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In this cross sectional study of 56,155 older adults enrolled in Medicare Advantage, we examined the extent to which self-reported health related social needs (HRSNs) are associated with acute care utilization among older adults enrolled in Medicare Advantage, and and which specific HRSNs seem to matter most. We found that HRSNs were associated with statistically significantly higher rates of acute care utilization, with the largest association observed for avoidable hospital stays (53.3% increase). Unreliable transportation had the largest association with hospital stays and emergency department visits (marginal effects of 51.2 and 95.5 events per 1000 beneficiaries, respectively). Overall, among older adults enrolled in Medicare Advantage, self-reported HRSNs are associated with increased rates of acute care utilization.