First, here are a few important points about Medicare Advantage plans:
- A Medicare Advantage plan includes
your Medicare Part A (in-patient and hospitalization coverage), Medicare Part B
(out-patient and physician coverage), and may include prescription drug
coverage (MAPD) or can be offered without drug coverage (MA).
-
A Medicare Advantage plan may
include supplemental healthcare benefits such as vision, dental, or fitness
coverage. A Medicare Advantage plan may
also include non-health related benefits such as meal delivery (in limited
situations) and non-health related transportation.
- You cannot add a stand-alone
Medicare Part D prescription drug plan (PDP) if you are enrolled in a Medicare Advantage plan
that does not include drug coverage (MA) –
unless your Medicare Advantage (MA) plan is a
PFFS,
MSA, or Cost plan.
- A Medicare Advantage plan is not a Medicare Supplement (Medigap plan) and a Medicare Advantage plan cannot be used with a Medicare Supplement.
Our Top 12 highlights of the 2025 Medicare Advantage plan landscape:
(1) The total number of 2025 Medicare Advantage plans will decrease slightly.
Across the country, there will be 3% fewer Medicare Advantage plans offered in 2025 – with 5,218 Medicare Advantage plans (MAs and MAPDs) available as compared to 5,377 Medicare Advantage plans offered in 2024.
Read more about the changes in the number (and type) of Medicare Advantage plans over the past few years.
(2) The total number 2025 Medicare Advantage plans does not adequately reflect the significant changes that many areas across the country will see in their county-wide Medicare Advantage plan landscape.
As in past years, when the total number of plans is viewed in detail, many 2024 Medicare Advantage plans will be terminated in 2025 or merged into other 2025 plans ("crosswalked*") – and new 2025 Medicare Advantage plans will be introduced. As an example, Chesterfield County, VA will lose 37 of the 74 currently-offered 2024 Medicare Advantage plans. However, in the same county, 33 new 2025 Medicare Advantage plans will be introduced.
As another example of the ever-changing Medicare Advantage plan landscape, in 2023, Monroe County, PA had a total of 67 Medicare Advantage plans. Then in 2024, five (5) plans left and 11 plans entered the county for a new total of 73 plans. Now in 2025, fifteen (15) Medicare Advantage plans are leaving the county and 24 plans are entering the area for a new total of 82 Medicare Advantage plans.
You can see more 2025 Medicare plan changes using our 2024/2025 Medicare Advantage plan compare tool: MA-Compare.com/2025.
A Closer Look: County-specific changes in the 2025 Medicare Advantage plan landscape (Losses and Gains)
The counties in the chart below will have the highest number of non-renewing Medicare Advantage plans.
|
Counties
with Largest Number of Non-Renewing Medicare Advantage Plans |
|
| County | Number of Non-Renewing
Plans including crosswalks* |
| Chesterfield County, VA | 37 |
| Henrico County, VA | 37 |
| Colonial Heights City County, VA | 35 |
| Hanover County, VA | 35 |
| Richmond City County, VA | 35 |
| Hopewell City County, VA | 34 |
| Petersburg City County, VA | 33 |
| Goochland County, VA | 32 |
| Powhatan County, VA | 31 |
| Orange County, CA | 30 |
*Note about "crosswalk" information: The term "crosswalk" is used when a 2024 Medicare plan automatically moves plan members to a different plan for 2025 because the 2024 Medicare plan will no longer be offered next year. Some of the plans above will "crosswalk" their 2024 plan members to a different 2025 Medicare Advantage plan. The new Medicare plan for crosswalked members is noted in our MA Compare tool. For example, 19 of the 2024 Medicare Advantage plans that will no longer be available in Los Angeles County, CA will "crosswalk" or move their members to a different 2025 Medicare Advantage plan.
Important: Low-Income Subsidy (LIS) Medicare beneficiaries losing 2025 Medicare Advantage (MAPD) plan coverage will be reassigned to a $0 premium-qualifying 2025 stand-alone Medicare Part D prescription drug plan (PDP).
