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Medicare Advantage

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

Most Medicare Advantage Markets are Dominated by One or Two Insurers

10 Reasons Why Medicare Advantage Enrollment is Growing

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
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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  • Medicare and Medicaid for the Elderly and Disabled Poor

    Fact Sheet

    This fact sheet provides an overview of the role of Medicare and Medicaid in serving these beneficiaries, describes the health status of dual Medicare/Medicaid beneficiaries, and discusses issues of managed care and access to care.This fact sheet is a summary of a longer Background Paper (#2132), which is also available.

  • Medicaid Managed Care for Persons With Disabilities: State Profiles-2114

    Report

    Medicaid Managed Care for Persons With Disabilities: State Profiles This report provides state estimates of the number of Medicaid disabled enrolled in managed care and profiles these programs. It provides detailed comparative state information on enrollment, program features, rate setting, quality issues, and special enrollment features for the disabled in Medicaid managed care.

  • Medicaid and Long Term Care

    Issue Brief

    This policy brief reviews Medicaid's role as the nation's primary source of coverage for long-term care services and examines the implications of recent legislative efforts to restructure the Medicaid program for those in need of care in nursing homes, intermediate-care facilities for the mentally retarded, and home- and community-based settings.

  • Medicaid and the Elderly

    Issue Brief

    This policy brief explains the Medicaid's program's relationship to the elderly and provides information on beneficiaries and expenditures. Also discussed is Medicaid coverage of long-term care and nursing home care for the elderly.

  • Medicare Beneficiaries: A Population At Risk – Findings from the Kaiser/Commonwealth 1997 Survey of Medicare Beneficiaries – Report

    Report

    Medicare Beneficiaries: A Population at RiskFindings from the Kaiser/Commonwealth Fund 1997 Survey of Medicare Beneficiaries Cathy Schoen, Patricia Neuman, Michelle Kitchman, Karen Davis, and Diane RowlandDecember 1998 Table Of ContentsExecutive Summary Findings from the Kaiser/Commonwealth 1997 Survey of Medicare Beneficiaries Medicare Beneficiaries: Health Status and Income Health Insurance Coverage Satisfaction, Access, and Financial Burden: Variations…

  • Medicare Provisions of the House and Senate Budget Bills

    Report

    A side-by-side comparison of H.R. 2491, the Seven Year Balanced Budget Reconciliation Act of 1995, and S. 1357 Balanced Budget Reconciliation Act of 1995. Report: Medicare Provisions Of The House And Senate Budget Bills: A Side-by-Side Comparison...

  • Disability, Health Coverage, and Welfare Reform

    Report

    This report analyzes data from a survey of 42 low-income families with children with moderate or severe disabilities to better understand the impact of welfare reform on health coverage for these families.