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Medicare Advantage in 2025: Enrollment Update and Key Trends

In 2025, more than half (54%) of eligible Medicare beneficiaries - 34.1 million out of about 62.8 million with both Medicare Parts A and B - are enrolled in Medicare Advantage plans. The Congressional Budget Office projects that the share will rise to 64% by 2034.

One in five (21%) Medicare Advantage enrollees is in a special needs plan (SNP), reflecting a steady increase in recent years. Overall, Medicare Advantage enrollment is highly concentrated among plans owned by a few firms.

Also: Medicare Advantage in 2025: Premiums, Out-of-Pocket Limits, Supplemental Benefits, and Prior Authorization

Medicare Advantage Enrollees Account for 25% of Inpatient Hospital Days

Most Medicare Advantage Markets are Dominated by One or Two Insurers

Medicare Advantage Quality Bonus Payments Will Total at Least $12.7 Billion in 2025

Medicare Advantage Insurers Made Nearly 50 Million Prior Authorization Determinations in 2023

New & Noteworthy

Health Provisions in the 2025 Federal Budget Reconciliation Law

On July 4, President Trump signed the budget reconciliation bill, previously known as the “One Big Beautiful Bill Act,” into law. This summary provides background, description, budgetary impact and related information on the health care provisions of the law in four categories: Medicaid, the Affordable Care Act, Medicare and Health Savings Accounts (HSAs).

Income and Assets of Medicare Beneficiaries in 2024

This brief examines the income, assets, and home equity of Medicare beneficiaries, overall and by age, race and ethnicity, and gender. Most Medicare beneficiaries live on relatively low incomes and have modest financial resources to draw upon if they need costly care or long-term services and supports.

State Profiles for Dual-Eligible Individuals

This data collection draws on Medicare and Medicaid administrative data to present national and state-level information on people who are covered by both Medicare and Medicaid, referred to as dual-eligible individuals (also known as dually-enrolled beneficiaries).

Medicare PArt D

The Uncertain Future of Medicare's Stand-Alone PDP Market and Why It Matters

This brief discusses the uncertain future of Medicare’s Part D stand-alone prescription drug plan (PDP) market, in light of declining PDP availability, rising premiums, and the unknown fate of a temporary demonstration program designed to stabilize the market more broadly. The uncertain future of the market is especially relevant for rural areas, where nearly 6 in 10 beneficiaries are enrolled in traditional Medicare and PDPs, and where there are fewer Medicare Advantage options.

A Current Snapshot of the Medicare Part D Prescription Drug Benefit

Stand-Alone Drug Plans Cover a Larger Share of Part D Enrollees Living in the Most Rural Areas Than Medicare Advantage Plans

Key Facts About Medicare Part D Enrollment, Premiums, and Cost Sharing in 2025

Changes to Medicare Part D in 2024 and 2025 Under the Inflation Reduction Act and How Enrollees Will Benefit

Prescription Drugs

The Effect of Delaying the Selection of Small Molecule Drugs for Medicare Drug Price Negotiation

Part of a recent executive order from President Trump directs the Secretary of HHS to work with Congress to implement a change in the Medicare Drug Price Negotiation Program to delay negotiation of so-called “small molecule” drugs beyond 7 years after FDA approval under current law. If that timeframe had already been in place, more than half of the Part D drugs that were selected for price negotiation in the first or second rounds – 13 out of 25 – would not have been eligible at the time drugs were selected.

FAQs About the IRA's Medicare Drug Price Negotiation Program

Allowing Medicare to Negotiate Drug Prices Is Broadly Popular

The Facts About the $35 Insulin Copay Cap in Medicare

Enrollees in Most Rural Areas Rely More on Stand-alone Part D Plans

Data Visualization

The Facts About Medicare Spending

This interactive provides the facts on Medicare spending. Medicare, which serves 67 million people and accounts for 12 percent of the federal budget and 21 percent of national health spending, is often the focus of discussions about health expenditures, health care affordability and the sustainability of federal health programs.

Explore data on enrollment growth, Medicare spending trends overall and per person, growth in Medicare spending relative to private insurance, spending on benefits and Medicare Advantage, Part A trust fund solvency challenges, and growth in out-of-pocket spending by beneficiaries.

Related: FAQs on Medicare Financing and Trust Fund Solvency

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  • What’s in There? The New Health Reform Law and Medicare

    Event Date:
    Event

    As part of an ongoing series to explore what is in the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010, this May 7 briefing sponsored by the Alliance for Health Reform and the Kaiser Family Foundation examines how the reform law affects Medicare.

  • Prescription Drug Trends Fact Sheet – May 2010 Update

    Fact Sheet

    This updated fact sheet provides trend information about prescription drug expenditures and coverage, key factors that contribute to rising prescription spending, and efforts to contain rising drug costs. May 2010 Fact Sheet (.

  • Tracking Medicare Health and Prescription Drug Plans Report—May 2010

    Report

    This brief presents current monthly data on Medicare Advantage plan participation, enrollment and penetration. It also summarizes recent activities by the Centers for Medicare and Medicaid Services (CMS), participating health plans, and the research community pertaining to the Medicare Advantage program and prescription drug plans that began serving the Medicare population in January 2006.

  • Explaining Health Reform: Key Changes in the Medicare Advantage Program

    Issue Brief

    This brief examines the changes in the 2010 health reform law affecting the Medicare Advantage program, which gives beneficiaries the option of enrolling in private insurance plans for their Medicare benefits, instead of the traditional fee-for-service program.

  • Summary of Key Changes to Medicare in 2010 Health Reform Law   

    Issue Brief

    Summary of Key Changes to Medicare in 2010 Health Reform Law . This brief provides a detailed look at the improvements in Medicare benefits, changes to payments for providers and Medicare Advantage plans, various demonstration projects and other Medicare provisions in the law. It includes a timeline of key dates for implementing the Medicare-related provisions in the law.

  • Pulling it Together: When Premiums Go Up 39%

    Perspective

    Our group that works on health care cost issues just updated an analysis that sheds light on what’s really happening to people in the individual health insurance market, the issue Secretary Sebelius, a former Kansas insurance commissioner, and others have put in the spotlight by calling on Anthem and other insurance companies to account for…