What Is the Mid-Year Enrollee Notification of Available Supplemental Benefits?
Key Takeaways
- A rule issued by the Centers for Medicare and Medicaid Services required Medicare Advantage plans to issue Mid-Year Enrollee Notification of Available Supplemental Benefits between June 30 and July 31.
- This notification would inform you of any additional benefits available from your plan that you haven’t used so far that year.
- Based on this document, you could make decisions about using your benefits and evaluate whether your plan still meets your needs.
- Under the Trump Administration, CMS has postponed enforcement of this rule.
Are you leaving money on the table by not using your Medicare Advantage plan benefits to the fullest?
Medicare Advantage plans (also called Medicare Part C) substitute for federally administered Original Medicare (also called Medicare Part A and Part B) healthcare coverage. Many Medicare Advantage plans feature benefits and services that go beyond the medical and hospital insurance provided under Original Medicare.
In the Final Rule for 2025, the federal Centers for Medicare and Medicaid Services (CMS) required Medicare Advantage plans to provide a document called the Mid-Year Enrollee Notification of Available Supplemental Benefits. This notification would remind you of the additional benefits you can access as part of your current plan.
Enforcement of this policy is currently paused.
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Additional Benefits on Medicare Advantage Plans
All Medicare Advantage plans differ in the benefits they offer, and plan eligibility depends on where you live and your personal situation. However, most available options include Medicare Part D prescription drug coverage — which people on Original Medicare must purchase as a standalone plan — and at least some other benefits not included in Original Medicare.
According to the health policy nonprofit KFF, the most common types of extra benefits in 2024 were:
- Vision, such as eye exams and glasses
- Dental services like cleanings and x-rays
- Hearing tests and hearing aids
- Gym memberships and fitness classes
- An allowance for over-the-counter items
The details of these benefits vary from plan to plan, so check your policy for information about the services available and whether you’re responsible for a share of the costs when you use them.
Why Would You Receive a Mid-Year Enrollee Notification?
People on Medicare Advantage frequently don’t use all the benefits that their plans offer. A study conducted from 2017 to 2021 found that only about 54% of enrollees were aware of their dental and vision coverage.
To address that disconnect, CMS established a policy that requires Medicare Advantage plans to mail a Mid-Year Enrollee Notification of Unused Supplemental Benefits to their enrollees.
This document would be sent every year between June 30 and July 31 and include personalized information like:
- A list of any benefits you haven’t used during the first six months of the year
- Details about how the benefit works and any costs you must pay to use it
- A customer service phone number you can call with questions or concerns
The notification would provide visibility into how you’re using your Medicare Advantage benefits so you can get all the care you need.
Under the Trump Administration, however, CMS decided to postpone enforcement of this policy. That means at least through 2026, you will not receive the notification.
“Following numerous implementation questions and requests for technical guidance from [Medicare Advantage] organizations, CMS determined that a temporary enforcement pause is necessary to address logistical concerns and reevaluate current requirements,” CMS wrote in a memo to insurance carriers.
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Do You Have the Right Benefits for Your Needs?
When you receive your mid-year notification, it’s a good time to evaluate whether your Medicare Advantage plan benefits still meet your needs. With dozens of plans available to the average Medicare-eligible adult, you might find that an alternative plan provides more of the coverage you need or costs less for those services.
Talk to a licensed insurance agent to explore whether there’s a better Medicare Advantage plan for you. You can change plans every year during the Annual Enrollment Period (Oct. 15-Dec. 7), or you may qualify for a Special Enrollment Period due to certain life events or changes in your coverage.
If you meet eligibility requirements, consider enrolling in a Special Needs Plan (SNP) to get benefits designed for people in certain situations. For example, a Chronic Condition Special Needs Plan (C-SNP) can offer coordinated care, drug coverage, and additional benefits specifically tailored to people living with a condition such as heart disease, diabetes, or COPD.
Being aware of all your plan’s features and the importance of routine services can make a difference in your healthcare.
Sources
- Contract Year 2025 Medicare Advantage and Part D Final Rule. CMS.
- Medicare Advantage in 2024: Premiums, Out-of-Pocket Limits, Supplemental Benefits, and Prior Authorization. KFF.
- Use and Costs of Supplemental Benefits in Medicare Advantage, 2017-2021. JAMA Network Open.
- CMS drops Medicare Advantage unused benefits notification policy. Modern Healthcare.