These 5 Medicare Advantage Perks Sound Impressive - But Most Enrollees Never See the Benefit

If you're comparing Medicare Advantage (MA) plans ahead of the open enrollment period, you've probably seen many "extra benefits" splashed across every brochure, and for good reason. They're one of the biggest reasons people choose MA over traditional Medicare, since the latter doesn't cover dental, vision, or hearing.

Still, a 2025 Commonwealth Fund survey of MA enrollees found a wide gap between having a benefit and using it. Almost all enrollees are in a plan that offers extra coverage, yet most never file a single claim. A companion study in JAMA Network Open backs this up with the dollar figures: MA insurers spend about $3.9 billion a year on these supplemental benefits, while enrollees are still paying $9.2 billion out of pocket for the same categories of care.

If you're living on just Social Security, the last thing you want is to pay out of pocket for benefits already included in your MA plan. Here's what the data shows for each one, and why a gap exists.

Dental: 98% have it, 42% use it

Almost every MA enrollee is in a plan that offers some form of dental coverage, but fewer than half used it in the past year.

Awareness is one of the reasons. The JAMA study found that only about 54% of enrollees knew their plan included dental coverage.

The second, and arguably more important reason, is what "dental coverage" means. A 2025 study of MA plans found that seniors may pick from dozens of plans offering some dental benefit. However, only a handful in any given area have comprehensive coverage (which goes beyond cleaning and X-rays and includes things like crowns, root canals, or dentures). Nationally, fewer than four in ten counties had even one MA plan with comprehensive coverage.

On top of that, most plans require prior authorization for anything beyond preventive care, and annual dollar caps (often less than $1,300) run out fast once real dental work is needed.

Vision: 100% have it, 41% use it

Vision coverage is essentially universal in MA plans, and usage tracks almost exactly with dental: 41% of enrollees used it. The pattern is also similar: Roughly half of enrollees aren't aware their plan covers eye exams, and the benefit itself is often thinner than it sounds.

Many plans cover one routine eye exam at no cost, but the allowance for glasses or contacts is often capped at $100–$400, which is well short of the cost of a pair of prescription glasses. Some plans also require prior authorization even for a routine eye exam, adding a step most people don't expect for a "free" benefit.

Hearing: 96% have it, just 7% use it

This is the steepest drop-off of the group, and it comes down to money. Hearing coverage sounds like a strong perk on paper, but hearing aids are expensive, and most MA hearing allowances only cover a few hundred dollars of the $1,000–$6,000 cost for a pair. Enrollees are still expected to pay the bulk of the cost themselves, which discourages them from using the benefit.

A 2024 JAMA study found that MA and traditional Medicare enrollees wear hearing aids at nearly identical rates, suggesting that the MA hearing benefit isn't moving the needle on actual access. Nearly all plans that cover hearing-related durable medical equipment also require prior authorization, adding friction on top of the cost.

Over-the-counter (OTC) allowance: 88% have it, 46% use it

The OTC card is a quarterly or monthly allowance for vitamins, pain relievers, and first-aid supplies. It has the best usage rate of the five, but it's still less than half of enrollees.

The most common reason is structural: These allowances are often "use it or lose it," restricted to a specific list of approved items, and redeemable through certain retailers. If you don't know the balance resets (and disappears) every few months, or you don't have an approved store nearby, the money goes unused.

Still, households with incomes under $75,000 use this benefit at meaningfully higher rates than higher earners, making it one of the more genuinely accessible perks on this list.

Fitness/SilverSneakers benefits: 81% have it, 19% use it

Fitness benefits are almost as ubiquitous as dental and vision coverage. However, less than 20% of MA enrollees used their gym benefit last year.

One issue here is whether the particular fitness program fits the enrollee. Medicare Advantage plans often provide access to participating gyms, fitness classes, workout videos, or similar programs rather than paying for whatever gym a member wants to join. The available locations and services vary by plan.

A "free gym membership" sounds great if you're already planning to work out at a participating gym. It isn't nearly as useful if the closest participating location is inconvenient, the classes you want aren't included, or you'd rather exercise somewhere else.

The takeaway for open enrollment

The above is hardly a reason to write off Medicare Advantage or assume every supplemental benefit is useless.

What you should do before enrollment is get answers for these four specific questions:

1. What's the annual dollar cap or allowance, and is it enough to cover the care you need?
2. Is the coverage comprehensive or preventive-only (especially for dental, where coverage could mean just a cleaning)?
3. Does the benefit require prior authorization, and how often are those requests approved?
4. Is your dentist, eye doctor, or audiologist in-network, or are you expected to pay full price anyway?

Bottom line

Medicare Advantage's supplemental senior benefits aren't a scam, but their value depends on how much coverage you get and how easy the benefit is to use. Before choosing a plan based on dental, vision, or fitness benefits, check the annual limits, provider network, cost-sharing, and authorization requirements. A benefit that looks great on paper isn't necessarily generous when you need it.

Don't compare plans based on the number of extra benefits they advertise. Pick the benefits that are useful to you, then compare the details of those benefits side by side. That's where the real difference between plans often shows up.

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