{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T07:35:38Z","timestamp":1791272138295,"version":"4.1.0"},"reference-count":28,"publisher":"American Medical Association (AMA)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>Nearly all Medicare Advantage (MA) plans offer dental, vision, and hearing benefits not covered by traditional Medicare (TM). However, little is known about MA enrollees\u2019 use of those benefits or how much they cost MA insurers or enrollees.<\/jats:p><\/jats:sec>Objective<\/jats:title>To estimate use, out-of-pocket (OOP) spending, and insurer payments for dental, hearing, and vision services among Medicare beneficiaries.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This cross-sectional analysis used pooled 2017-2021 Medical Expenditure Panel Survey (MEPS) and Medicare Current Beneficiary Survey (MCBS) data for MA and TM beneficiaries (excluding those also covered by Medicaid). The analysis was performed from September 10, 2023, to June 30, 2024.<\/jats:p><\/jats:sec>Exposures<\/jats:title>MA compared with TM coverage.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>The main outcome was receipt of eye examinations, corrective lenses, hearing aids, optometry and dental visits, and MA and TM enrollees\u2019 and insurers\u2019 spending for such services. MEPS and MCBS data were weighted to be nationally representative.<\/jats:p><\/jats:sec>Results<\/jats:title>We included 76\u202f557 non\u2013dually eligible Medicare beneficiaries, including 23\u202f404 from the MEPS and 53\u202f153 from the MCBS. Weighted demographic characteristics of MA and TM beneficiaries were similar (54.7% and 51.9% female; 39.8% and 35.2% older than 75 years, respectively). Only 54.2% (95% CI, 52.4%-55.9%) and 54.3% (95% CI 52.2%-56.3%) of MA beneficiaries were aware of having MA dental and vision coverage, respectively. MA enrollees were no more likely to receive eye examinations, hearing aids, or eyeglasses than TM enrollees. After adjustment for demographic differences, MA and TM enrollees paid OOP $205.86 (95% CI, $192.44-$219.27) and $226.12 (95% CI, $212.02-$240.23), respectively, for eyeglasses (MA\u2009\u2212\u2009TM difference, \u2212$20.27 [95% CI, \u2212$33.77 to \u2212$6.77] or \u22129.0% [95% CI, \u221214.9% to \u22123.0%]); $226.82 (95% CI, $202.24-$251.40) and $249.98 (95% CI, $226.22-$273.74) for dental visits, respectively (MA\u2009\u2212\u2009TM difference, \u2212$23.16 [95% CI, \u2212$43.15 to \u2212$3.17] or \u22129.3% [95% CI, \u221217.3% to \u22121.3%]); and no less for optometry visits or durable medical equipment (a proxy for hearing aids). Nationwide, MA plans\u2019 annual spending on vision, dental services, and durable medical equipment totaled $3.9 billion (95% CI, $3.3-$4.4 billion), while enrollees spent OOP $9.2 billion (95% CI, $8.2-$10.2 billion) annually for these services and other private insurers covered $2.8 billion (95% CI, $2.7-$3.0 billion).<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In this cross-sectional study of 2 nationally representative surveys, MA beneficiaries did not receive more supplemental services than TM beneficiaries, possibly because of cost-sharing and limited awareness of benefit coverage.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.54699","type":"journal-article","created":{"date-parts":[[2025,1,14]],"date-time":"2025-01-14T16:02:36Z","timestamp":1736870556000},"page":"e2454699","source":"Crossref","is-referenced-by-count":13,"title":["Use and Costs of Supplemental Benefits in Medicare Advantage, 2017-2021"],"prefix":"10.1001","volume":"8","author":[{"given":"Christopher L.","family":"Cai","sequence":"first","affiliation":[{"name":"Division of General Internal Medicine and Primary Care, Brigham and Women\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"Iyengar","sequence":"additional","affiliation":[{"name":"Department of Medicine, Montefiore Einstein, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steffie","family":"Woolhandler","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Public Health, Hunter College, City University of New York, New York, New York"},{"name":"Cambridge Health Alliance\/Harvard Medical School, Cambridge, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David U.","family":"Himmelstein","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Public Health, Hunter College, City University of New York, New York, New York"},{"name":"Cambridge Health Alliance\/Harvard Medical School, Cambridge, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kavya","family":"Kannan","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, The University of Texas at Dallas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Simon","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine and Primary