Introduction

The Medicare Advantage (MA) supplemental benefits landscape continues to evolve as payors adapt their offerings to meet changing member needs and market dynamics. This comprehensive analysis examines the trends, patterns, and strategic shifts across supplemental benefits, enhanced benefits, and Value-Based Insurance Design (VBID) programs from 2022 through 2026.

Our findings reveal a market characterized by selective optimization—while core clinical benefits maintain near-universal adoption, cost-intensive and logistics-heavy benefits face multi-year declines. Simultaneously, emerging growth segments around weight management, caregiver support, and social determinants of health signal where payors are placing strategic bets for the future.

Supplemental Benefits Trends (2022–2026)

High Adoption Benefits (95%+ Coverage)

Eye Exam leads in coverage with 98.16%, followed by Enhanced Benefits (96.66%), Eye Wear (96.48%), Hearing Exam (96.42%), Dental Preventive (95.31%), Emergency (95.19%), Outpatient Blood (95.17%), and Hearing Aids (94.62%). These benefits maintain very small year-over-year shifts of less than -2%.

Key Takeaway

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Benefit2025 Plans2026 Plans2026 Share
Eye Exam5,5915,48998.16%
Enhanced Benefits5,4935,40596.66%
Eye Wear5,4975,39596.48%
Hearing Exam5,4885,39296.42%
Dental Preventive5,4375,33095.31%
Emergency5,3935,32395.19%
Outpatient Blood5,3365,32295.17%
Hearing Aids5,3965,29194.62%

High Adoption Benefits: 2025 vs 2026 Plan Counts

Moderately High Adoption (60–90%)

The highest decline was observed in Meal benefits, with reduced offerings in 475 plans (-12.5% YoY). Total coverage dropped from 66.68% to 59.53%. Dental Comprehensive also saw a steep decline from 5,080 to 4,845 plans (-4.6% YoY), while OTC dipped by losing coverage in 210 plans (-4.7% YoY).

Meal Benefit

59.53%

-475 plans

Sharpest decline in category

Dental Comprehensive

86.64%

-235 plans

Still widely available

OTC Benefit

75.36%

-210 plans

Second consecutive year decline

Low Adoption (<50%) and Declining

Transport shows the steepest decline in this segment, losing coverage in 395 fewer plans than 2025 with total offering around 38%. Podiatry is the only benefit that increased in offerings by two plans in 2026, reaching 45.85% coverage.

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Benefit2025 Plans2026 Plans2026 Share
Podiatry2,5622,56445.85%
Transport2,5192,12437.98%
Acupuncture1,8371,78131.85%
Chiropractor1,3041,22921.98%
Psychiatry4613977.10%
Cardiac39230.41%

Year-over-Year Change in Declining Benefits

Benefits With Improved Share

Despite absolute plan count decreases, several benefits showed improvements in percentage share: Emergency Services rose from 94.5% to 95.2% (+0.7 pts), Podiatry increased from 44.9% to 45.9% (+0.9 pts), Outpatient Blood improved from 93.5% to 95.2% (+1.6 pts), and Physical Exam increased from 89.9% to 90.6% (+0.7 pts).

State-Level Insights

Florida Dominates

Florida appears as the #1 state for almost every benefit category—from Dental, Vision, Hearing, Emergency, Outpatient Blood, Transportation, Meal, and Enhanced Benefits. Florida is the national leader in supplemental benefit breadth and plan adoption.

Texas: The Consistent Runner-Up

Texas emerges as the consistent #2 across most benefits, showing up repeatedly for Dental, Vision, Hearing, Enhanced Benefits, Physical Exam, OTC, and Transportation. Texas mirrors Florida’s benefit pattern but at slightly lower scale.

California's Selective Strength

California only appears in the top ranks for specific categories: Acupuncture (#1), Chiropractor, Psychiatry, and Inpatient Hospital – Acute (#2). These benefits lean toward alternative care or behavioral health, suggesting California’s MA plans invest more heavily in non-traditional supplemental services.

Niche Benefits Show Unique Leaders

Cardiac benefit is uniquely led by Wisconsin (#1), followed by Iowa, indicating unusual focus on cardiac support. Psychiatry is topped by California and Wisconsin—consistent with behavioral health prioritization in these states. Niche benefits tend to be led by smaller states with specialized plan offerings.

Payor-Level Insights

Humana: The Dominant Leader

Humana ranks #1 in Dental Comprehensive, Dental Preventive, Eye Exam & Eye Wear, Hearing Exam & Hearing Aids, Emergency, Inpatient Hospital – Acute, Physical Exam, Meal, Acupuncture, Chiropractor, Transportation, and Outpatient Blood. Humana also shows strong year-over-year growth in 2026 across these categories.

UnitedHealthcare: Primary Challenger

UnitedHealthcare frequently appears as #2, especially in Eye Exam, Eye Wear, Hearing Exam, Hearing Aids, OTC, Meal, Inpatient Hospital – Acute, Physical Exam, Outpatient Blood, and Transportation. UHC leads Enhanced Benefit, Podiatry, and OTC as the #1 payor.

