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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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  • Health Reform Implementation Timeline

    Interactive

    The health reform implementation timeline is an interactive tool designed to explain how and when the provisions of the Affordable Care Act will be implemented over the next several years.

  • Medicare Quiz

    Feature

    Take this quiz to find out how much you know about Medicare, the people it serves, the benefits it covers, and its financial status.

  • Medicare and Medicaid at 40

    Video

    The Medicare and Medicaid health coverage programs were signed into law July 30, 1965. The Kaiser Family Foundation has some new resources that examine how Medicare and Medicaid came into existence and how they have evolved over the past 40 years. You will find new documentaries and extended interviews with key policymakers and government officials examining the origins of Medicare and Medicaid, new interactive historical timelines, a chart pack of key information and statistics, a webcast of a retrospective of the two programs with historian Robert Dallek and key government officials responsible for the programs over the past 40 years, and many other background resources on the two programs.

  • 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.

  • What’s Trending in Health Care? Conservative Ideas

    From Drew Altman

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman cuts through the political debate and reviews how some ideas conservatives like are taking hold in the American health system.

  • How Much Is Enough? Out-of-Pocket Spending Among Medicare Beneficiaries: A Chartbook

    Report

    This new analysis and chartbook examines out-of-pocket spending among Medicare beneficiaries, including spending on health and long-term care services and insurance premiums, using the most current year of data available from a nationally representative survey of people on Medicare. It explores which types of services account for a relatively large share of out-of-pocket spending, which groups of beneficiaries (including by age, gender, health status, and chronic conditions) are especially hard hit by high out-of-pocket costs, and trends in out-of-pocket spending between 2000 and 2010.

  • Standard Medicare Prescription Drug Benefit, 2013

    Feature

    Standard Medicare Prescription Drug Benefit, 2013 Download Source Kaiser Family Foundation illustration based on CMS standard benefit parameter update for 2013.  Amounts rounded to nearest dollar.

  • Solvency Projections of the Medicare Part A Trust Fund, 1970-2013

    Feature

    Solvency Projections of the Medicare Part A Trust Fund, 1970-2013 Download Source Intermediate projections from 1970-2013 Annual Reports of the Boards of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds.