Top stats on Medicare Advantage enrollment, costs in 2025

KFF recently released two analyses on Medicare Advantage enrollment in 2025, as well as this year's premiums, out-of-pocket limits, supplemental benefits and prior authorization requirements. The first analysis identified trends in MA enrollment, which now covers most eligible Medicare beneficiaries. The second analysis covered MA premiums, out-of-pocket limits, supplemental benefits and prior authorization requirements in 2025. The MA program -- also known as Medicare Part C -- is administered by private payers and offers beneficiaries plans that cover Parts A, B and D, usually with lower out-of-pocket costs. However, growth in MA enrollment over the past couple of years has triggered scrutiny. Higher enrollment has implications for federal spending, especially since Medicare payments to private payers for administering MA plans tend to be higher than spending on Traditional Medicare beneficiaries, KFF explained. 54% of Medicare beneficiaries enrolled in MA KFF reported that 34.1 million out of about 62.8 million eligible Medicare beneficiaries are enrolled in an MA plan in 2025. That means over half of eligible beneficiaries (54%) belong to an MA plan. Since 2007, MA enrollment has steadily increased, according to KFF data. But 2023 was the first time over half of eligible beneficiaries were enrolled in the program. Since then, MA enrollment has continued to grow by over 50% of eligible Medicare beneficiaries. However, MA enrollment notably slowed in 2025 compared to the previous year. This year, enrollment grew by just 1.3 million beneficiaries, or by 4%. In 2024, MA enrollment increased by 7%. Enrollment in special needs plans accelerated Nearly half of the total increase in MA enrollment between 2024 and 2025 was among special needs plans, or SNPs, KFF found. Beneficiaries can enroll in an SNP if they have significant or specialized care needs or who may qualify because they are dually eligible for Medicare and Medicaid. In 2025, about one in five MA enrollees were enrolled in an SNP, representing nearly 7.3 million Medicare beneficiaries. MA enrollment in SNPs has steadily increased since 2010, KFF reported. However, SNP enrollment has accelerated over the past couple of years, consistent with the increasing number of SNPs available and enhanced access to SNPs among dual eligibles. About 83% of SNP enrollees are in plans designed for dual eligibles, or D-SNPs. Most MA enrollees in plans with supplemental benefits Nearly all MA enrollees were in a plan that offered supplemental benefits beyond what Traditional Medicare covers. The KFF analysis showed that, in 2025: 99% of MA enrollees had benefits for eye exams and/or glasses. 98% of MA enrollees had benefits for dental care. 95% of MA enrollees had benefits for hearing exams and/or aids. 94% of MA enrollees had a fitness benefit. Most enrollees in SNPs also had access to these benefits, KFF added. Although SNP enrollees had greater access to transportation (80% versus 28% of other MA enrollees), meal benefits (82% versus 70%, bathroom safety devices (68% versus 32%, over-the-counter benefits (97% versus 79%) and in-home support services (11% versus 7%). UnitedHealth dominates MA enrollment MA enrollment is highly concentrated among plans owned by a select group of parent organizations. KFF found that UnitedHealth Group Inc. and Humana alone accounted for almost half of all MA enrollees in the U.S. in 2025. Specifically, UnitedHealth accounted for 29%, or 9.9 million enrollees, and Humana accounted for 17%, or 5.7 million enrollees. Other top payers by MA enrollment included CVS Health Corporation with 4.1 million enrollees, Elevance Health Inc. with 2.2 million enrollees and Kaiser Health Foundation Health Plan Inc. with 2.0 million enrollees. KFF also noted that UnitedHealth has consistently accounted for a relatively large share of MA enrollment and enrollment growth since 2010, when it accounted for 18% of all MA enrollment. 76% of MA enrollees in plans with no premium In 2025, over three-quarters of MA enrollees in plans with prescription drug coverage (MA-PDs) had no premiums other than for Part B, KFF reported. What's more, 96% of MA enrollees in individual plans that are open for general enrollment (about 62% of all MA enrollees) are in MA-PDs. For MA enrollees who pay a premium, the average premium in 2025 was $13 per month. This includes those who do not pay a premium, KFF explained. For those with just the Part D portion covered benefits, the average premium was $7 per month, significantly lower than the $39 for stand-alone prescription drug plans. Average MA-PD premiums have substantially dropped since 2015, when it cost $36 per month, according to the KFF analysis. Out-of-pocket limit $5,320 for in-network services The out-of-pocket limits in 2025 were well below the federally regulated caps of $9,350 for in-network services and $14,000 for in-network and out-of-network services combined, KFF found. In 2025, the out-of-pocket limit for in-network services averaged $5,320. The average for both in- and out-of-network services combined was $9,547. These averages were weighted for MA enrollment, KFF stated. The average out-of-pocket limit for in-network services has generally decreased since 2017, when the average was $5,297, despite a small increase between 2024 and 2025. KFF also reported that the average combined in- and out-of-network limit increased slightly from $8,707. The MA program continues to show strong growth as enrollment remains robust and costs remain relatively low. However, the program is anticipating changes in 2026 related to prescription drug coverage, the Medicare Prescription Payment Plan, D-SNPs, Star Ratings and other areas, including the Medicare Drug Price Negotiation Program. CMS finalized these changes in a rule released in April. Jacqueline LaPointe is a graduate of Brandeis University and King's College London. She has been writing about healthcare finance and revenue cycle management since 2016.