Insurers are facing a June 1 deadline to submit their 2027 Medicare Advantage bids to the federal government, including their benefits.
In recent years, MA plans have been under pressure amid rising medical costs and utilization. While the federal government ultimately settled on a higher MA rate than initially suggested, the possibility of supplemental benefits cuts is still real.
“To the extent that you make adjustments to benefits, you do it in a way where it has the least impact on the things that are most important to them,” Humana President and CEO Jim Rechtin said on the company’s first-quarter earnings call. “It doesn’t mean you don’t make adjustments. It means you do it in a way that is thoughtful to your members.”
The comment was even more stark considering how Humana was one of this year’s stronger players: Its MA membership grew by more than 1.2 million members during this annual enrollment period, while other insurers saw drops.
CMS also sunsetted its Medicare Advantage Value-Based Insurance Design Model, which included MA benefits to address socioeconomic issues and chronic conditions, at the end of 2025. An estimated $86 billion was spent on supplemental benefits in 2025.
However, plans can still offer similar benefits — Special Supplemental Benefits for the Chronically Ill — through a 2018 law, but not all are included. For example, CMS warned of disruptions to Part D cost-sharing.
But benefits contraction extends beyond the regulatory pressures. While some payers plan to exit markets or adopt a more disciplined enrollment approach, some could scale back their offerings. Dental, vision and hearing benefits may not be as threatened — considering no other coverage pathway in Medicare exists beyond MA — but here are four benefits that could feel the squeeze.
Over-the-counter, flex card allowances
Health plans are now joining OTC values with other benefits, limiting their standalone value. The average standalone OTC limit per month dropped about 13% in 2026, down to $23 per month, according to consulting firm Milliman. This change could be a bellwether showing how plans are folding OTC offerings into other benefits.
Milliman also found that OTC rollover offerings have dropped from 9.6% to 2.4% of plans from 2025 to 2026. The most recent CMS MA rule for contract year 2027 rescinds midyear notifications to members of their unused supplemental benefits. However, an earlier rule established these notifications going into a previous round of bid development, which could have shaped rollover policies. Without rollovers, the annual purchasing power of these benefits takes a hit.
Fitness benefits
Some plans have pulled back their SilverSneakers offering, which can include gym memberships and fitness classes for older adults. Blue Cross and Blue Shield of Alabama discontinued its SilverSneakers benefit going into 2026. BCBS Minnesota also scaled back its benefit to exclude YMCA of the North and Life Time, even though 26,000 BCBS beneficiaries used those gyms.
“As a market, Minnesota is experiencing high cost pressures related to Medicare coverage. In order to ensure Blue Cross could continue offering SilverSneakers to our Medicare members in Minnesota, we needed to adjust the network structure of locations included in the program,” a spokesperson for BCBS Minnesota told Becker’s.
Still, about 93% of MA plans continue to offer this benefit in 2026, despite a dip from over 95% in 2025, according to Milliman.
MA beneficiaries may also underutilize this benefit simply due to lack of awareness. A Humana Healthcare Research from November survey found a major gap: About one-third of those who did not use the SilverSneakers fitness benefit said they were not aware of it. Andrea DeVries, PhD, a director of research within Humana Healthcare Research and the study’s lead researcher, said a study in collaboration with State College, Pa.-based Penn State University is taking place to better understand outreach.
Transportation
Milliman also found dips in plans covering nonemergency transportation. The share of MA plans with this benefit dropped to 24% in 2026, down from about 31% in 2025.
Looking at CMS data, KFF similarly found that MA special needs plans in particular also saw a drop, down to 67% in 2026 versus 81% in 2025.
Meal benefits
KFF and Milliman both noted drops in meal benefits offered by MA plans, from about 65% of plans in 2025 to 57% in 2026. While 73% of SNPs covered a meal benefit in 2025, only 66% do so in 2026, KFF found.
Another Milliman report found food and utilities were the most commonly offered benefits under the now-defunct VBID model in 2024, attributing this to availability for the dual-eligible SNP population.
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