Medicare Advantage plans faced with rising costs and lower reimbursement rates have slowly started to scale back their supplemental benefits, a new KFF analysis shows. Meanwhile, MA special needs plans are moving in the opposite direction, offering a range of benefits to ensure these higher-need members get the support they need.
Recently, Medicare Advantage has outpaced traditional, fee-for-service Medicare, accounting for 54% of the eligible Medicare population (nearly 33 million people) as well as 54% of overall federal Medicare spending ($462 billion).
Compared to typical Medicare plans, MA plans offer additional benefits such as dental and vision coverage, non-emergency transportation, remote patient monitoring, and nutrition counseling, without requiring higher premiums—and research shows they can deliver better health outcomes. MA special needs plans (SNPs) are tailored to those who are dually eligible for Medicaid and Medicare or those that have significant care needs, and they often offer even more supplemental benefits, per this KFF analysis.
Among health plan members who are enrolled in special needs plans:
- 88% are in plans for people who are dually eligible (D-SNPs)
- 10% are in plans for people with severe chronic or disabling conditions (C-SNPs)
- 2% are in plans for people who need a nursing home or institutional level of care (I-SNPs)
C-SNP enrollment grew by 45% from 2023 to 2024 to 675,000 people. According to KFF, most C-SNP enrollees in 2024 were in plans for people who have diabetes or cardiovascular conditions.
What’s the Latest on MA Supplemental Benefits?
From 2023 to 2024, SNPs have maintained or slightly increased access to supplemental benefits, and even more dramatic increases took place from 2015-2024. For example, 74% of SNP plans offered transportation benefits in 2015; that rose to 91% of plans in 2023 and 2024. Clearly, health plans recognize the needs of these members and are working to ensure they can access the care they need—which often means regular appointments to manage chronic conditions. The KFF analysis did not include data on utilization, which is not available.
Individual MA plans saw subtle decreases in some supplemental benefits over the past year. Compared to 2023, MA plans in 2024 offered fewer plans with transportation benefits (36% in 2024 vs. 44% in 2023)—though it is still a more popular offering than it was in 2015, when 21% of MA plans offered transportation benefits. Other individual MA benefits that saw slight decreases since 2023 included fitness, meal services, acupuncture, and over the counter benefits.
The decreases are at least partially due to the CMS announcement in April that the federal government will pay health plans 0.16% less in maximum reimbursements for an average Medicare Advantage plan member in 2025. It was disappointing news for many big health insurers that experienced higher utilization rates and healthcare costs in 2023.
Core health-related benefits including eye exams, dental care, and hearing exams/aids were offered by 96% or more of all individual MA plans, and there was little change in how many plans offer them, though KFF noted that the design of these benefits may have changed or be under review.
Who Qualifies for Special Needs Plans?
Special Needs Plans are restricted to MA enrollees who have significant or specialized care needs or to those eligible for Medicare and Medicaid.
Enrollment in SNPs has risen dramatically over the past five years: More than 6.6 million Medicare enrollees had a special needs plan in 2024—and that number has more than doubled since 2019, when SNP enrollment reached 2.92 million. Enrollment grew 16% from 2023 to 2024 and makes up 20% of total MA enrollment. According to KFF, the increase is due to a rise in available special needs plans and dual eligible people who have access to them.
How Do Individual MA Plans and SNPs Compare?
People enrolled in SNPs have greater access to a range of benefits compared to other MA enrollees, according to the KFF analysis. The gap is biggest for transportation benefits, or non-emergency medical transportation, available to 91% of SNP health plan members versus 36% of MA health plan members. A similar trend holds true when it comes to transportation for non-medical needs, such as going to the grocery store or a gym, which is offered to 29% of SNP enrollees and 9% of those enrolled in individual MA plans.
Other benefits include meal services (offered with 85% of SNP plans vs. 74% of individual MA plans), bathroom safety devices (49% vs. 31%), and in-home support services (23% vs. 9%).