Medicare will automatically reassign people who are currently 2024 LIS-eligible - and will remain 2025 LIS-eligible - into a $0 premium qualifying stand-alone Medicare Part D prescription drug plan (PDP) if the person is currently enrolled in a Medicare Advantage plan that includes drug coverage (MAPD) "that is non-renewing or reducing their service area [SAR] as of 2025." The person will also be returned to Original Medicare Part A and Part B coverage. The LIS-eligible person will be notified of the automatic PDP enrollment in mid-November (look for a Blue-Colored mailing from Medicare).
Medicare "will carry out all [automatic] reassignments, including assigning beneficiaries into zero premium Prescription Drug Plans (PDP) owned by the same organization [offering the person’s 2024 Medicare Advantage plan], if available, or randomly assigning beneficiaries to [other $0 premium qualifying] PDPs offered by different sponsors."
However, Medicare will not reassign the LIS-eligible person if the person is enrolled in "an MA Private Fee-for-Service [PFFS] or Medical Savings Account (MSA) plan, and the individual already has associated enrollment in a stand-alone [Medicare Part D] PDP that is not affected by PDP premium increase reassignment for 2025 [where people are reassigned to another PDP when their current 2024 PDP no longer qualifies for the 2025 $0 LIS premium]."
(Reference: CMS Memo October 1, 2024, "2025 Reassignment of Low-Income Subsidy Beneficiaries in Non-Renewing Medicare Advantage Plans and Medicare Advantage Plans Reducing their Service Areas")
Bottom Line: Read your Medicare Advantage plan’s Annual Notice of Change (ANOC) letter to ensure that your Medicare plan is being offered in 2025 or to see whether you are being automatically moved to another 2025 Medicare Advantage plan.
(3) Most 2025 Medicare Advantage plans include Part D drug coverage (MAPDs) and are local HMOs.
As in past years, over 91% of 2025 Medicare Advantage plans will include prescription drug coverage (MAPDs) and the majority (62%) of 2025 Medicare Advantage plans will be local HMOs (Health Maintenance Organizations). However, keep in mind that there will be a decrease in most types of Medicare Advantage plans - the only exception, the number of 2025 Local PPO Medicare Advantage plans (MA-only, without drug coverage) will increase.
You can click here for a chart showing how the number and type of MAPDs and MAs has changed over the past years.
(4) Changes in the Special Needs Plan (SNP) landscape result in wider availability of 2025 SNP options.
Special Needs Plans (SNPs) are a type of Medicare Advantage plan with plan benefits, healthcare provider choices, and drug formularies (list of covered drugs) designed to accommodate the needs of a particular group of people meeting certain requirements – such as people suffering from a chronic condition or illness (for example, diabetes or a chronic cardiac conditions) or nursing home residents or people who have limited financial resources (for example, people eligible for both Medicare and Medicaid).
Although about 29% of the 2024 Medicare Advantage Special Needs Plans (SNPs) will be discontinued in 2025, the number of 2024 SNPs leaving the market will be offset by the introduction of new 2025 SNPs, resulting in a 8% actual increase in the total number of SNPs.
As in past years, the vast majority (63%) of SNPs remain Dual-Eligible Medicare/Medicaid plans (D-SNPs). However, the number of counties across the country offering a Medicare Advantage Chronic Care (C-SNP) will increase by 22% and the number of counties offering an Institutional I-SNP will decrease almost 8%.
Designation of 2025 D-SNP Medicare/Medicaid integration
People enrolling in a Dual-Eligible Medicare Advantage Special Needs Plan (D-SNP) can now learn more about whether their chosen D-SNP is a Fully-Integrated Dual-Eligible (FIDE) SNP, Highly-Integrated Dual-Eligible (HIDE) SNP, or Coordination-only D-SNP – along with whether the D-SNP is designated as an Applicable Integrated Plan (AIP) and if the D-SNP has Medicare zero-dollar cost-sharing.
(5) 2025 Medicare Medical Savings Accounts (MSAs) continue to have limited access.
