How Do Wellness Programs Benefit Medicare Advantage Members?

One of the biggest advantages of Medicare Advantage over Original Medicare is the extra benefits — and wellness programs are among the most valuable. These programs are designed to keep you healthier, more active, and more engaged in managing your own care. But many members never fully take advantage of them.

Here is a breakdown of the wellness benefits commonly included in Medicare Advantage plans and how they can make a real difference.

What Are Wellness Programs in Medicare Advantage?

Wellness programs are supplemental benefits that go beyond what Original Medicare (Parts A and B) covers. They focus on preventive care, fitness, and overall well-being. Insurance companies like Humana, UnitedHealthcare, and Aetna bundle these into their Medicare Advantage plans to help members stay out of the hospital and manage chronic conditions before they become serious.

These programs vary by plan and insurer, but they often include:

• Fitness memberships (such as SilverSneakers or Renew Active)
• Chronic disease management programs for conditions like diabetes, COPD, or heart disease
• Telehealth and virtual care services
• Health education resources and coaching programs
• Over-the-counter (OTC) allowances for health-related products
• Nutrition and meal delivery programs for qualifying members

How Wellness Programs Benefit You

1. Staying Physically Active

Most Medicare Advantage plans include access to fitness programs at no extra cost. SilverSneakers, for example, gives members access to thousands of gyms, fitness centers, and online workout classes. Regular physical activity reduces the risk of falls, improves cardiovascular health, and supports mental well-being — all of which become increasingly important as we age.

2. Managing Chronic Conditions

For members living with diabetes, heart disease, or other ongoing conditions, disease management programs provide structured support. These may include regular check-ins with a health coach, personalized care plans, medication reminders, and educational resources. Studies consistently show that structured chronic care management reduces hospitalizations and improves quality of life.

3. Reducing Your Out-of-Pocket Costs

Wellness programs are included in your plan premium — you are not paying extra for them. Using an OTC allowance for vitamins, first aid supplies, or blood pressure monitors is money you would otherwise spend out of pocket. Over a year, these allowances can be worth hundreds of dollars.

4. Access to Telehealth

Virtual care visits became a standard benefit in many Medicare Advantage plans following the pandemic. Being able to consult a doctor from home — without transportation, waiting rooms, or scheduling delays — makes it easier to stay on top of routine care and catch issues early.

5. Mental Health and Social Wellness

Some plans also include benefits like transportation to medical appointments, caregiver support resources, and even companion programs. Social isolation is a significant health risk for older adults, and plans that address it holistically tend to produce better health outcomes for their members.

Are You Actually Using Your Benefits?

Research from KFF found that a significant portion of Medicare Advantage members are unaware of or do not use their supplemental benefits. Starting in 2025, CMS now requires plans to send a mid-year notification detailing benefits you have not yet used — a direct response to this problem.

The bottom line: if you are enrolled in a Medicare Advantage plan and not using its wellness benefits, you are leaving value on the table.

How to Find Out What Your Plan Includes

The best way to understand your wellness benefits is to:

1. Log into your plan's member portal
2. Call your plan's member services line
3. Review your Annual Notice of Change (ANOC) each fall

If your current plan's wellness benefits do not match your needs, the Annual Enrollment Period (October 15 – December 7) is your opportunity to switch to a plan that does.

Ready to Find a Plan That Works Harder for You?

Not all Medicare Advantage plans offer the same level of wellness benefits. A licensed Medicare Advocate can compare plans in your area side by side — at no cost to you — to make sure you are enrolled in a plan that fits your health and your lifestyle.

Talk to an Advocate today and get a free plan comparison.