{"id":34069,"date":"2025-03-11T13:00:26","date_gmt":"2025-03-11T17:00:26","guid":{"rendered":"https:\/\/avalere.com\/?p=34069"},"modified":"2025-03-11T14:43:40","modified_gmt":"2025-03-11T18:43:40","slug":"ma-and-part-d-enrollment-growth-slows-in-2025","status":"publish","type":"post","link":"https:\/\/advisory.avalerehealth.com\/insights\/ma-and-part-d-enrollment-growth-slows-in-2025","title":{"rendered":"MA and Part D Enrollment Growth Slows in 2025"},"content":{"rendered":"

Background<\/span><\/b>\u00a0<\/span><\/p>\n

During the Medicare Open Enrollment Period, which runs from October 15 to December 7, Medicare beneficiaries can choose their Part D or Medicare Advantage (MA) plans. Medicare beneficiaries decide whether to enroll in fee-for-service (FFS) with a standalone Prescription Drug Plan (PDP) or in an MA plan. Enrollment decisions take effect at the start of the plan year on January 1.\u00a0<\/span>\u00a0<\/span><\/p>\n

There are several types of PDP and MA plan options. Although some MA plans only cover Part A and B benefits, most MA plans include drug coverage. These plans are known as Medicare Advantage Prescription Drug Plans (MA-PDs). While many plans allow general enrollment by all Medicare beneficiaries, some limit coverage to specific types of beneficiaries. For example, MA-PD Special Needs Plans (SNPs) limit enrollment to beneficiaries with certain chronic conditions (C-SNPs), those who are dually eligible for both Medicare and Medicaid (D-SNPs), or beneficiaries who need long-term or other institutional care (I-SNPs). Other PDP and MA plans, known as Employer Group Waiver Plans (EGWPs), are offered to retirees by certain employers or associations.\u00a0\u00a0\u00a0<\/span>\u00a0<\/span><\/p>\n

In late February, the Centers for Medicare and Medicaid Services (CMS) released the February 2025 MA and Part D <\/span>Enrollment <\/span>data<\/span><\/a>. These data provide insight into enrollment decisions by beneficiaries in 2025 and indicate how MA and Part D enrollment is shifting in the first year of Part D benefit redesign implementation under the <\/span>Inflation Reduction Act<\/span><\/a> (IRA).<\/span>\u00a0<\/span><\/p>\n

Part D Enrollment by Plan Type<\/span><\/b>\u00a0<\/span><\/p>\n

The share of enrollees in both PDPs and MA-PDs has remained relatively stable from 2024 (Figure 1).\u00a0<\/span>\u00a0<\/span><\/p>\n

Figure 1. Part D Enrollment by Plan Type, in Millions, 2021\u20132025<\/span><\/b>\u00a0<\/span><\/p>\n

\"\"<\/p>\n

From 2024 to 2025, enrollment in PDPs grew by 1.5% and enrollment in MA-PDs grew by about 4% (Figure 2). While PDP enrollment continues to reflect a trend of slower growth in recent years, the MA-PD enrollment growth in 2025 was more moderate compared to previous years (7% from 2023 to 2024 and over 9% from 2021 to 2022 and 2022 to 2023).\u00a0<\/span>\u00a0<\/span><\/p>\n

Total enrollment in Medicare, encompassing both FFS and MA, has been steadily increasing at roughly 2% annually since 2020 according to the <\/span>2024 <\/span>Medicare Trustees\u2019 Report<\/span><\/a>. While MA-PD enrollment slowed considerably in 2025, MA-PD enrollment continues to outpace the growth in overall Medicare enrollment.\u00a0<\/span>\u00a0<\/span><\/p>\n

Figure 2. Annual Change in MA-PD and PDP Enrollment, 2022\u20132025<\/span><\/b>\u00a0<\/span><\/p>\n

\"\"<\/span><\/p>\n

Enrollment in PDPs varies by geography (Figure 3). Rural states continue to have a higher proportion of enrollment in PDPs, potentially due to provider networking constraints that impact MA-PD availability. PDPs are also more prevalent in areas where there is a significant population of retirees who receive medical coverage through programs such as Federal Employee Health Benefits.<\/span>\u00a0<\/span><\/p>\n

Figure 3. Proportion PDP Enrollment by State, as a Percentage of Total Part D Enrollment, 2025<\/span><\/b>\u00a0<\/span><\/p>\n

\"\"<\/p>\n

Part D Enrollment by Plan Sponsor<\/span><\/b>\u00a0<\/span><\/p>\n

Part D enrollment continues to be concentrated among national health plans. In 2025, 73% of Part D enrollment is in one of the five largest Part D plans. Among these plans, Centene had the largest increase in enrollment, growing by 19% across both PDP and MA-PD, while CVS had the largest decrease in enrollment, declining by 9% across both PDP and MA-PD.<\/span>\u00a0<\/span><\/p>\n

