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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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  • Visualizing Health Policy: The Role of Medicare Advantage

    Other

    This September 2014 Visualizing Health Policy Infographic examines the role of private plans, such as HMOs and PPOs, in Medicare. These Medicare Advantage plans offer an alternative to traditional Medicare and provide all benefits covered under Medicare Parts A and B, and often Part D. The infographic includes data on Medicare Advantage penetration across the country. It shows the concentration of enrollment among a small number of firms and affiliates, and displays the extent to which Medicare pays more for Medicare Advantage enrollees than for beneficiaries in fee for service Medicare, on average, and that the payment differential is declining

  • The Rising Cost of Living Longer: Analysis of Medicare Spending by Age for Beneficiaries in Traditional Medicare

    Report

    This analysis provides a detailed look at per person Medicare spending on the nearly 30 million beneficiaries over age 65 who are enrolled in the traditional Medicare program. Among the key findings of the report is that per person spending rises with age, peaking at age 96. But this rise is not entirely explained by Medicare spending on end of life care, which declines with age. What Medicare spends money on also changes as beneficiaries age. Hospital care is the largest component of Medicare spending throughout the age curve, up to age 100, but there is less spending on physician services and more on home health, skilled nursing and hospice care as beneficiaries age.

  • One Year into Duals Demo Enrollment: Early Expectations Meet Reality

    Perspective

    One year into initial enrollment in the Medicare-Medicaid financial alignment demonstrations for dual eligible beneficiaries, some initial insights are beginning to emerge. This policy insight highlights key challenges and trends emerging in states’ demonstrations.

  • The Medicare Part D Coverage Gap: Costs and Consequences in 2007

    Report

    This study quantifies the number of Medicare Part D plan enrollees in 2007 who reached a gap in their prescription drug coverage known as the “doughnut hole,” as well as the changes in beneficiaries’ use of medications and out-of-pocket spending after they reached that gap.

  • Drew Altman: 3 Takeaways From the Medicare Trustees Report

    News Release

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman dives into this week’s release of the Social Security and Medicare Trustees Report to discuss the good news that may have been missed. All previous columns by Drew Altman are available online.

  • 3 Takeaways From the Medicare Trustees Report

    From Drew Altman

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman dives into this week’s release of the Social Security and Medicare Trustees Report to discuss the good news that may have been missed.

  • Medicare Part D in Its Ninth Year: The 2014 Marketplace and Key Trends, 2006-2014

    Report

    This report presents findings from an analysis of the Medicare Part D marketplace in 2014 and changes in features of the drug benefit offered by Part D plans since 2006. It examines the latest information and trends related to Part D enrollment and plan availability, premiums, benefit design and cost sharing, pharmacy networks, the Low-Income Subsidy Program, and plan performance ratings.