October 21, 2024
It’s that time of year! Medicare Advantage (MA) plans have prepared their Medicare products in anticipation of the 2025 Annual Election Period (AEP), which is upon us once again! The MA market is comprised of national health plans, Blue Cross Blue Shield organizations, prominent regional health plans, and specialized Medicare companies. MA plans currently provide medical coverage for nearly 34.4 million beneficiaries, as of October 2024. While MA market penetration is strong, there is still ample opportunity for growth in this segment, with approximately 51% of the 67.5 million people eligible for Medicare enrolled in MA plans. This brief presents a snapshot of the 2025 Medicare Advantage market with insights from the Centers for Medicare and Medicaid Services (CMS) Medicare Landscape reports and Mark Farrah Associates’ (MFA’s) Medicare Benefits Analyzer™.
MA plans have collectively increased enrollment by approximately 6.4 million members in the past three years. The 2025 AEP for MA plans and prescription drug plans (PDPs) is currently underway, as of October 15th. Medicare Benefits Analyzer™, an MFA database, helps simplify analysis of the Medicare.gov data for companies competing in this segment.
2025 Medicare Landscape at a Glance
Based on an aggregate analysis of CMS Landscape reports, a total of 5,691 distinct MA plan offerings are in the market lineup for the 2025 AEP. This includes MA plans, MA with prescription drug plans (MAPDs), Medicare/Medicaid plans (MMPs), and Special Needs Plans (SNPs). During the AEP, Medicare beneficiaries can choose to change MA plans or switch from Original Medicare to MA for plan benefits effective on January 1, 2025. As indicated in the charts below:
2025 MA Premium Spread
Per the chart below, 70% of 2025 MA plans (excluding SNPs) are available at the under $2 plan premium level, and 18% of plans will be charging monthly premiums ranging from $2 to $50. Only 54 plans (1%) are charging monthly premiums greater than $200. These benefits-rich plans typically have low copays and, as a result, estimated out-of-pocket expenses are often minimal.
2025 MA Plan Competition
Medicare Benefits AnalyzerTM for Comparing Medicare Benefits
Analysts often use benefits data from the Medicare.gov website to compare plan premiums, copays, and star quality rating awards, market-by-market. Identifying plan-by-plan benefits details such as annual Out-of-Pocket Limits and Deductibles; Primary Care Doctor Visit Copays; Specialist Doctor Visit Copays; Inpatient Hospital Copays; Ambulance and Emergency Room Copays; and Drug Tier Copays helps companies to assess competitive advantages across markets. This type of comparative analysis provides invaluable intelligence that prepares Medicare plans to promote and sell their products.
In order to help Medicare plans access and use Medicare.gov data more efficiently, Mark Farrah Associates (MFA) maintains this data in its Medicare Benefits AnalyzerTM product. Benefits detail for 2025 is online now, along with Star Quality Ratings. Subscribers may query tables presenting plan benefit comparisons by state and county or download large datasets using the file export interface. Subscribers also have access to Medicare Business Online™ for tracking month-to-month Medicare Advantage and Prescription Drug Plan enrollment changes. Visit our website at www.markfarrah.com or call 724-338-4100 for more information.
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 or call 724-338-4100.
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