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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

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 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...

  • Medicaid and the Elderly

    Other Post

    Long-Term Care Spending In 1993, Medicaid spent $25.5 billion for long-term care services for elderly beneficiaries (Figure 5). This represents 58 percent of the $44 billion Medicaid spent on long-term care services for all population groups. The majority of spending was for care delivered in nursing facilities (84 percent) and ICFs-MR (2 percent).

  • Medicaid and the Elderly – Policy Brief

    Issue Brief

    Medicaid and the Elderly September 1995 Medicaid is a crucial health financing program for the elderly population, providing assistance to over 1 in 10 Americans age 65 or older. Nearly four million elderly people receive Medicaid assistance with medical and long-term care expenses.

  • 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.

  • Medical Savings Accounts for Medicare Beneficiaries

    Report

    This report provides an analysis of key issues in the design and implementation of medical savings accounts for the Medicare population. It focuses on benefit design, eligibility, enrollment, risk selection and adjustment, and the effects of managed care.

  • National Survey of Public Knowledge of the Medicare Program and Public Support for Medicare Policy Proposals

    Other Post

    New Survey finds most Americans oppose slowing the growth of Medicare to balance the budget or cut taxes, but would support changes to avoid bankruptcy Embargoed for release until: 9:30 AM EST Thursday, June 29, 1995 Contacts: Matt James Tina Hoff (415) 854-9400 --Public Favors Incremental Rather than Sweeping Reforms-- --Significant Generational Differences on Medicare…

  • Analysis of Focus Groups Concerning Managed Care and Medicare

    Report

    A report and press release summarizing the findings of 14 focus groups held in eight cities nationwide to explore the attitudes and experiences of Medicare beneficiaries in managed care programs, particularly health maintenance organizations (HMOs), and those with traditional fee-for-service coverage, as well as pre-Medicare beneficiaries aged 60-65.

  • Medicare: Holes in the Safety Net

    Other Post

    Medicare: Holes in the Safety Net This report discusses findings from focus groups that consisted of those individuals who interact with the Medicare program, including beneficiaries, health professionals, caretakers, and program management staff.