As competition in the Medicare Advantage (MA) market continues to intensify, MA plans are striking a balance between cost control and delivering tangible value to members. In our latest whitepaper, we take a closer look at vision benefits and their evolving role in Medicare Advantage. Here’s a preview of what’s inside.

Vision continues to lead

Vision is the most widely offered supplemental benefit in Medicare Advantage (MA), with 99% of MA plans providing vision coverage in 2025.¹ As the top-ranked supplemental benefit, vision has shifted from a differentiator to a baseline expectation for members. Plans lacking competitive vision benefits may lose members or have diminished satisfaction scores.

Making vision benefits easier to use

There is a continued shift towards global allowances across MA plans. In fact, they represent 90.8% of vision benefits structures.² By replacing itemized benefits, these allowances simplify communication and create a more intuitive member experience.

Shifts in vision benefit frequency

Though material allowance amounts across plans are achieving parity, reduced frequency changes the value equation. Members accustomed to annual refreshes may view a two-year schedule as reduced value. This perception gap can drive dissatisfaction and switching.

DSNP retention, EED and Star Ratings

For dual-eligible special needs plans (DSNPs), vision is a critical piece of an integrated benefit package. Data shows that among duals receiving grocery, OTC and eyewear benefits, two-thirds would consider switching plans if any of those were removed.³ The Eye Exam for Diabetics (EED) measure significantly affects Star Ratings. Plans with richer vision benefits tend to show higher EED utilization rates, contributing to better quality scores.⁴

Meeting member needs

For Medicare Advantage, vision benefits have gone from a bonus perk to a must have. It’s clear that health plans that strategically align their vision benefit design with member value and quality performance will be best positioned to lead in both retention and Star Ratings. Ready to learn more? Download our latest whitepaper or speak with your EyeMed representative.

1 “CMS Medicare Advantage Landscape Files (2023-2025)”: Centers for Medicare & Medicaid Services; CMS.gov; September 2024.2 CMS Medicare Advantage Landscape Files (2023-2025)”: Centers for Medicare & Medicaid Services; CMS.gov; September 2024.3 “Medicare 2024 Part C & D Star Ratings Technical Notes”; Centers for Medicare & Medicaid Services; CMS.gov; March 2024.4  EyeMed internal data; 2024.