Growth Rate for Medicare Advantage Plans Slowed in 2025

 

April 14, 2025

Now that the 2025 Medicare Open Enrollment season is finished, over half, 51.5%, of people eligible for Medicare have decided on Medicare Advantage plans (MA), up from 50.8% in March of 2024. Based on the Centers for Medicare & Medicaid Services (CMS) enrollment data* for March 1, 2025, MA, including MA with Prescription Drug benefits (MA-PD) membership, stood at 34,601,557 with a net gain of 1,271,901 members from March 1, 2024, up 3.8%. The percentage increase is down from 6.5% between March 2023 and March 2024. The top 10 companies, out of 289 insurers offering coverage in the MA market, covered 78.8% of MA enrollees in 2025. Another third, 34.5%, of people eligible for Medicare selected a stand-alone Medicare Part D, prescription drug plan (PDP). Medicare PDPs covered 23,194,849 members as of March 1, 2025, a net increase of 397,868 from the previous year. This brief assesses MA and PDP performance, market share, and market growth by state as of March 1, 2025.

 

Medicare Advantage (MA) Membership

Medicare Advantage (MA) market penetration remains strong; however, with 51.5% of the 68.1 million people eligible for Medicare enrolled in a MA plan, the growth rate has noticeably slowed. According to CMS MA enrollment reports aggregated by Mark Farrah Associates (MFA) in Medicare Business Online™, total MA plan enrollment, as of March 1, 2025, increased 3.8% from March 2024, down from 6.5% between March 2023 and March 2024. The MA growth rate has been trending down since it reached a high of 9.7% between March 2020 and March 2021, which may have been a result of the Covid pandemic. For the years prior to Covid, the growth rate was relatively steady around 7.5%. Most of the top ten companies, each with more than 300,000 members in this segment, realized year-over-year growth with an overall net gain of 2.9%.

MA Leading Plan Performance

There are 289 insurers covering the MA marketplace in the United States; however, 78.8% of MA enrollees selected one of only 10 insurers. As of March 2025, UnitedHealth continues to dominate in this highly competitive segment. With over 9.9 million enrolled, UnitedHealth commands 28.7% of the MA market. Humana ranks second with 16.6% market share and 5.7 million lives; it was one of the two top plans to report enrollment declines year-over-year. CVS maintains the third position, enrolling over 4.1 million, and Elevance Health follows with over 2 million lives. Together the top three insurers cover 57.2% of the MA market, a decline of 1.4% from last year.

 

 

The table below indicates the MA organizations with the largest membership gains from March 2024 to March 2025. UnitedHealth had the largest increase in membership, adding over 500,000 members year-over-year, for a net gain of 5.3%. Elevance experienced the second largest gain with more than 243,000 new members. Cigna also gained over 100,000 new enrollees between March 1, 2024, and March 1, 2025. On March 19, 2025, Cigna announced completion of the sale of its MA, Cigna Supplemental Benefits, PDPs, and CareAllies businesses to Health Care Service Corporation (HCSC). Combined Cigna and HCSC have close to 925,000 MA members, and this acquisition propels HCSC into seventh place among the top ten MA plans.

 

 

MA Individual and Group Enrollment

As of March 1, 2025, 83.5% of membership was from individual MA policies with approximately 28.9 million enrolled lives. UnitedHealth Group, with its AARP branded products, consistently leads in the individual sector with nearly 8.1 million members enrolled in individual MA plans. In addition to direct purchase policies, slightly over 5.7 million members originated through an employer group health plan or retirement health benefit. Group membership increased by approximately 17,200 members as compared to the same period a year ago. UnitedHealth’s MA group enrollment declined by approximately 118,000, with the company’s total employer-group membership still over 1.8 million. Among the leading companies, Elevance had the largest gain from employer group MA plans with over 72,000 additional members. Both Kaiser Foundation Group and Humana had more than 530,000 members from group plans and increased enrollment in this sector by nearly 5,000 and 22,000, respectively.

