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This brief provides information about Medicare Advantage plans in 2025, including premiums, out-of-pocket limits, supplemental benefits, and prior authorization, as well as trends over time.
Following a pledge by insurance companies to reduce the burden of prior authorizations, KFF's Health Tracking Poll examines the publics experience with the process. The poll finds that most view insurers' delays and denials as a problem, and few are aware of the newly announced pledge.
Higher market concentration in Medicare Advantage insurance markets may lower the incentive for insurers to compete for potential enrollees by making plans more appealing through more comprehensive benefits or lower costs.
Federal spending on the Medicare Advantage quality bonus program has more than quadrupled since 2015, rising to at least $12.7 billion in 2025. Most Medicare Advantage enrollees are in a plan that receives a bonus payment in 2025, with employer- and union-sponsored plans receiving the highest bonus payments and special needs plans receiving the lowest bonus payments, on average.
For 2023, the average Medicare beneficiary has access to 43 Medicare Advantage plans and can choose from plans offered by nine firms. Among the majority of Medicare Advantage plans that cover prescription drugs, 66 percent will charge no premium in addition to the monthly Medicare Part B premium. As in previous years, the vast majority of Medicare Advantage plans will offer supplemental benefits, including fitness, dental, vision, and hearing benefits. In addition, virtually all will also offer telehealth benefits in 2023.
During the Medicare open enrollment period for 2020, Medicare beneficiaries had an average of 24 Medicare Advantage prescription drug plans and 28 stand-alone Part D prescription drug plans to choose from for their coverage. Despite having so many Medicare options, relatively few Medicare private plan enrollees opted to switch their coverage.
Medicare Advantage enrollment is lower, but has grown more rapidly in recent years in rural areas than in metropolitan areas. In 2023, nearly 40% of eligible Medicare beneficiaries in rural areas are in Medicare Advantage. Rural Medicare beneficiaries can choose from 27 Medicare Advantage plans on average and most are enrolled in a plan that charges no additional premium.
To capture the state of television marketing activities and consider the implications for people with Medicare, KFF analyzed ad data compiled by the Wesleyan Media Project, that were obtained from Vivvix (formerly Kantar) CMAG, a data analytics and consulting firm, and were coded by the Wesleyan Media Project in collaboration with KFF. The data set included all English-language TV ads that aired across national and local markets on broadcast television or national cable, from October 1st, 2022, through December 7th, 2022, the period that includes the Medicare open enrollment period for coverage in 2023.
To capture Medicare beneficiaries’ views and experiences in choosing between traditional Medicare and private plans, and among private plans, and the factors that influence these decisions, KFF worked with PerryUndem to conduct focus groups with Medicare beneficiaries in the Fall of 2022, during the annual Medicare open enrollment period. This report summarizes first-hand accounts of participants’ reactions open enrollment advertising and factors that influence their decision-making around Medicare plan choice.
Recently released data show that Medicare Advantage, the private plan alternative to traditional Medicare, now covers half of eligible Medicare beneficiaries. As the role of Medicare Advantage grows, so will interest in understanding how well the program serves the increasingly diverse group of enrollees who receive their Medicare coverage from private insurers.
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