Medicare Advantage Enrollment by Plan Type<\/span><\/b>\u00a0<\/span><\/p>\n

In 2025, 62% of MA enrollees are in a general enrollment MA plan, 21% are in a SNP, and 17% are in an EGWP. While enrollment in general and employer MA plans grew modestly from 2024 to 2025 (by 1% and 3%, respectively), enrollment in SNPs continues to grow by double digits, fueled primarily by growth in C-SNP enrollment. Enrollment in C-SNPs grew by 67% from 2024 to 2025. C-SNPs now comprise 15% of all SNP enrollees, a five percentage point increase from 2024 (Figure 4). C-SNP offerings increased by 22% from 2024 to 2025. This broader availability of C-SNPs offerings may have influenced enrollment.\u00a0<\/span>\u00a0<\/span><\/p>\n

Figure 4. Enrollment by SNP Type, 2021-2025<\/span><\/b>\u00a0<\/span><\/p>\n

\"\"<\/p>\n

Medicare Advantage Enrollment by Parent Organization<\/span><\/b>\u00a0<\/span><\/p>\n

Enrollment in MA is concentrated among several national health plans. In 2025, 70% of MA enrollment is in one of the five largest MA plans. Among these plans, Elevance had the largest increase in enrollment, growing by 14% across all MA plan types (including MA-PDs), while Humana had the largest decrease in enrollment, declining by 4% across all MA plan types.<\/span>\u00a0<\/span><\/p>\n

Enrollment Shifts Under the IRA<\/span><\/b>\u00a0<\/span><\/p>\n

In the first year of IRA implementation, enrollment shifts from PDPs into MA-PDs were moderate, despite a 26% reduction in the number of PDPs offered in 2025 relative to 2024. While many factors influence beneficiary enrollment decisions, the Part D premium stabilization demonstration, which limited enrollee PDP monthly premium increases to no more than $35, may have contributed to more moderate enrollment shifts into MA-PDs.<\/span>\u00a0<\/span><\/p>\n

To learn more about how MA and Part D enrollment shifts under the IRA may impact your organization, <\/span>connect with us<\/span><\/a>.\u00a0<\/span>\u00a0<\/span><\/p>\n

Methodology<\/span><\/b>\u00a0<\/span><\/p>\n

Avalere used MA and Part D enrollment data released in February 2025 by CMS to conduct this analysis. The analysis includes territories and employer plans.\u00a0<\/span>\u00a0<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

Background\u00a0 During the Medicare Open Enrollment Period, which runs from October 15 to December 7, Medicare beneficiaries can choose their Part D or Medicare Advantage (MA) plans. Medicare beneficiaries decide whether to enroll in fee-for-service (FFS) with a standalone Prescription Drug Plan (PDP) or in an MA plan. Enrollment decisions take effect at the start…<\/p>\n","protected":false},"author":28,"featured_media":32741,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[3],"tags":[],"content-categories":[259],"class_list":["post-34069","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-insights","content-categories-policy","entry","has-media"],"acf":[],"yoast_head":"\nMA and Part D Enrollment Growth Slows in 2025 | Avalere Health Advisory<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/advisory.avalerehealth.com\/insights\/ma-and-part-d-enrollment-growth-slows-in-2025\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"MA and Part D Enrollment Growth Slows in 2025 | Avalere Health Advisory\" \/>\n<meta property=\"og:description\" content=\"Background\u00a0 During the Medicare Open Enrollment Period, which runs from October 15 to December 7, Medicare beneficiaries can choose their Part D or Medicare Advantage (MA) plans. Medicare beneficiaries decide whether to enroll in fee-for-service (FFS) with a standalone Prescription Drug Plan (PDP) or in an MA plan. Enrollment decisions take effect at the start…\" \/>\n<meta property=\"og:url\" content=\"https:\/\/advisory.avalerehealth.com\/insights\/ma-and-part-d-enrollment-growth-slows-in-2025\" \/>\n<meta property=\"og:site_name\" content=\"Avalere Health Advisory\" \/>\n<meta property=\"article:published_time\" content=\"2025-03-11T17:00:26+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2025-03-11T18:43:40+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/advisory.avalerehealth.com\/wp-content\/uploads\/2024\/07\/32685-1-KirstenStrykerBlasch\u200b\u200b\u200b\u200b_400x600.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"600\" \/>\n\t<meta property=\"og:image:height\" content=\"400\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Leah Keller\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@avalerehealth\" \/>\n<meta name=\"twitter:site\" content=\"@avalerehealth\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Leah Keller\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"5 minutes\" \/>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"MA and Part D Enrollment Growth Slows in 2025 | Avalere Health Advisory","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/advisory.avalerehealth.com\/insights\/ma-and-part-d-enrollment-growth-slows-in-2025","og_locale":"en_US","og_type":"article","og_title":"MA and Part D Enrollment Growth Slows in 2025 | Avalere Health Advisory","og_description":"Background\u00a0 During the Medicare Open Enrollment Period, which runs from October 15 to December 7, Medicare beneficiaries can choose their Part D or Medicare Advantage (MA) plans. 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