Billions in Medicare Benefits Are Going Unused — And Most People Don’t Even Realize It
Every year, millions of Americans enrolled in Medicare programs unknowingly leave billions of dollars in valuable benefits untouched. These unused funds could cover a wide range of everyday health and wellness products — at zero cost to them. But here’s the surprising twist: most people have no idea these perks exist or how to use them.
What’s Actually Being Missed
Within the Medicare Advantage (MA) program, many participants have access to what are called “over-the-counter” (OTC) benefits. These allow seniors to buy non-prescription health products like vitamins, first aid supplies, or pain relievers using funds included in their plan. According to Dr. Mark Fendrick from the University of Michigan, about 87% of Medicare Advantage plans provide some kind of OTC allowance, based on data from consulting firm Milliman.
Why It Matters
Given today’s rising costs of groceries, healthcare, and utilities, these benefits could offer huge financial relief for older Americans living on fixed incomes. An estimated 18 million people qualify for OTC benefits through Medicare Advantage, and on average, each receives around $400 a year to spend on approved health-related items, data from the Consumer Healthcare Products Association (CHPA) shows. For many retirees, that’s enough to cover a year’s worth of essential health supplies.
But here’s where it gets controversial: despite the widespread availability, most of this money is simply going to waste.
Billions Left on the Table
Only about 30% of eligible recipients actually take advantage of their OTC benefits. That means nearly $5 billion in benefits vanish unused every year, according to CHPA. Seniors could be using that money for everyday essentials like vitamins, eye drops, or even dental and foot care items—but they’re not.
Dr. Lucas Berenbrok from the University of Pittsburgh explains that some MA plans preload these benefits onto special debit cards, making them easy to use. However, the real challenge is awareness: “Many members don’t know these benefits exist or aren’t sure how to access them,” he told Newsweek.
Common Mistakes and Missed Opportunities
Dr. Fendrick emphasizes that people should regularly confirm which items are covered under their plan—either online or through a mailed catalog. He also warns that these benefits usually expire and do not roll over to the next year. “Checking your balance and expiration dates is crucial to avoid losing free money,” he said.
So why do so many people miss out? The main culprits include a lack of awareness, confusion about what’s eligible, and the simple inconvenience of navigating insurance paperwork. Even though many plans now offer easy-to-use cards and tools, countless beneficiaries never take full advantage.
Insider Advice and Helpful Tools
Dr. Berenbrok suggests that online catalogs and mobile apps can make the process much simpler by showing updated lists of eligible OTC products. Covered items often go beyond standard medications and may include things like canes, braces, denture care products, and even COVID-19 tests. He also points out that community pharmacies are great places to maximize these benefits because pharmacists are trained to advise on safe and effective self-care. “Always check with your local pharmacist before starting a new OTC product,” he recommends.
A New Way to Simplify It
To make it easier for seniors to understand and use their benefits, a free app called Chapter OTC, created by Cobi Blumenfeld-Gantz, now helps users track their balance, browse eligible products, and even have them delivered right to their homes. It’s a simple solution to a surprisingly expensive problem.
Millions of dollars are being left untouched each week—money that could go directly toward improving the daily lives of seniors nationwide. So the big question is: why aren’t more people making the most of what they’ve already paid for? Do you think insurance providers should do more to raise awareness, or does the responsibility fall on the individuals themselves? Share your thoughts below—this is a debate worth having.
