Medicare Advantage Supplemental Benefits
Key Trends, Insights & Market Analysis (2022–2026)
- December 2024
- 7 min read
- Healthcare Analytics Report
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
- Across 45% of benefits, plan coverage remains high (90%+) and stable. However, all supplemental categories show declines in absolute counts except for Podiatry—the only benefit to increase offerings in 2026.
| Benefit | 2025 Plans | 2026 Plans | 2026 Share |
|---|---|---|---|
| Eye Exam | 5,591 | 5,489 | 98.16% |
| Enhanced Benefits | 5,493 | 5,405 | 96.66% |
| Eye Wear | 5,497 | 5,395 | 96.48% |
| Hearing Exam | 5,488 | 5,392 | 96.42% |
| Dental Preventive | 5,437 | 5,330 | 95.31% |
| Emergency | 5,393 | 5,323 | 95.19% |
| Outpatient Blood | 5,336 | 5,322 | 95.17% |
| Hearing Aids | 5,396 | 5,291 | 94.62% |
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
-475 plans
Sharpest decline in category
Dental Comprehensive
-235 plans
Still widely available
OTC Benefit
-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.
| Benefit | 2025 Plans | 2026 Plans | 2026 Share |
|---|---|---|---|
| Podiatry | 2,562 | 2,564 | 45.85% |
| Transport | 2,519 | 2,124 | 37.98% |
| Acupuncture | 1,837 | 1,781 | 31.85% |
| Chiropractor | 1,304 | 1,229 | 21.98% |
| Psychiatry | 461 | 397 | 7.10% |
| Cardiac | 39 | 23 | 0.41% |
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
- Humana overwhelmingly leads supplemental benefit coverage across core clinical and preventive services, while UnitedHealthcare consistently ranks #2 and dominates Enhanced Benefits. CVS Health, Elevance, and regional payors appear only in selected services.
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).
| Benefit | 2025 Plans | 2026 Plans | 2026 Share |
|---|---|---|---|
| Fitness Benefit | 5,210 | 5,047 | 90.25% |
| Remote Access Technologies | 2,962 | 2,635 | 47.12% |
| Health Education | 2,125 | 1,831 | 32.74% |
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.
| Benefit | 2025 Plans | 2026 Plans | 2026 Share |
|---|---|---|---|
| Counselling Services | 129 | 112 | 2.00% |
| Telemonitoring Services | 157 | 102 | 1.82% |
| Re-admission Prevention | 117 | 83 | 1.48% |
| Post-discharge Med Reconciliation | 104 | 66 | 1.18% |
| Adult Day Health Services | 5 | 2 | 0.04% |
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
+75% YoY
Share: 7.3% → 13.1%
Caregiver Support
+96% YoY
Share: 4.9% → 9.7%
Alternative Therapies
+17% YoY
Share: 13.6% → 16.2%
In-Home Support
+38% YoY
Share: 8.8% → 12.4%
Medical Nutrition Therapy
+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
- Florida ranks #1 in 9 out of 22 enhanced benefits, including Fitness Benefit, Health Education, Nutritional/Dietary Benefit, Additional Tobacco Cessation Sessions, Weight Management, Wigs for Hair Loss, In-Home Support Services, Alternative Therapies, and Bathroom Safety Devices. Florida shows consistent year-over-year growth, making it the clear center of enhanced supplemental benefit adoption.
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.
| State | Benefit Leadership |
|---|---|
| Ohio | Home-Based Palliative Care (#1) |
| Wisconsin | Re-admission Prevention (#1) |
| Nevada | Telemonitoring (#2) |
| Maryland | Re-admission Prevention (#2) |
| Texas | Alternative Therapies & Fitness Benefit (#2) |
Overall State-Level Pattern
- Florida overwhelmingly leads enhanced benefits nationwide. Michigan and Pennsylvania hold strong positions in targeted niches. California dominates tech-enabled and wellness categories. Texas emerges as the consistent but distant runner-up across major benefit groups.
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
Strongest player in digital health, wellness, and preventive programs
UnitedHealthcare
Leader in home safety and caregiver support services
Devoted Health
Focused strength in clinical nutrition and alternative therapies
Elevance Health
#2 in Remote Access Technologies
Corewell Health
Specialized in home-based clinical services
Kaiser Permanente
#2 in Nutritional Benefits
Payor Market Summary
- Unlike other categories, enhanced benefits show a diversified landscape where CVS, UHC, Devoted, Elevance, Kaiser, and Corewell each lead specific benefit domains based on their organizational strengths and care delivery models.
Portfolio Optimization Underway
- Enhanced Benefits are undergoing portfolio optimization, with plans shifting toward high-impact, member-experience-focused services and away from broad digital/monitoring programs.
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
| Benefit | 2025 Plans | 2026 Plans | 2026 Share |
|---|---|---|---|
| Food and Produce | 1,831 | 1,946 | 34.80% |
| General Supports for Living | 1,391 | 1,582 | 28.29% |
| Transportation (Non-Medical) | 930 | 846 | 15.13% |
| Pest Control | 461 | 534 | 9.55% |
| Indoor Air Quality | 365 | 414 | 7.40% |
| Social Needs Benefit | 312 | 326 | 5.83% |
| Meals (beyond limited basis) | 294 | 287 | 5.13% |
| Structural Home Modifications | 97 | 112 | 2.00% |
| Services Supporting Self-Direction | 93 | 100 | 1.79% |
| Complementary Therapies | 82 | 19 | 0.34% |
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
- Plans are shifting toward social-determinant-driven offerings—food-based & nutrition programs, general supports for living, and environmental home safety/quality. Pullback areas include complementary therapy, non-medical transportation, and meals beyond limited basis, which are cost-intensive with lower measurable ROI.
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
- Florida overwhelmingly leads VBID benefits nationwide, Texas emerges as the consistent but distant runner-up across major benefit groups, and Puerto Rico holds strength in social-support categories.
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
- Humana is the dominant multi-category leader, Centene and CVS Health play strong but focused supporting roles, UnitedHealthcare leads in nutrition, and Momentum remains the only payor sustaining Complementary Therapies.
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
- The data suggests Enhanced Benefits are undergoing portfolio optimization, with plans shifting toward high-impact, member-experience-focused services and away from broad digital/monitoring programs. VBID benefits are increasingly focused on social determinants of health—particularly food-based programs and general supports for living—while pulling back from cost-intensive categories with lower measurable ROI.
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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