New analyses published by KFF explore the latest trends in Medicare Advantage (MA). Here are key findings from the reports.
The two KFF briefs provide a snapshot of the MA landscape in 2025. The first brief examines 2025 trends in premiums, out-of-pocket limits, supplemental benefits, and prior authorization. The second analysis focuses on enrollment. Here are six trends they uncovered:
More than half of eligible Medicare beneficiaries will be enrolled in MA in 2025. Enrollment as a share of the eligible Medicare population has increased from 19 percent in 2007 to 54 percent in 2025.
One in five MA enrollees is in a special needs plan (SNP). Indeed, 48 percent of the total increase between 2024 and 2025 was among SNPs, up from 42 percent in the prior year. More than 80 percent of SNP enrollment is in plans designed for dual eligibles. And SNPs for people with certain chronic conditions skyrocketed in 2025. KFF found enrollment soared by more than 70 percent between 2024 and 2025.
Most MA members are in plans that offer supplemental benefits not covered by traditional Medicare, such as vision, hearing, and dental. However, KFF noted there was a decrease in the share of individual plan enrollees in plans providing remote access technologies, over-the-counter benefits, and transportation benefits. The share of SNP enrollees in plans that offered bathroom safety devices increased, but there was a decrease in the share of SNP enrollees in plans that offered transportation benefits, remote access technologies, and acupuncture.
Seventy-six percent of enrollees in individual MA plans with prescription drug coverage pay no premium other than the Medicare Part B premium. There was also a 32 percent increase in the share of enrollees in these plans that received a Part B premium rebate. Half of these individuals are in plans that offer rebates of less than $10 a month, while 36 percent are in plans that offer rebates of $50 or more per month.
Nearly all MA members (99 percent) are in plans that require prior authorization for some services. Prior authorization is typically required for expensive services, such as skilled nursing facility stays, Part B drugs, inpatient hospital stays, and outpatient psychiatric services.
The average out-of-pocket limit for MA enrollees is $5,320 for in-network services and $9,547 for both in-network and out-of-network services. Federal requirements in 2025 stipulate that the out-of-pocket limit for MA plans may not exceed $9,350 for in-network services and $14,000 for in-network and out-of-network services combined. These out-of-pocket limits apply to Part A and B services only and do not apply to Part D spending.