Federal regulators have quietly eliminated one of the only tools Medicare Advantage enrollees had for finding out, partway through the year, that a chunk of a plan’s dental, hearing or grocery allowance was about to go unused. Under a final rule the Centers for Medicare & Medicaid Services issued this spring, insurers will no longer have to send that personalized mid-year reminder starting with the 2027 plan year. The requirement is not being weakened or narrowed — it is being erased outright. Once it goes, the unused dollars behind it disappear the same way they always have: quietly, and on the insurer’s calendar rather than the enrollee’s.
The Notice CMS Created in 2024 and Is Rescinding for 2027
CMS first created this requirement in its Contract Year 2025 Medicare Advantage and Part D final rule, issued April 4, 2024. That rule ordered every Medicare Advantage plan to send each enrollee an annual “Mid-Year Enrollee Notification of Unused Supplemental Benefits,” personalized to that person, between June 30 and July 31 of the plan year. The letter had to list every supplemental benefit the enrollee had not touched in the first six months of coverage, spell out the benefit’s scope and any cost-sharing, explain how to access it, note any network requirements, and give a customer service number.
CMS built that rule around a specific worry: that Medicare Advantage rebate dollars — an estimated $67 billion in 2024 alone, on top of roughly $337 billion over the prior decade — were funding benefits enrollees never touched. In 2022, more than 99% of Medicare Advantage plans offered at least one supplemental benefit, with a median of 23 per plan; vision, hearing, fitness and dental were the most common. Two years later, in its Contract Year 2027 Medicare Advantage and Part D final rule, CMS reversed course, listing the mid-year notice among six requirements it is rescinding as part of a broader push to cut what it calls duplicative and burdensome regulation.
Free download: How to read the Annual Notice of Change, spot the cost, drug and network changes, and decide whether to keep or switch. Get the free 2027 plan-change checklist.
What Disappears: Dental, Hearing and Grocery Dollars With No Reminder Attached
Nothing about the underlying supplemental benefits changes. Medicare Advantage plans can still offer dental cleanings, hearing aid fittings, over-the-counter allowances, or grocery and produce cards funded through Medicare’s rebate dollars. What changes is whether anyone tells an enrollee, partway through the year, that an allowance is sitting there unspent. Supplemental benefits have never rolled over between plan years and have never converted to cash; whatever an enrollee does not use by December 31 is simply gone, replaced the following January by a fresh amount tied to the new plan year.
The mid-year letter was the one structural check on that pattern: a forced, plan-by-plan accounting of who had not used a fitness benefit, dental cleaning or grocery card by midyear, mailed out while there was still time to act on it. Once CMS’s rescission takes hold with the 2027 plan year, that accounting stops. Plans are not required to replace it with anything — no mid-year email, no app alert, no phone call is mandated in its place.
The Debit Card Rule That Ties Grocery and OTC Money to the Calendar Year
The same CY2027 final rule that erases the mid-year letter also tightens the mechanics of how many plans pay these benefits out in the first place. A large share of Medicare Advantage plans load dental, over-the-counter and grocery allowances onto a prepaid debit card rather than reimbursing receipts. CMS is codifying that those cards must be electronically linked to plan-covered items through a real-time verification system at the point of sale, and, separately, that the balance loaded onto a card is good only for the specific plan year it was issued for.
Put together, the two changes pull in the same direction. The allowance itself stays locked to a calendar-year clock, while the letter that used to flag an unused balance before that clock ran out goes away. An enrollee whose card still shows money in it come November has no rule requiring anyone to point that out.
Where to Check a Balance Without Waiting for a Letter
Without a mandated mid-year notice, tracking an unused allowance falls entirely to the enrollee and to whatever a plan chooses to offer voluntarily. Every Medicare Advantage plan still has to publish an Evidence of Coverage and a Summary of Benefits, both of which list supplemental benefits and how to use them, and plans still send an Annual Notice of Change every September describing what a plan will cover the following year. A supplemental-benefits balance can also usually be checked through a plan’s member portal, mobile app or member services line — none of which CMS requires a plan to prompt anyone to use.
The Contract Year 2027 rule is effective June 1, 2026, and applies to coverage beginning January 1, 2027 — the point at which Medicare Advantage plans become free to stop mailing a mid-year unused-benefits letter that, since 2024, was the only itemized proof a plan sent enrollees of what supplemental-benefit money had gone untouched.
Comparing Plans Without a Letter That Won’t Arrive
With CMS no longer requiring a mid-year check-in, the only structured moment left for a Medicare Advantage enrollee to reassess a plan’s dental, hearing or grocery benefit is Open Enrollment itself, running October 15 through December 7. That window asks for a premium, drug formulary and provider network to all be weighed at once, on a clock that does not pause to explain what an old plan’s supplemental benefits were actually worth. Working through that comparison plan by plan is a different task than reading a single mailed notice ever was.
The 2027 Medicare Open Enrollment Decision Kit lays out a 42-page decision kit alongside a cost calculator spreadsheet that compares plans on cost, drugs and doctors, plus the Open Enrollment calendar for the dates that matter this fall.
Compare plans on cost, drugs and doctors with the cost calculator spreadsheet in The 2027 Medicare Open Enrollment Decision Kit.
AI-assisted research and drafting; reviewed by an editor.
