AISmartBids Launches Tool to Activate Medicare Benefits
One & Done Smart Bids (AISmartBids), a HealthTech firm based in New York, is gearing up to launch a new benefit utilization activation engine at the end of June. This innovative tool is designed to tackle the underutilization of Medicare supplemental benefits by alerting members to their unused entitlements and connecting them with local healthcare providers.
In recent years, the Centers for Medicare & Medicaid Services (CMS) endeavored to mandate Medicare Advantage carriers to inform members about their unused benefits. Initially finalized in 2024, this regulation faced implementation challenges at scale and was rescinded in 2026. Despite carriers receiving $86 billion annually for supplemental benefits, many beneficiaries remain unaware of their full entitlements. Reports reveal over half of enrollees do not utilize dental or vision benefits, with hearing benefits seeing even lower utilization rates.
AISmartBids currently offers a platform that delivers personalized pricing based on real health records for Medicare beneficiaries. By translating these records into comprehensive plan costs, including supplements like dental and vision, the platform ensures accurate cost representation. Leveraging integration with Medicare Blue Button 2.0 and real-time clinical data, the platform provides insights that standard claims data cannot match.
The upcoming benefit activation engine will enhance these offerings further by identifying unused benefits members are entitled to. The system will deliver personalized notifications, recommending specific services and highlighting nearby participating providers. This advancement aims to bridge the awareness gap, motivating members to utilize their available benefits.
For Medicare Advantage carriers, this initiative offers a strategic opportunity to improve Medical Loss Ratios through the promotion of preventive care, potentially reducing hospital visits due to conditions that preventive measures could avert. Enhancing member engagement may also support better member retention. AISmartBids is seeking a carrier partner to co-develop the outcomes framework and publicize results.
Current data from AISmartBids reveals that nearly 90.6% of Medicare enrollees might not be on their optimal plan, causing an average annual overspend of $3,193 due to plan misalignment. Use of the platform has been linked with a 77% increase in agent revenue per client and significant improvements in client retention rates, ranging from 84% to 95%.
Founded in 2023, One & Done Smart Bids positions itself as a key player in consumer-controlled commerce within regulated markets, serving seniors, Medicare agents, and enterprise call centers. More information is available on their website. For inquiries, contact Matt Ingalls at One & Done Smart Bids or visit their LinkedIn page.