthcare coverage choices under Medicare's annual enrollment period, which ends Dec. 7. Medicare Advantage also has an open-enrollment period, which runs from Jan. 1 to March 31, during which time subscribers can switch to another Medicare Advantage plan or drop their plan and return to original Medicare.
The reasons for not using benefits
Among the reasons beneficiaries aren't using the supplemental benefits include not being aware of them, not understanding the steps to take to access them, administrative hurdles, or benefits being more limited than they may have initially looked, said Matthew Fiedler, senior fellow at the Center on Health Policy at the Brookings Institution, a nonpartisan think tank.
Some beneficiaries don't seem to care if they are leaving the unused benefits behind: 2 in 5 Medicare Advantage enrollees said they don't plan to use some of their plan benefits, according to the Commonwealth Fund. When asked why, 58% said it was because they don't need them, 21% said that they didn't know all the benefits, and 24% said they didn't know how to use them.
Read: Are taxpayers wasting $86 billion on SilverSneakers and Medicare Advantage goodies they don't use?
Medicare Advantage plans can be confusing for beneficiaries, Johnson said. When doing comparative shopping, for example, she said plans will say that some vision benefits are covered - but frequently never specify whether that means one eye exam a year and one pair of glasses, or just a discount.
The same can be true with dental benefits, Johnson noted. "Often, plans want an additional premium for dental coverage, and that coverage could be pretty meager and not include the big-dollar stuff like dentures or implants," she said.
Still, the attraction of Medicare Advantage goes beyond supplemental benefits. It is simpler and often less expensive to deal with than having to get separate Part B supplemental coverage and a Part D plan under traditional Medicare, analysts said. Medicare Advantage also has an out-of-pocket limit that could provide peace of mind for subscribers.
The extra benefits, such as vision, dental and gym benefits, represent just a fraction of the overall value of Medicare Advantage programs - with the bulk of the benefit coming from premium reductions, reduced cost-sharing for drug prices and lower copays, Fiedler said.
"People choose [Medicare Advantage] for multiple reasons. One-stop shopping is very important to people, the out-of-pocket maximum - there's a lot of factors that go into it," said Laura Skopec, a senior research associate at the Urban Institute.
CMS proposes vacating rule alerting beneficiaries of unused benefits
In September, the Centers for Medicare and Medicaid Services delayed a rule that would require Medicare Advantage plans to notify enrollees about their unused supplemental benefits. Last week, CMS proposed vacating that rule entirely, Skopec noted.
That move came even though 8 in 10 Medicare Advantage enrollees said that they would like to receive notifications about their unused benefits, with most preferring email notification (73%) followed by mail (39%), text (27%) and phone (6%), according to the Commonwealth Fund.
"Insurers pushed back on the rule, saying it was difficult administratively to implement. But it's also fair to assume it would have led them to paying for those services," Skopec said.
However, the rule may not make much of a difference when it comes to consumer behavior, Fiedler said.
"It would be just another piece of paper that comes in the mail," he said.
-Jessica Hall
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December 03, 2025 12:48 ET (17:48 GMT)
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