2025 AEP Insight: Benefits Overview 📊
Medicare Advantage in 2025: Shifts in Supplemental, Enhanced, and SSBCI Benefits to Meet Evolving Demands
November 7, 2024 Market Research
Table of Contents
Benefits Overview
a. Supplemental Benefits Overview:
The inclusion of Over-the-Counter (OTC) benefits in plans has seen a sharp decline, with Meal and Transport benefits also experiencing significant reductions.
As the plan count decreased at the national level, the number of plans offering various supplemental benefits also declined across all categories compared to 2024. High-prevalence benefits like Eye Exam, Enhanced Benefits, and Emergency consistently show high adoption rates, with around 98-99% of plans including these benefits. Despite this, there is a slight decline in the number of plans offering these benefits in 2025, with YoY changes showing declines of -6.0%, -7.1%, and -5.8%, respectively. On similar lines, Hearing Exam and Dental Preventive also maintain high inclusion percentages of about 97%, though they saw saw reductions in count: Hearing Exam plans dropped from 4,317 to 4,062, while Dental Preventive decreased from 4,289 to 4,073.
Mid-level benefits such as Hearing Aids, Eye Wear, Physical Exam, and Outpatient Blood continue to show higher offering rates. Hearing Aids maintain a 95% inclusion rate, despite 275 fewer plans than in 2024. Eye Wear, included in 96% of plans, saw a 6% YoY decline. Physical Exam benefits, now included in 93% of plans, decreased from 4,162 to 3,903, while Outpatient Blood, with a 96% inclusion rate, experienced a 5% YoY drop. Dental Comprehensive have fewer plans reaching 3,734 in 2025 from 4,019 accounting to 7% YoY drop.
The most significant drop in benefit offerings was observed in Over-the-Counter (OTC), which declined by 738 plans, resulting in a decrease in its inclusion rate from 85% to 72.4%. This was followed by Meal benefits, which saw a reduction of 441 plans, and Transport benefits, which decreased by 344 plans. These reductions reflect a notable shift in the availability of these supplemental benefits. Transport and Acupuncture benefits, which had experienced significant growth in prior years, saw notable drops in 2025, with Transport plan inclusion rates decreasing from 36.7% to 30.6% and Acupuncture from 33.9% to 31.8%. Chiropractor benefits down by -20.5% YoY and Psychiatry by -13.4% YoY.
The smallest prevalence is observed in Cardiac and Skilled Nursing Facilities (SNF), which have consistently low shares of total plans. SNF benefits experienced a YoY decline of 2.8%, while the number of Cardiac plans dropped significantly from 44 to just 19 in 2025.
In 2025, new plan additions reveal notable trends in benefit inclusion: Emergency and Eye Exam benefits lead with approximately 513 and 509 offerings, respectively, showcasing strong demand and high prioritization. Benefits such as OTC, Meal, Transport, Chiropractor, and Podiatry show lower inclusion rates in newly added plans compared to 2024 levels, while Cardiac and SNF lack any new plans for the second year in a row. Conversely, OTC in new plans offered in 503 plans (+49 from 2024), marking the highest increase. Inpatient Hospital follows closely with 462 new plans (+46), and Physical Exam benefits reach 494 plans, adding 40 more plans compared to the previous year.
b. Enhanced Benefits Overview:
Fitness and Remote Access Technologies Lead Enhanced Benefits: Fitness at 94.6% and Remote Access at 53%, with all other benefits under 40% inclusion.
Among 22 different Enhanced benefits, only three experienced an increase in plan count: Alternative Therapies (+264), Weight Management Programs (+57), and Bathroom Safety Devices (+46). Conversely, all other benefits saw a decline. Despite a slight drop in prevalence, the Fitness Benefit remains one of the most widely offered Enhanced benefits, with its inclusion rate decreasing from 97.2% in 2024 to 94.6% in 2025, reflecting an 8.1% YoY decline of 348 plans. Remote Access Technologies experienced a substantial decrease in availability, dropping from 3,287 to 2,198, marking a significant 33.1% YoY decline. This trend may indicate a shift away from telehealth as pandemic-related demands stabilize. Health Education continued to grow modestly, with a slight increase in offerings to 39.8%, although its growth rate has slowed.
The highest reduction in offerings was observed in Remote Access Technologies, which declined from 74.2% to 52.5%. This was followed by the Personal Emergency Response System (PERS), which dropped from 19.2% to 9.4%. Medical Nutrition Therapy (MNT) also saw a significant decline, decreasing from 564 plans to 152. Additionally, the Smoking and Tobacco Cessation Counseling benefit experienced a notable YoY reduction of 29.7%, falling from 30.4% to 22.6%. While the Nutritional/Dietary benefit maintained a reasonable presence, it experienced a significant YoY decline of 32.6%, decreasing from 27.1% to 19.4%.
Adult Day Health Services already rare in previous years, has now become virtually non-existent, with only 1 plan offering it in 2025, while Re-admission Prevention, Counselling Services and Post-discharge In-Home Medication Reconciliation benefits saw declining inclusion rates, reflecting less focus.
Despite the introduction of new plans, offerings for the PERS have significantly decreased from 99 plans to 36. MNT also saw a reduction of 85 plans, dropping from 102 in 2024, while Remote Access Technologies experienced a decline of 80 plans, reaching a total of 281. In contrast, the highest increases in new plan offerings were observed in Alternative Therapies (from 30 to 124 plans), Weight Management Programs (from 33 to 101 plans), and Bathroom Safety Devices (from 120 to 176 plans). Overall, Fitness remains the leading benefit with 495 new plans in 2025.
c. SSBCI Overview:
General Supports for Living is included in 116 new plans (+68), marking the highest absolute increase among SSBCI benefits at approximately 26%.
Compared to Supplemental and Enhanced benefits, SSBCI offerings have seen moderate declines overall, with exceptions like General Supports for Living and Transportation for Non-Medical Needs, which have risen in availability. Food and Produce remains the most offered benefit among SSBCI, though it slightly declined to 609 offerings in 2025 (640 in 2024), making up 14.6% of the total. General Supports for Living saw a significant increase, reaching 443 offerings (10.6% of the total), up from 310 in 2023, signaling a stronger focus on essential support services. Transportation for Non-Medical Needs also shows growth, increasing from 6% to 7.2% of the total, reflecting a sustained commitment to enhancing accessibility.
In contrast, several moderate-prevalence benefits have experienced continued declines. For instance, Meals (Beyond Limited Basis) has dropped for a second consecutive year, decreasing from 255 plans in 2023 to 186 in 2024, and further down to 93 offerings in 2025—a notable 50% YOY decrease, raising concerns about its prioritization. Similarly, Pest Control and Social Needs Benefit have declined to 116 (2.8%) and 83 (2.0%) offerings, respectively, signaling a reduction in focus on these services. Indoor Air Quality Equipment and Services has also seen a substantial decrease, dropping from 102 to 69 plan offerings.
At the lower end of the spectrum, Services Supporting Self-Direction has dropped to 44 offerings (1.1%) from 69 in 2024, while Complementary Therapies fell to 42 (1.0%) after previous growth, suggesting a need for strategic reassessment of these offerings. Structural Home Modifications has plummeted to just 3 offerings (0.1%), underscoring a potential gap in addressing critical home-related needs.
General Supports for Living benefit offering experienced a spike in new plans from 10.1% to 22.5%, that added 68 more plans in 2025. Followed by Food and Produce increased from 110 to 141 plans and Transportation for Non-Medical Needs also increased from 7.3% to 11% in new plans.
