Fewer Meals, Fewer Rides, Thinner Dental Coverage: What Seniors Lose in Medicare Advantage in 2027
In 2027, Medicare Advantage plans will have to offer fewer of the everyday supports that keep seniors healthy and on budget. Meal benefits are disappearing from hundreds of plans; rides to the doctor are being cut, and dental coverage is shrinking even in plans that still offer it. Some plans are also cutting Part B givebacks, the refunds that lower seniors’ monthly premium.
A new Avalere Health analysis of CMS’s 2027 plan data, prepared for Better Medicare Alliance (BMA), confirms: after years of funding pressure and rising costs, plans are having to pull back on many of the benefits seniors rely on.
2027 at a Glance
- Meals: 21% fewer plans. Fewer than half will offer them.
- Rides to medical appointments: 15% fewer plans. Only one in three will offer them.
- Over-the-counter allowances: 6% fewer plans.
- Fitness: 5% fewer plans.
- Dental, vision and hearing: Still offered by nearly every plan, but several of the largest carriers will cover less.
When a Benefit Disappears, the Need Doesn’t
Traditional Medicare generally doesn’t pay for meals, routine rides to the doctor, over-the-counter health essentials, or most dental, vision and hearing care. For millions of seniors, Medicare Advantage is the only place they get this help.
That help matters in concrete ways:
- A senior who no longer drives uses a ride benefit to get to dialysis.
- A patient just home from the hospital relies on delivered meals while recovering.
- A retiree on a fixed income stretches the monthly budget with an over-the-counter allowance.
- A dental allowance is often what makes dentures affordable.
When the benefit goes away, the cost lands on the senior.
Meals: The Steepest Drop
Plans offering meals fall from 3,084 to 2,441, from 61% of plans to 49%. The decline hits both general-enrollment plans (58% to 46%) and special needs plans, or SNPs (67% to 55%).
Rides: Hardest Hit Where Needs Are Greatest
Plans offering transportation fall from 1,913 to 1,633, from 38% of plans to 33%. The sharpest cut comes in SNPs, which serve many of the beneficiaries with the greatest needs. The share of SNPs offering rides drops from 67% to 56%. In general-enrollment plans, it falls from 23% to 19%.
Everyday Health Costs and Staying Active
Over-the-counter benefits drop from 3,812 plans to 3,577. The entire loss falls on general-enrollment plans, where the share drops from 66% to 58%. Most seniors are in those plans, not SNPs.
Fitness benefits are still offered by 87% of plans, down from 91%. The decline is again driven by general-enrollment plans, which fall from 93% to 87%.
Chronic Care: Growth Masks a Gap
The number of plans offering at least one Special Supplemental Benefit for the Chronically Ill rises from 1,893 to 1,946, but only because of growth in SNPs. Among general-enrollment plans, the number falls from 405 to 351.
Dental, Vision and Hearing: Still on the Menu, Covering Less
Dental (96%), vision (98%), and hearing (95%) coverage will continue to be offered by most plans, in line with recent years. But public data show whether a plan offers a benefit, not how much it covers. A plan can keep dental on the list and still cover less, and for 2027 many will.
A Leerink Partners review of Medicare Plan Finder, reported by Healthcare Dive, found dental benefit reductions affecting:
- Nearly 70% of UnitedHealthcare’s Medicare Advantage members,
- 45% of Centene’s,
- 36% of Aetna’s, and
- 23% of Elevance’s.
Protecting the Benefits Seniors Count On
Lawmakers see the value of these benefits. Last month, Rep. Greg Murphy, M.D. (R-N.C.), and seven House colleagues urged CMS to make it easier for Medicare Advantage plans to provide healthy food. BMA’s 10-point Policy Roadmap goes further. It calls on CMS to make healthy food a standard supplemental benefit for all enrollees, not just those with chronic illnesses.
Seniors choose Medicare Advantage for comprehensive care they can afford. Keeping these benefits requires sufficient funding and predictable policy from Washington, and seniors are counting on policymakers to deliver both.
Source: Avalere Health analysis of CMS’s 2027 Medicare Advantage Landscape and Plan Benefit Package data, prepared for Better Medicare Alliance. The analysis excludes MSA, PFFS, Employer Group Waiver, PACE, Cost and demonstration plans. Figures describe plan offerings rather than the number of beneficiaries affected, and do not measure changes in benefit allowances or coverage limits. Percentages are rounded. Dental allowance reduction figures come from a Leerink Partners analysis of Medicare Plan Finder data, as reported by Healthcare Dive, and refer to each carrier’s own membership.