A new report shows decelerating growth for Medicare Advantage plans.
The annual 2025 Medicare Advantage competitive enrollment report by healthcare advisory firm Chartis and consulting firm HealthScape Advisors said the market is undergoing a period of correction, following rapid growth in the early 2020s.
The Medicare Advantage market grew by 1.3 million beneficiaries, or 3.9%, in 2024. This is down from 7% growth in 2023 and 9.4% in 2022.
Despite the numbers, the market remains strong, the report said. Health plan leaders are optimistic and generally more positive than when they were surveyed last year, according to the report. The MA market has continued growth and favorable economics compared to other market segments, they said. Also, the Trump administration has signaled support for the program and less administrative burden is expected for plans.
Ninety-one percent expect the same or better performance in 2026, compared to 74% the year prior.
Special needs plan enrollment increased 10% from 2024 to 2025.
WHY THIS MATTERS
This year, Medicare Advantage overtook original Medicare as the plan of choice for people 65 years and older, those with disabilities or end stage renal disease who need healthcare coverage.
Currently, 51% of those on Medicare have a Medicare Advantage plan, compared to 49% of those who have original Medicare, according to the report. Last year, there was a 50% split in enrollment for each.
This compares to five years ago, when 60% of seniors had original Medicare and 40% were in a Medicare Advantage plan.
MA growth has skyrocketed in the last five years due in part to the aging demographics of baby boomers. However, this year is expected to be the peak annual age-in for Medicare overall, according to the report.
This year was the highest on record for overall Medicare growth.
An interesting trend is that for the first time, original Medicare enrollment has not declined, despite MA gaining the upper hand in market share. Original Medicare grew by about 200,000 beneficiaries this year.
THE LARGER TREND
MA plans have faced recent headwinds of declining payment rates, medical cost pressures, regulatory burden and less favorable star ratings.
Several plans exited the market, including Premera and Blue Cross Blue Shield Kansas City, and others reduced their service areas, such as Aetna and Humana, according to the report. Prior to the annual enrollment period, many for-profit health plans signaled their intent to slow growth or even contract membership due to the pressures. This has resulted in a flattening of MA plans available nationally, the report said.
For-profit insurers control nearly three-quarters of the Medicare Advantage market. Meanwhile, Blues, nonprofit and provider-sponsored health plans continue to see marginal market share erosion, despite notching overall enrollment growth, the report said.
Email the writer: SMorse@himss.org