Care, Brigham and Women\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2025,1,14]]},"reference":[{"issue":"2","key":"zoi241535r4","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1377\/hlthaff.2019.00451","article-title":"Dental, vision, and hearing services: access, spending, and coverage for Medicare beneficiaries.","volume":"39","author":"Willink","year":"2020","journal-title":"Health Aff (Millwood)"},{"issue":"2","key":"zoi241535r7","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.0401","article-title":"Dental use and spending in Medicare Advantage and Traditional Medicare, 2010-2021.","volume":"7","author":"Simon","year":"2024","journal-title":"JAMA Netw Open"},{"issue":"6","key":"zoi241535r10","doi-asserted-by":"publisher","DOI":"10.1001\/jamahealthforum.2021.0626","article-title":"Estimating rebates and other discounts received by Medicare Part D.","volume":"2","author":"Feldman","year":"2021","journal-title":"JAMA Health Forum"},{"issue":"15","key":"zoi241535r11","doi-asserted-by":"publisher","first-page":"1515","DOI":"10.1001\/jama.2022.17825","article-title":"Prescription drug spending in fee-for-service Medicare, 2008-2019.","volume":"328","author":"Dusetzina","year":"2022","journal-title":"JAMA"},{"issue":"7","key":"zoi241535r12","doi-asserted-by":"publisher","first-page":"882","DOI":"10.7326\/M23-2480","article-title":"Association of Medicare Advantage enrollment with financial burden of care: a retrospective cohort study.","volume":"177","author":"Park","year":"2024","journal-title":"Ann Intern Med"},{"issue":"8","key":"zoi241535r13","doi-asserted-by":"publisher","first-page":"865","DOI":"10.1001\/jamainternmed.2024.1868","article-title":"Less care at higher cost\u2014the Medicare Advantage paradox.","volume":"184","author":"Gaffney","year":"2024","journal-title":"JAMA Intern Med"},{"issue":"6","key":"zoi241535r15","doi-asserted-by":"publisher","first-page":"945","DOI":"10.1377\/hlthaff.2021.00118","article-title":"Growth in Medicare Advantage greatest among Black and Hispanic enrollees.","volume":"40","author":"Meyers","year":"2021","journal-title":"Health Aff (Millwood)"},{"issue":"2","key":"zoi241535r16","doi-asserted-by":"publisher","first-page":"286","DOI":"10.1377\/hlthaff.2021.01899","article-title":"Dental services use: Medicare beneficiaries experience immediate and long-term reductions after enrollment.","volume":"42","author":"Simon","year":"2023","journal-title":"Health Aff (Millwood)"},{"issue":"6","key":"zoi241535r17","doi-asserted-by":"publisher","first-page":"937","DOI":"10.1377\/hlthaff.2020.02149","article-title":"Comparing Medicare Advantage and traditional Medicare: a systematic review.","volume":"40","author":"Agarwal","year":"2021","journal-title":"Health Aff (Millwood)"},{"issue":"7","key":"zoi241535r18","doi-asserted-by":"publisher","first-page":"909","DOI":"10.1377\/hlthaff.2022.01547","article-title":"Psychiatrist networks in Medicare Advantage plans are substantially narrower than in Medicaid and ACA markets.","volume":"42","author":"Zhu","year":"2023","journal-title":"Health Aff (Millwood)"},{"issue":"6-8","key":"zoi241535r19","doi-asserted-by":"publisher","first-page":"1117","DOI":"10.1177\/08982643221095716","article-title":"Racial and ethnic differences in hearing aid use among Medicare beneficiaries.","volume":"34","author":"Yi","year":"2022","journal-title":"J Aging Health"},{"issue":"10","key":"zoi241535r20","doi-asserted-by":"publisher","first-page":"e89","DOI":"10.1016\/j.ophtha.2022.07.010","article-title":"Disparities in vision health and eye care.","volume":"129","author":"Elam","year":"2022","journal-title":"Ophthalmology"},{"issue":"2","key":"zoi241535r21","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1016\/j.adaj.2023.12.001","article-title":"Racial disparities in oral health care.","volume":"155","author":"Frazier-Bowers","year":"2024","journal-title":"J Am Dent Assoc"},{"issue":"3","key":"zoi241535r25","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1097\/01.aud.0000441036.40169.29","article-title":"Hearing aid use among older U.S. adults; the National Health and Nutrition Examination Survey, 2005-2006 and 2009-2010.","volume":"35","author":"Bainbridge","year":"2014","journal-title":"Ear Hear"},{"issue":"4","key":"zoi241535r26","doi-asserted-by":"publisher","first-page":"346","DOI":"10.1111\/cdoe.12607","article-title":"Prevalence of and factors associated with unmet dental need among the US adult population in 2016.","volume":"49","author":"Taylor","year":"2021","journal-title":"Community Dent Oral Epidemiol"},{"issue":"8","key":"zoi241535r28","doi-asserted-by":"publisher","first-page":"763","DOI":"10.1056\/NEJMsb2313939","article-title":"The future of Medicare and the role of traditional Medicare as competitor.","volume":"391","author":"McWilliams","year":"2024","journal-title":"N Engl J Med"},{"key":"zoi241535r1","unstructured":"Freed? M, Damico? A, Guglesten Biniek? J, Neuman? T. Medicare Advantage 2024 spotlight: first look. KFF. Published November 15, 2023. Accessed August 30, 2024. https:\/\/www.kff.org\/medicare\/issue-brief\/medicare-advantage-2024-spotlight-first-look\/"},{"key":"zoi241535r2","unstructured":"The Medicare Advantage program: status report. Medicare Payment Advisory Commission. 