Other Notable Payors

CVS Health performs strongly in dental and specific niche services, ranking #2 for Dental Comprehensive, Acupuncture, and Podiatry. Elevance Health stands out for Psychiatry—unique among payors. Smaller payors appear only in niche benefit categories: University Health leads in Cardiac, St. Francis appears in Cardiac support, and Highmark is #2 in Chiropractor.

Market Summary

Enhanced Benefits Overview

High Adoption but Losing Traction

Remote Access Tech, Fitness Benefit, and Health Education observed declines in absolute coverage counts. Fitness Benefit remains at 90.25% (down from 5,210 to 5,047 plans), Remote Access Technologies dropped to 47.12% (2,962 to 2,635 plans), and Health Education fell to 32.74% (2,125 to 1,831 plans).

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Benefit2025 Plans2026 Plans2026 Share
Fitness Benefit5,2105,04790.25%
Remote Access Technologies2,9622,63547.12%
Health Education2,1251,83132.74%

Low Adoption & Declining Further

Adult Day Care, Counselling Services, Post-Discharge Med Reconciliation, and Telemonitoring services have offerings less than 2% and are shrinking over the years.

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Benefit2025 Plans2026 Plans2026 Share
Counselling Services1291122.00%
Telemonitoring Services1571021.82%
Re-admission Prevention117831.48%
Post-discharge Med Reconciliation104661.18%
Adult Day Health Services520.04%

Enhanced Benefits – Declines & Growth Segments

Benefits Showing Largest Declines

Several enhanced benefits show meaningful absolute declines, YoY drops, and shrinking adoption. Remote Access Technologies declined by 327 plans (-11% YoY) with share dropping from 51.9% to 47.1%. Nutritional/Dietary Benefit saw -207 plans (-19.7% YoY). Telemonitoring Services experienced the steepest decline at -35% YoY, falling from 2.75% to 1.82% share.

Enhanced Benefits: Largest YoY Declines

Growth Segments Emerging

Alternative Therapies, MNT, and Caregiver Support Services saw significant growth in 2026. In-Home Support Services (IHS) showed a rebound in 2026, with Support for Caregivers growing from 277 to 544 plans.

Weight Management

+314 plans

+75% YoY

Share: 7.3% → 13.1%

Caregiver Support

+267 plans

+96% YoY

Share: 4.9% → 9.7%

Alternative Therapies

+133 plans

+17% YoY

Share: 13.6% → 16.2%

In-Home Support

+192 plans

+38% YoY

Share: 8.8% → 12.4%

Medical Nutrition Therapy

+74 plans

+32% YoY

Share: ~4% → 5.4%

Enhanced Benefits: Fastest Growing Segments

Multi-Year Structural Decline (2022 to 2026)

Several benefits show consistent year-over-year decreases: Counseling Services dropped from 11.8% (2022) to 2.0% (2026), Adult Day Health Services from 0.94% to 0.04%, Telemonitoring services from 4.7% to 1.8%, Nutrition/Dietary Benefit from 26.8% to 15.1%, and PERS from 24.9% to 13.2%. These categories are likely being consolidated under broader care-management or digital-health platforms.

Enhanced Benefits – State-Level Insights

Florida: The Dominant Leader

Michigan appears as #2 in Additional Smoking & Tobacco Cessation, Enhanced Disease Management, and Nutritional/Dietary Benefit.

Pennsylvania shows unique strength in home-based and safety-related benefits, ranking #1 in MNT, Enhanced Disease Management, and Counselling Services. Pennsylvania frequently ranks #2 in Bathroom Safety Devices, Home Safety Assessment, Home-Based Palliative Care, and Support for Caregivers.

California excels in technology and health-aligned benefits, ranking top in PERS (Personal Emergency Response System), Remote Access Technologies, and Support for Caregivers, while second in Health Education and In-Home Support Services.

Massachusetts ranks #2 in Adult Day Health Services, Medical Nutrition Therapy (MNT), Post-discharge In-Home Medication Reconciliation, Weight Management Programs, and Wigs for Hair Loss Related to Chemotherapy.

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StateBenefit Leadership
OhioHome-Based Palliative Care (#1)
WisconsinRe-admission Prevention (#1)
NevadaTelemonitoring (#2)
MarylandRe-admission Prevention (#2)
TexasAlternative Therapies & Fitness Benefit (#2)

Overall State-Level Pattern

Enhanced Benefits – Payor-Level Insights

The enhanced benefits market is highly fragmented—no single payor dominates across all benefits. CVS Health, UnitedHealthcare, Devoted Health, Elevance, Kaiser, and Corewell all hold #1 positions in different categories.

