Why Stand-Alone Policies Often Outshine Medicare Advantage OSBs

Why Stand-Alone Policies Often Outshine Medicare Advantage OSBs

When clients start comparing Medicare Advantage (MA) plans, many are drawn in by the promise of “extra” perks—like dental, vision, or hearing coverage. These supplemental benefits can sound appealing, but agents know the story isn’t always that simple. Many 2026 Medicare Advantage plans include Preventative-Only or a small Comprehensive benefit, sometimes requiring the member to pay 50% coinsurance.  

Most of these plans have added Optional Supplemental Benefits (OSBs) which may include, for example, a dental rider that members can elect to enroll in at the time of their plan enrollment, for an additional monthly premium.  

While OSBs can provide some value, stand-alone benefit policies often deliver more comprehensive, consistent, and flexible coverage—making them a smarter long-term solution for many beneficiaries.

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What Are Medicare Advantage OSBs?

Optional Supplemental Benefits are extras that Medicare Advantage plans may include, typically for an additional cost. Examples include:

• Preventive dental services (cleanings, X-rays)
• Basic vision exams or eyeglasses
• Hearing aid allowances
• Gym memberships or transportation services

The catch? These benefits are plan-specific, can change every year, and often come with narrow provider networks.

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What Are Stand-Alone Policies?

Stand-alone dental, vision, or hearing plans are purchased separately from a beneficiary’s Medicare Advantage or Original Medicare. Unlike OSBs, they are independent policies, which means:

• They follow their own provider networks (often broader than MA plans).
• Coverage continues even if the client switches or drops their MA plan.
• Benefits are usually more detailed and robust.
• They pay commissions- unlike OSBs.

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Why Stand-Alone Policies Come Out Ahead

1. More Comprehensive Coverage

• ‍OSBs: Commonly cover just the basics—two cleanings, one exam, maybe a small allowance for additional care.
• ‍Stand-Alone: Provide higher annual maximums, cover major procedures like crowns or root canals, and often include additional preventive visits. Some plans may even include dental implant coverage.  
• For clients who may need anything beyond cleanings, stand-alone plans generally deliver much more value.

2. Greater Flexibility

• OSBs: Tied directly to the MA plan—if the client changes plans during AEP, their benefits will change too.
• Stand-Alone: Independent of Medicare Advantage. Clients keep their coverage even if they switch plans or return to Original Medicare.
• This stability is a big win for clients who don’t want to lose coverage year to year.

3. Broader Networks

• OSBs: Usually limited to in-network providers under the MA plan.
• Stand-Alone: Tend to have larger networks and in some cases, out-of-network coverage.
• Clients can keep their preferred dentist or eye doctor without worrying about losing access.

4. Cost vs. Value

• OSBs: May appear cheaper because some benefits are bundled into the MA plan. But limited coverage often means higher out-of-pocket costs for services not included.
• Stand-Alone: Require a separate premium, but the broader coverage usually offsets the cost—especially for clients anticipating major care needs.
• Stand-alone plans protect clients from unexpected, high bills down the road.

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A Real-World Example: Dental Coverage

• MA Dental OSB: Covers two cleanings and one set of X-rays per year with a $1,000 annual cap. Major services like crowns, root canals, or dentures may not be included—or may only be partially covered.
• Stand-Alone Dental Plan: Covers preventive and major services, with higher annual maximums ($1,500–$3,000+). Clients can plan with more certainty, knowing larger dental needs won’t wipe out their coverage.
• For a client needing major dental work, the stand-alone policy is clearly the better option.

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How Agents Can Position This With Clients

When walking clients through their options, frame the discussion around predictability and protection. OSBs may be fine for light, preventive coverage—but if clients want peace of mind and flexibility, stand-alone plans are almost always the safer choice.

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Bottom Line

While Medicare Advantage OSBs can add a little convenience, they often fall short when clients need them most. Stand-alone policies, on the other hand, provide more comprehensive coverage, better provider choice, and long-term stability—benefits that matter when unexpected health needs arise.

For agents, helping clients see beyond the “included extras” of MA plans and understand the real advantages of stand-alone coverage can strengthen trust and ensure beneficiaries get the protection they truly need.

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