2024. Accessed May 20, 2024. https:\/\/www.medpac.gov\/wp-content\/uploads\/2024\/03\/Mar24_Ch12_MedPAC_Report_To_Congress_SEC.pdf"},{"key":"zoi241535r3","unstructured":"Freed? M, Fuglesten Biniek? J, Damico? A, Neuman? T. Medicare Advantage in 2024: premiums, out-of-pocket limits, supplemental benefits, and prior authorization. KFF. August 8, 2024. Accessed December 3, 2024. https:\/\/www.kff.org\/medicare\/issue-brief\/medicare-advantage-in-2024-premiums-out-of-pocket-limits-cost-sharing-supplemental-benefits-prior-authorization-and-star-ratings\/"},{"key":"zoi241535r5","unstructured":"Freed? M, Neuman? T, Jacobson? G. Drilling down on dental coverage and costs for Medicare beneficiaries. KFF. March 13, 2019. Accessed December 3, 2024. https:\/\/www.kff.org\/medicare\/issue-brief\/drilling-down-on-dental-coverage-and-costs-for-medicare-beneficiaries"},{"key":"zoi241535r6","unstructured":"Biniek? J, Sroczynski? N, Freed? M, Neuman? T. Extra benefits offered by Medicare Advantage firms vary. KFF. November 16, 2022. Accessed December 3, 2024. https:\/\/www.kff.org\/medicare\/issue-brief\/extra-benefits-offered-by-medicare-advantage-firms-varies"},{"key":"zoi241535r8","unstructured":"Freed? M, Biniek? J, Damico? A, Neuman? T. Medicare Advantage 2023 spotlight: first look. KFF. November 10, 2022. Accessed December 18, 2024. https:\/\/www.kff.org\/medicare\/issue-brief\/medicare-advantage-2023-spotlight-first-look"},{"key":"zoi241535r9","unstructured":"Xu? L, Welch? WP, Ruhter? J, . Medicare Advantage overview: a primer on enrollment and spending. Office of the Assistant Secretary for Planning and Evaluation; 2023. Accessed August 8, 2024. https:\/\/aspe.hhs.gov\/sites\/default\/files\/documents\/9b42ffbf2341726d5b63a9647b0aad15\/medicare-advantage-overview.pdf"},{"key":"zoi241535r14","unstructured":"Freed? M, Cubanski? J, Srozynski? N, Ochieng? N, Neuman? T. Dental, hearing, and vision costs and coverage among Medicare beneficiaries in traditional Medicare and Medicare Advantage. KFF. Published September 21, 2021. Accessed May 20, 2024. https:\/\/www.kff.org\/health-costs\/issue-brief\/dental-hearing-and-vision-costs-and-coverage-among-medicare-beneficiaries-in-traditional-medicare-and-medicare-advantage\/"},{"key":"zoi241535r22","unstructured":"Comprehensive adult eye and vision examination. American Optometric Association. 2015. Accessed May 4, 2024. https:\/\/www.aoa.org\/AOA\/Documents\/Practice%20Management\/Clinical%20Guidelines\/EBO%20Guidelines\/Comprehensive%20Adult%20Eye%20and%20Vision%20Exam.pdf"},{"key":"zoi241535r23","unstructured":"Ali? R, Hellow? L. Small share of Medicare supplement plans offer access to dental, vision, and other benefits not covered by traditional Medicare. Commonwealth Fund. August 13, 2021. Accessed July 31, 2024. https:\/\/www.commonwealthfund.org\/blog\/2021\/small-share-medicare-supplement-plans-offer-access-dental-vision-and-other-benefits-not"},{"key":"zoi241535r24","unstructured":"Gangopadhyaya? A, Shartzer? A, Garrett? B, Holahan? J. Are vision and hearing benefits needed in Medicare? Urban Institute. 2021. Accessed May 4, 2024. https:\/\/www.urban.org\/sites\/default\/files\/publication\/105115\/are-vision-and-hearing-benefits-needed-in-medicare_1.pdf"},{"key":"zoi241535r27","unstructured":"Contract year 2025 policy and technical changes to the Medicare Advantage plan program, Medicare Prescription Drug Benefit program, Medicare Cost Plan program, and programs of all-inclusive care for the elderly, and health information technology standards. Centers for Medicare & Medicaid Services. November 6, 2023. Accessed December 21, 2023. https:\/\/www.cms.gov\/newsroom\/fact-sheets\/contract-year-2025-policy-and-technical-changes-medicare-advantage-plan-program-medicare"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2829183\/cai_2025_oi_241535_1736185777.04227.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,14]],"date-time":"2025-01-14T16:02:41Z","timestamp":1736870561000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2829183"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,14]]},"references-count":28,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1,2]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2024.54699","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,14]]}}}