New Analysis Shows Impact of Recent Policymaking on Medicare Advantage Plans: Fewer Choices, Higher Costs, and Reduced Benefits for Seniors in 2025
WASHINGTON — Millions of seniors across the country are set to face significant disruptions to their Medicare Advantage plans as the 2025 Medicare Annual Enrollment Period begins, according to an analysis released today by Better Medicare Alliance.
While premiums for the average Medicare Advantage enrollee will remain stable next year, the findings show a reduction in plan choices, higher out-of-pocket costs, and fewer supplemental benefits for seniors. These changes are a direct result of recent federal policy decisions impacting the Medicare Advantage program, including insufficient funding, coding changes, and changes in the Inflation Reduction Act; as well as pressures from higher utilization rates and growing medical costs.
“Seniors are choosing Medicare Advantage in record numbers because the program works. But recent policy changes are leaving them with fewer choices, higher costs, and reduced benefits. As our analysis confirms, these disruptions will impact seniors nationwide,” said Mary Beth Donahue, President and CEO of Better Medicare Alliance. “Washington policymakers must protect Medicare Advantage and provide stability for seniors who depend on it.”
The analysis, conducted by Avalere on behalf of Better Medicare Alliance, is based on 2025 Medicare Advantage and Part D Landscape and Plan Benefit Package files released recently by the Centers for Medicare & Medicaid Services (CMS). Key findings include:
- Plan Availability: Individual Medicare Advantage plan offerings are set to decline by 6.54% in 2025, while Special Needs Plans (SNPs) will increase 8.5%.
- Higher Costs: The median out-of-pocket maximum will increase by 8%, rising from $5,000 in 2024 to $5,400 in 2025. Premiums for the average Medicare Advantage enrollee will remain stable, however, with an average premium of $17 in 2025 compared to $18.23 in 2024.
- Reduced Benefits: While dental, vision, and hearing benefits remain stable, fewer plans will offer other important benefits that close coverage gaps. Specifically:
- Plans offering fitness benefits will decline from 98% to 96%
- In-home support services will decline from 9% to 6%
- Meals will decline from 72% to 66%
- Nutrition services will decline from 40% to 29%
- The over-the-counter benefit, which helps defray costs of certain health and wellness products, will decline from 86% to 73%
- Transportation offerings will decline from 36% to 29% of plans
At the state level, the change in the number of available plans varies greatly: from a nearly 22.9% increase in Mississippi, to a 66.7% decrease in Vermont. Overall, 31 states will see a decrease in the availability of individual Medicare Advantage plans, and seven states and Washington, D.C. will see a decrease in the availability of Special Needs Plans (SNPs). Changes in premiums, out-of-pocket costs, and benefits will also vary by state.
Read the full analysis here.
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Better Medicare Alliance is a community of more than one million grassroots beneficiaries and 200+ ally organizations working to improve health care through a strong Medicare Advantage. Learn more at www.bettermedicarealliance.org.