Key Takeaways

• In 2025, Medicare Advantage plans are increasing the range of perks and supplemental benefits—but these additions often come with strict eligibility rules, limited availability, or trade-offs in other parts of coverage.

• Not all added benefits are as accessible or as valuable as they appear in marketing materials. You must carefully review plan details and understand what you may be giving up.

Medicare Advantage in 2025: New Perks, Familiar Pitfalls

Medicare Advantage (Part C) plans in 2025 continue to evolve, offering a broader array of benefits beyond what Original Medicare provides. Many of these perks aim to support your whole-person health, going beyond clinical treatment to address wellness, preventive care, and even everyday living needs. However, there is a growing concern that while these benefits look attractive, they often come with strings attached that you should know before enrolling or switching plans.

What’s Actually Being Added in 2025?

This year, Medicare Advantage plans are emphasizing enhancements in the following categories:

Expanded Supplemental Benefits

• Over-the-counter (OTC) allowances: While still common, the number of plans offering OTC benefits has decreased slightly. In 2024, 85% of plans offered them; in 2025, this number has dropped to 73%.

• Transportation services: Coverage for rides to medical appointments is offered by fewer plans in 2025—down from 36% to 30%.

• Grocery cards and healthy food allowances: Some plans now offer benefits tied to healthy eating, often limited to enrollees with certain chronic conditions.

• In-home support services: These benefits are expanding, but are typically restricted to those who meet defined criteria, such as being diagnosed with complex chronic illnesses.

Enhanced Care Coordination

• Integrated behavioral health services: In 2025, more plans are including mental health support, including therapy sessions and virtual behavioral care.

• Care management tools: Many plans are offering mobile apps and wearable integrations that help track health status and medication adherence.

Telehealth and Digital Innovations

• Virtual consultations: Now common, telehealth remains a central offering, especially for primary care and behavioral health.

• Remote monitoring: Devices and apps that transmit your vitals and activity levels to care teams are increasingly included.

The Fine Print: Why You Should Pause Before Getting Excited

The benefits described above sound generous. But in practice, their usability, value, and accessibility may fall short of expectations unless you read the details carefully.

1. Limited Eligibility

Not all plan enrollees qualify for every perk. For example, grocery cards or in-home support services are often limited to individuals with chronic illnesses such as diabetes, heart failure, or COPD. If you don’t meet the plan’s criteria, the perk doesn’t apply.

2. Geographic Availability

Many supplemental benefits are only offered in select service areas or are contracted through specific vendors. Even if your plan advertises a service, it might not be available in your ZIP code.

3. Trade-Offs in Core Coverage

To offer more supplemental benefits, some plans shift costs elsewhere. That could mean:

• Higher copayments for outpatient visits

• Tighter provider networks

• Prior authorization hurdles

The more perks a plan advertises, the more important it is to inspect what’s happening to your base coverage and out-of-pocket costs.

4. Benefit Caps and Restrictions

Perks like OTC allowances or transportation services usually have usage caps. For instance:

• OTC: Monthly spending limits that reset

• Transportation: A limited number of one-way trips per year

These benefits aren’t unlimited, and exceeding the cap means you’ll pay out-of-pocket.

5. Low Utilization Rates

A growing issue in 2025 is benefit underuse. Even when perks are available, many enrollees don’t use them—often because they’re unaware they exist or don’t understand how to access them. To counter this, CMS now requires plans to send out a mid-year notification reminding enrollees of any unused benefits.

What You Can Do to Evaluate These Perks Honestly

You don’t need to ignore new benefits—but you do need to assess them carefully.

Look Beyond Marketing Materials

Always review the Summary of Benefits and Evidence of Coverage (EOC). These documents explain:

• What’s covered

• What’s not

• Who qualifies

• How to use the benefit

A flashy brochure may highlight a benefit, but the fine print determines whether it truly helps you.

Prioritize Your Core Needs First

While a plan offering dental, vision, and a fitness benefit may be appealing, it’s essential to ensure that it also offers:

• Access to your preferred doctors and hospitals

• Affordable copays for your prescriptions

• Reliable care management if you have chronic conditions

Consider the Annual Notice of Change (ANOC)

If you’re already enrolled in a Medicare Advantage plan, you receive an ANOC each September. In 2025, this document is more critical than ever. It shows:

• What’s changing in your plan’s costs and benefits

• Whether any current perks are being discontinued

• How your drug formulary may be affected

Contact a Licensed Agent Listed on This Website

A licensed agent can walk you through plan comparisons, clarify benefit eligibility, and help you weigh trade-offs. In 2025, with so many plan variations and benefit nuances, professional support is often worth the time.

The Role of CMS Oversight in 2025

The Centers for Medicare & Medicaid Services (CMS) has tightened rules around benefit transparency and member communication.

• Benefit notifications: Plans are now required to send mid-year reminders to enrollees who have unused supplemental benefits.

• Marketing compliance: New rules limit how plans can promote supplemental perks to avoid misleading beneficiaries.

• Simplified language requirements: Benefit documents must now use clearer terms to describe eligibility and limitations.

These updates aim to protect you from overpromises while promoting better understanding and utilization of available benefits.

Open Enrollment 2025: Key Dates to Remember

You can change your Medicare Advantage plan during specific periods:

• Annual Enrollment Period (AEP): October 15 to December 7, 2025. During this time, you can switch between Medicare Advantage plans or return to Original Medicare.

• Medicare Advantage Open Enrollment: January 1 to March 31, 2025. This period lets current Medicare Advantage enrollees switch plans or go back to Original Medicare.

Keep these dates on your calendar to ensure your coverage continues to match your needs.

If You Have Chronic Conditions, You May Be Targeted for More Perks

In 2025, Medicare Advantage plans are using risk-based modeling to identify enrollees who may benefit from condition-specific perks. If you have heart disease, diabetes, or kidney issues, you may be:

• Eligible for extra care coordination

• Offered nutrition or fitness support

• Contacted about remote monitoring or virtual check-ins

But remember—eligibility still depends on your plan’s internal rules, and these offerings may not be standardized across plans.

Watch Out for Changes in Prescription Drug Coverage

The structure of Part D prescription drug coverage is shifting in 2025:

• There is now a $2,000 annual cap on out-of-pocket drug costs.

• Once you hit this limit, your plan covers 100% of covered drug costs for the rest of the year.

• This eliminates the coverage gap (“donut hole”) that existed in prior years.

While this change is separate from supplemental perks, it can free up your budget, making some Advantage plan features more useful than before.

Rethinking What Matters Most in 2025

The trend toward adding perks continues, but you’re best served by focusing on how the plan performs in the areas that matter most to your health and finances. Supplemental benefits should be the icing—not the cake.

If a plan doesn’t give you access to the providers, medications, and services you actually need, no amount of extras can make up for it.

Let the Extras Serve You, Not Distract You

Medicare Advantage in 2025 brings another round of shiny new perks, but don’t lose sight of what counts. Use this time of year to:

• Compare your options with a clear eye

• Ask specific questions about eligibility and access

• Talk with a licensed agent listed on this website for help

Your health needs deserve coverage that works for you—not just one that sounds good on paper.