CVS Health

#1 in: Additional Tobacco Cessation, Health Education, Remote Access Technologies, Wigs for Hair Loss

Strongest player in digital health, wellness, and preventive programs

UnitedHealthcare

#1 in: Adult Day Health, Bathroom Safety Devices, Fitness Benefit, Support for Caregivers

Leader in home safety and caregiver support services

Devoted Health

#1 in: Alternative Therapies, Medical Nutrition Therapy (MNT), Nutritional/Dietary Benefit, Therapeutic Massage, Weight Management Programs

Focused strength in clinical nutrition and alternative therapies

Elevance Health

#1 in: Personal Emergency Response System (PERS)

#2 in Remote Access Technologies

Corewell Health

#1 in: In-Home Safety Assessment, Post-Discharge Medication Reconciliation, Telemonitoring Services

Specialized in home-based clinical services

Kaiser Permanente

#1 in: Home-Based Palliative Care

#2 in Nutritional Benefits

Payor Market Summary

Portfolio Optimization Underway

VBID Supplemental Benefits Trends

High Adoption & Growing (Above 25% share)

Food and Produce (34.8%) is the strongest and fastest-growing VBID benefit, followed by General Supports for Living (28.3%) showing steady multi-year growth. These represent the most mainstream VBID offerings among plans.

Enhanced Benefits: Largest YoY Declines

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Benefit2025 Plans2026 Plans2026 Share
Food and Produce1,8311,94634.80%
General Supports for Living1,3911,58228.29%
Transportation (Non-Medical)93084615.13%
Pest Control4615349.55%
Indoor Air Quality3654147.40%
Social Needs Benefit3123265.83%
Meals (beyond limited basis)2942875.13%
Structural Home Modifications971122.00%
Services Supporting Self-Direction931001.79%
Complementary Therapies82190.34%

VBID Benefits With Significant Declines

Complementary Therapies showed the largest decline with -63 plans YoY, share dropping from 1.44% to 0.34% (–1.10 pts)—this benefit appears to be exiting the market. Transportation for Non-Medical Needs lost -84 plans YoY, with share falling from 16.3% to 15.1%.

VBID Benefits Showing Strong Growth

Food and Produce is the strongest performer with +115 plans YoY and +2.7 pts increase in share, reaching 34.8% (highest of all VBID categories). General Supports for Living shows the fastest YoY share growth with +191 plans and share jumping from 24.38% to 28.29% (+3.9 pts). Pest Control added +73 plans with +1.5 pts increase, showing reliable upward trend.

VBID Market Direction

VBID – State Insights

Florida Dominates VBID Benefits

Florida ranks #1 in almost every VBID benefit except Complementary Therapies. It leads in major categories including Food & Produce, Pest Control, Indoor Air Quality, Meals (Beyond Limited Basis), Social Needs Benefit, Services Supporting Self-Direction, General Supports for Living, and Transportation for Non-Medical Needs.

Texas: Consistent Second Place

Texas is the consistent #2 coverage state for Food & Produce, Indoor Air Quality, Meals Beyond, Transportation for Non-Medical Needs, and General Supports for Living. Texas uniquely leads Structural Home Modifications, with Florida appearing as #2 but with far lower counts.

Puerto Rico's Social Support Strength

Puerto Rico shows prominent placement in Pest Control (#2), Social Needs Benefit (#2), Services Supporting Self-Direction (#2), and Complementary Therapies (#1). Although Complementary Therapies appeared in 17 states previously, the only state maintaining measurable coverage in 2026 is Puerto Rico.

State-Level Pattern

VBID – Payor Insights

Humana: Multi-Category Leader

Humana is the dominant leader across Indoor Air Quality, Pest Control, Social Needs, Transportation (Non-Medical), Services Supporting Self-Direction, and General Supports for Living.

Supporting Players

Centene appears as Top 1 or Top 2 in Structural Home Modifications, Meals (beyond limited basis), and Indoor Air Quality (#2). CVS Health consistently ranks #2 for Food & Produce, Transportation (Non-Medical), and General Supports for Living. UnitedHealthcare dominates Food & Produce, growing from 278 to 293 plans (#1 position). Elevance Health appears selectively, mostly as #2 in Meals (beyond limited basis) and Social Needs Benefit.

Niche Player

Momentum Health is now the sole payor still offering Complementary Therapies, maintaining this benefit as other payors exit the category.

VBID Payor Summary

Conclusion

The Medicare Advantage supplemental benefits landscape from 2022 to 2026 reveals a market in strategic transition. While core clinical benefits—Dental, Vision, and Hearing—maintain near-universal adoption above 94%, the industry is clearly optimizing its benefit portfolios with selective investments and deliberate pullbacks.

Cost-sensitive and logistics-heavy benefits such as Meals, Transportation, OTC, and Psychiatry are experiencing multi-year declines in both adoption and share. Conversely, growth segments around Weight Management (+75% YoY), Caregiver Support (+96% YoY), and Alternative Therapies (+17% YoY) signal where payors see future value and member demand.

Geographic concentration remains pronounced: Florida dominates across virtually all benefit categories, with Texas serving as the consistent runner-up. California shows selective strength in alternative care and behavioral health services, while niche benefits are led by smaller states with specialized plan offerings.

Among payors, Humana leads supplemental benefit coverage across core clinical and preventive services, UnitedHealthcare dominates Enhanced Benefits and OTC, while CVS Health, Elevance, and regional payors focus on selected niche categories.

Strategic Outlook

As the Medicare Advantage market continues to mature, payors that strategically balance core benefit stability with targeted investments in emerging growth segments will be best positioned to meet evolving member needs while managing operational costs.

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