The Medicare annual enrollment period has begun, marked by significant changes in the Medicare Advantage market.
Among these changes are increased government scrutiny, tighter CMS regulations, reduced base payments, and rising healthcare costs among older adults.
In response to these market shifts, many MA carriers are prioritizing their margins over membership by reducing certain benefits and exiting unprofitable markets. As margins tighten and negotiations with providers become more strained, some providers are choosing to no longer accept some or all MA plans.
10 key notes about the annual enrollment period:
1. Medicare annual enrollment runs from Oct. 15 to Dec. 7., when beneficiaries can review and make changes to their Medicare Advantage (Part C) and prescription drug (Part D) plans for 2025 coverage.
2. CMS projects 35.7 million people will enroll in Medicare Advantage in 2025, accounting for more than half of the Medicare population.
3. Major insurers have launched their Medicare product portfolios for 2025, offering older adults many new plan options, especially those with special needs.
4. MA plans are tasked with educating members about the significant changes coming to the program, and they also have to find a way to break through the noise of an election year.
5. While MA plan offerings are shrinking in around half of states, options will stay the same or grow in the other half. In 22 states and Washington, D.C., there will be fewer Medicare Advantage plans available in 2025, with Pennsylvania seeing the largest number of plan exits.
6. At least 10 insurers exited MA markets for 2025 coverage.
7. Nearly 30 health systems dropped some MA contracts for 2025.
8. The average Medicare Advantage monthly premium in 2025 will be $17, down from $18.23 in 2024. The average total Part D premium decreased to $46.50. Average MA premiums range from $2.44 in Nevada to $62.25 in Minnesota.
9. The average Medicare Advantage star rating declined for the third year, decreasing from 4.07 in 2024 to 3.92 in 2025. Seven MA plans earned a 5-star rating, and 24 plans received ratings below 3-stars. Click here to see how the largest MA carriers rank on average star ratings.
10. There are major changes taking effect for Part D coverage in 2025, including a $2,000 annual cap on out-of-pocket drug costs for enrollees and elimination of the "coverage gap," meaning beneficiaries once will no longer face a coverage gap once they hit the out-of-pocket spending cap. More details on changes to 2025 Part D benefits are here.