 

 

MA Enrollment Growth by State

As of March 1, 2025, MA enrollment increased in forty-eight states, the District of Columbia, and most U.S. territories. Both Kentucky and Vermont had declines year-over-year, with 10,520 and 1,575, losses, respectively. Overall, a net membership gain of approximately 1.3 million was seen nationally. California, Texas, Florida, Pennsylvania, and North Carolina experienced significant enrollment gains, each with increases of 69,000 members or more. California experienced the most sizeable year-over-year increase, gaining over 123,000 members.

 

 

Stand-alone Prescription Drug Plan (PDP) Enrollment

Stand-alone prescription drug plans (PDPs), also referred to as Medicare Part D stand-alone plans, enrolled approximately 23.2 million members as of March 1, 2025, reflecting an increase of roughly 398,000 enrollees from March 1, 2024. More than 49,000 of the PDP enrollment gain came from the BlueCross BlueShield Association’s (BCBSA’s) federal employee plan, first introduced on January 1, 2024, to over 800,000 auto assigned enrollees. PDP plans provide prescription drug coverage for 34.5% of the 68.1 million people eligible for Medicare. Enrollment in products sold to individuals was 18.1 million in March 2025, an increase of 198,270, year-over-year. Approximately 5.1 million Medicare beneficiaries were enrolled in employer group PDPs as of March 1, 2025. It is important to note that this assessment is reporting on stand-alone PDP members only, and MA with prescription drug benefits (MA-PD) members are included in the MA portion of this report.

PDP Leading Plan Performance

There are currently 38 organizations, down from 43 in 2024, competing in Medicare stand-alone PDPs, as of March 2025. Five companies have more than 2 million members and command 89.5% of the PDP market. As indicated in the table below, there were significant enrollment swings between March 2024 and March 2025 among leading PDP organizations. After announcing that it was pursuing significant expansion initiatives in MA and PDP markets for 2024, Centene continues to cover the largest number of people enrolled in PDPs, having increased PDP membership by 23.1% between March 2024 and March 2025. With an increase of over 452,000 PDP members, Cigna increased its market share to nearly 13% as of March 1, 2025. Combined Cigna and HCSC have over 3.2 million PDP members, and 13.9% market share.

 

 

PDP Market Penetration by State

As of March 1, 2025, stand-alone PDP enrollment increased in 40 states within the U.S., including the District of Columbia. California had the largest year-over-year aggregate increase with over 57,000 more enrollees in this segment. Texas and Washington also had noteworthy increases, adding 44,815 and 44,341 new PDP enrollees, respectively. Michigan, with more than 799,000 PDP enrollees, continued to have the largest decline with a drop of over 10,000.

 

 

About this Data

This brief is based on an analysis of enrollment data for Medicare Advantage (MA) and Prescription Drug Plans (PDPs) released by the Centers for Medicare & Medicaid Services (CMS). Mark Farrah Associates’ Medicare Business Online™ simplifies the tracking of monthly MA and PDP enrollment by competitor. Enrollment data is updated monthly as CMS releases new data.

* It is important to note that MA enrollment counts by company or geography for the same reporting period may be slightly different, depending on the CMS enrollment source. CMS county-level reports, used in the above analysis, do not output enrollment for plans with 10 or fewer members per county.

Many companies conduct their post-OEP competitive assessments by using tools such as Mark Farrah Associates’ (MFA) Medicare Business Online™, Medicare Benefits Analyzer™, and Health Coverage Portal™. Health insurers continue to invest in MA and PDP growth opportunities for increased enrollment, revenue, and profits as the number of people entering retirement increases each year. MFA will continue to monitor plan performance in this highly competitive Medicare segment.

About Mark Farrah Associates (MFA)

Mark Farrah Associates (MFA) is a leading data aggregator and publisher providing health plan market data and analysis tools for the healthcare industry. Our product portfolio includes Health Coverage Portal™, County Health Coverage™, Medicare Business Online™, Medicare Benefits Analyzer™, 5500 Employer Health ^PLUS, and Health Plans USA™. For more information about these products, refer to the informational videos and brochures available under the Our Products section of the website (www.markfarrah.com), or call 724-338-4100.

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