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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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  • What Are the Implications for Medicare of the American Health Care Act and the Better Care Reconciliation Act?

    Issue Brief

    This issue brief highlights a major implication of the American Health Care Act and Better Care Reconciliation Act for Medicare. Both bills would repeal the Affordable Care Act provision to increase the payroll tax on high-income earners. Repealing this surtax would move up the insolvency date of the Medicare Part A trust fund by 2 years, from 2028 to 2026, and also worsens the program's long-term financial outlook.

  • 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.

  • Transitions 2005

    Video

    Transitions is a video that explores some of the issues and challenges “dual eligibles” may face during the transition from Medicaid drug coverage to Medicare.

  • Nursing Home Reform: Then and Now

    Video

    To mark the 20th anniversary of the passage of landmark federal legislation to improve the quality of nursing home care, the Omnibus Budget Reconciliation Act of 1987 (known as OBRA 87), this video examines the history surrounding the law. The video includes a look at the state of nursing home care before the law, an overview of the legislative process that brought about the law, and recent developments in nursing home quality. The video features historical clips and new interviews of key individuals from government, the nursing home industry, and consumer advocates who were instrumental in the historical developments related to nursing home reform.

  • 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.