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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
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-for-All vs. Single Payer: The Impact of Labels

    News Release

    In his latest column for The Wall Street Journal’s Think Tank, “Medicare-for-All vs. Single Payer: The Impact of Labels”, Drew Altman uses new polling on a Medicare-for-all or single payer health system to explain how what you call a health reform plan can substantially affect the public’s response. All previous Drew Altman columns are online.

  • An Overview of Medicare

    Issue Brief

    This issue brief provides an overview of Medicare, the health insurance program for people ages 65 and over and younger people with long-term disabilities. The brief review the characteristics of people on Medicare, what Medicare covers, benefit gaps and supplemental coverage, beneficiaries' out-of-pocket health care spending, program spending and financing, payment and delivery system reform, and issues for the future of Medicare.

  • Visualizing Health Policy: Recent Trends in Prescription Drug Costs

    News Release

    This Visualizing Health Policy infographic spotlights national spending on prescription drugs and the public’s views on pharmaceutical prices. Prescription drug spending rose sharply in 2014, driven by growth in expenditures on specialty drugs, including medications to treat cancer and hepatitis C.

  • Drilling Down on Dental Coverage and Costs for Medicare Beneficiaries

    Issue Brief

    Medicare does not cover routine dental care and the majority of Medicare beneficiaries do not have dental coverage. Some beneficiaries have dental coverage through other sources, including Medicare Advantage, Medicaid, and private plans, but almost half of all beneficiaries have not been to the dentist in the past year and many older adults face high out-of-pocket costs for needed dental care. The brief reviews the state of oral health for people on Medicare, describing the consequences of foregoing dental care, current sources of dental insurance, use of dental services, and beneficiaries’ out-of-pocket spending.

  • JAMA Forum: Medicare-For-All or Medicare-For-More?

    Perspective

    In this May 2019 post for The JAMA forum, Larry Levitt examines how the early discussion and positioning among the presidential candidates offers a glimpse into how a debate about Medicare-for-all might play out.

  • What Percent of New Medicare Beneficiaries Are Enrolling in Medicare Advantage?

    Issue Brief

    The analysis examines enrollment in Medicare Advantage plans during beneficiaries’ first year on Medicare and finds that less than one-third or 29% enrolled in these private health plans, including HMOs or PPOs. The majority of people new to Medicare are choosing traditional Medicare in the year they first go on Medicare. The study looks at how these findings vary across age, Medicaid status, states, and counties.

  • 10 Things to Know About Medicare Part D Coverage and Costs in 2019

    Issue Brief

    The Medicare Part D program provides an outpatient prescription drug benefit to older adults and people with long-term disabilities in Medicare who enroll in private plans. This analysis provides the latest data about Medicare Part D coverage and costs in 2019 and trends over time, including enrollment, premiums, cost sharing, and participation in the low-income subsidy program.