Millions of seniors are seeing their current Medicare Advantage coverage disrupted because of two consecutive years of cuts to the Medicare Advantage program.
Data released by the Centers for Medicare & Medicaid Services (CMS) on MA plan offerings for 2025 confirm that many seniors are now experiencing a reduction in coverage choices, higher costs and reduced benefits, which can vary substantially based on where a beneficiary lives.
While health plans have worked to shield seniors from the full impact of these cuts, AHIP’s initial analysis of the CMS data shows:
Fewer Coverage Choices:
- About 1.3 million Americans are currently enrolled in MA general enrollment plans that will not be available to them in 2025, forcing these beneficiaries to change their Medicare coverage for 2025.
- The number of general enrollment MA plans in 2025 decreased by 6% relative to 2024.
- Over 60% of Medicare eligible Americans live in counties with fewer general enrollment plans in 2025 relative to 2024.
- Nine insurers stopped offering any MA general enrollment plans in 2025.
Higher Costs:
- National averages on MA premiums do not tell the whole story. In fact, MA seniors in many states are seeing double-digit premium increases.
- MA seniors in 19 states are seeing an average premium increase of more than 10%: AL, GA, ID, IN, IA, LA, ME, MA, MO, NJ, NY, ND, SC, SD, UT, VT, WA, and WY.
- The number of $0 premium general enrollment plans fell by 5% in 2025, though the share of all general enrollment plans that are $0 premium rose slightly.
- An estimated 243,000 beneficiaries are currently in MA general enrollment plans that have $0 premium in 2024 but will have a premium in 2025.
- Maximum out-of-pocket (MOOP) levels in MA plans are rising for 2025.
- The share of general enrollment MA plans with a MOOP of $3,500 or less decreased from 23% to 20%.
- The share of general enrollment MA plans with a MOOP over $5,000 rose from 46% in 2024 to 52% in 2025.
More than 33 million seniors and individuals with disabilities choose MA because it provides them better care at a lower cost than fee-for-service Medicare. These beneficiaries are counting on policymakers to keep the bipartisan promise of protecting their Medicare coverage from additional cuts.
Sources: AHIP, ATI Advisory, Avalere and Better Medicare Alliance.
Note: General enrollment plans are available to all eligible Medicare beneficiaries living in the service area. This analysis excludes special needs plans and employer group waiver plans, which are available only to specified groups.
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