It's really hard to know how much a MOV has been used up, and whether it will protect from a future surge event. You can see whether it is absorbing voltage spikes with a power quality meter, but most people don't have those.
In the US, you should have a solid neutral-earth bond at the distribution panel, so the MOV between live and neutral provides (indirect) lightning protection. They do not protect from direct lightning strikes. The voltage rating of the MOVs are also commonly too low: because they are most effective if they are large in size and as close as possible to the power entry, the correct approach is to have a single large MOV at the distribution panel main fuse, which is rated to absorb all power spikes. The small MOVs in power strips should be a higher voltage rating so they only absorb spikes or surges if the previous MOV has failed. Most computer power supplies have MOVs internally, which are the absolute last ditch protection and should have the highest voltage rating of all.
It used to be that MOV based surge protectors had significant safety issues, and
many of them were in fact recalled for this. The problem is that when the MOVs were damaged by surges, they could go low impedance and begin to heat up, which eventually ignited the circuit board and wire insulation. The way these surge protectors
should have been designed is with thermal fuses directly in contact with the MOVs, to break the circuit in case of overheating. The protection offered by a series suppressor is simpler, doesn't wear out, and isn't subject to overheating.