Millions of Medicare Advantage Benefits Go Unused Each Year — Here’s Why Seniors Are Missing Out
Despite rising healthcare costs, new data shows that older Americans are leaving billions in free OTC health benefits unclaimed due to lack of awareness and poor communication.
New data shows that millions of Americans enrolled in Medicare Advantage are missing out on billions of dollars in free health benefits every year—resources that could significantly reduce their expenses amid rising medical and living costs.
According to Newsweek, the findings reveal a striking gap between the benefits offered to Medicare Advantage members and the amount they actually use. This gap raises important questions about communication, awareness, and how these plans manage their incentives.
Billions in Free Benefits Left Unused
Most Medicare Advantage plans include what are known as over-the-counter (OTC) benefits. These allow enrollees to purchase a wide range of health-related products—such as vitamins, pain relievers, first-aid supplies, dental products, mobility aids, and more—at no cost.
A report by the consulting firm Milliman found that:
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87% of Medicare Advantage plans offer OTC benefits
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Eligible members receive up to $400 per year in free products
But despite the generosity of these programs, only about 30% of beneficiaries use their full allowance, leaving an estimated $5 billion in unused benefits every year.
A Major Awareness Problem
Health experts say the biggest reason for this loss is simple: many seniors don’t know these benefits exist, don’t understand how to use them, or receive confusing instructions from their insurance providers.
Some plans provide debit-style cards pre-loaded with the yearly OTC allowance, yet many older adults are unaware of how they work or what products are covered.
Another complication: OTC balances expire at the end of each cycle, meaning unused benefits cannot roll over into the next year. Once the deadline passes, the money is gone.
How Seniors Can Use These Benefits More Effectively
Experts emphasize the importance of seniors reviewing their health plans carefully. Lists of eligible OTC products are usually available:
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On the plan’s website
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In printed catalogs mailed to members
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At community pharmacies
Professor Lukas Bienebrock of the University of Pittsburgh stresses that local pharmacies are one of the best places for seniors to use these benefits, since pharmacists can guide them on what to buy and how to use non-prescription products safely.
He also notes that OTC benefits go beyond basic medicines, covering:
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Dental and joint care products
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Mobility support items
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Health screening tools such as COVID-19 tests
These items can significantly reduce day-to-day health expenses for older Americans.
New Technology Aims to Close the Gap
To help address this awareness problem, a new free app called “Chapter OTC” was recently launched. Created by Kobi Blumenfeld-Gantz, the app allows users to:
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Check their remaining OTC balance
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Browse eligible items
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Order products for home delivery
With more seniors turning to mobile health tools, experts believe the app could greatly increase the usage of these underutilized benefits.
A Growing Challenge in an Era of Inflation
These findings highlight the increasing financial pressures facing American households. As inflation continues to raise the costs of essentials—from food to healthcare—failing to use available Medicare benefits directly impacts seniors’ financial well-being.
Federal programs offer important support, but awareness and clear guidance remain essential to ensure that older Americans receive the full value of the benefits they are entitled to.