According to the latest data available from CMS, in 2025, Medicare Medical Savings Accounts (MSAs) will continue to only be available in Wisconsin as compared to being available in 37 states in 2023. Unlike other Medicare Advantage plans, MSAs are made up of a high-deductible health plan and a medical savings account funded by an annual tax-free deposit. MSA members can use the medical savings account to pay for healthcare costs before the health plan deductible is met. MSA members can enroll in any available stand-alone Medicare Part D plan (PDP) for their drug coverage.
Read more about the changes in the number (and type) of Medicare Advantage plans over the past few years.
(6) Monthly 2025 Medicare Advantage plan premiums will remain low.
Here are a few additional highlights of 2025 Medicare Advantage plan premium changes:
- More $0 premium Medicare Advantage plans.
In 2025, over 58% of all Medicare Advantage plan will have a $0 premium. As a comparison, 55% of all 2024 Medicare Advantage plan have a $0 premium.
- Slightly fewer Medicare Advantage plans will have a premium under $50.
Just over 87.5% of the 2025 Medicare Advantage plans (MA and MAPD) will have a premium of $50 or less. In comparison, just over 88% of the 2024 Medicare Advantage plans have a premium of $50 or less.
- As noted in a recent CMS press release, the average Medicare Advantage plan premium is expected to decrease from $18.23 in 2024 to $17.00 in 2025 (a decrease of $1.23). Our analysis shows 87.5% of all 2025 Medicare Advantage plans have a monthly premium under $50 and over 58% of all 2025 Medicare Advantage plans have a $0 premium.
| Premium Range | 2025 MA/MAPD Plans | 2024 MA/MAPD Plans | 2023 MA/MAPD Plans | 2022 MA/MAPD Plans | 2021 MA/MAPD Plans | |||||
| Total Plans | 5,691 | 5,806 | 5,764 | 5,430 | 4,958 | |||||
| MSA no Premium | 72 | 1.27% | 72 | 1.24% | 3 | 0.05% | 11 | 0.20% | 5 | 0.10% |
| $0 Premium Plans | 3,315 | 58.25% | 3,188 | 54.91% | 3,238 | 56.18% | 2,810 | 51.75% | 2,363 | 47.66% |
| Premium >$0-$25 |
695 | 12.21% | 453 | 7.80% | 612 | 10.62% | 493 | 9.08% | 541 | 10.91% |
| Premium >$25-$50 |
968 | 17.01% | 1,473 | 25.37% | 1,220 | 21.17% | 1,349 | 24.84% | 1,196 | 24.12% |
| Premium $0-$50 |
4,978 | 87.47% | 5,114 | 88.08% | 5,070 | 87.96% | 4,652 | 85.67% | 4,100 | 82.69% |
| Premium >$50-$75 |
309 | 5.43% | 197 | 3.39% | 222 | 3.85% | 232 | 4.27% | 285 | 5.75% |
| Premium >$75-$100 |
109 | 1.92% | 141 | 2.43% | 174 | 3.02% | 199 | 3.66% | 216 | 4.36% |
| Premium >$100-$200 |
169 | 2.97% | 225 | 3.88% | 238 | 4.13% | 273 | 5.03% | 293 | 5.91% |
| Premium >$200-$300 |
50 | 0.88% | 55 | 0.95% | 56 | 0.97% | 60 | 1.10% | 56 | 1.13% |
| Premium >$300 |
4 | 0.07% | 2 | 0.03% | 1 | 0.02% | 3 | 0.06% | 3 | 0.06% |
The corresponding chart below illustrates the stability of Medicare Advantage plan premiums for the past few years.
Please remember, your 2025 Medicare Advantage plan premium may increase.
Important: The overall stability of Medicare Advantage plan premiums does not indicate that your current 2024 Medicare Advantage plan premium will remain the same in 2025. To see how your 2024 Medicare Advantage plan premium is changing in 2025, please use our Medicare Advantage plan comparison tool (MA-Compare.com/2025) - just enter your ZIP code to get started.
You can also review your Medicare Advantage plan's Annual Notice of Change (ANOC) letter that you should receive in late-September or early-October of every year. You can also call your Medicare Advantage plan using the toll-free number on your Member ID card to learn more about 2025 plan premiums.
(7) Significantly fewer 2025 MAPDs have a $0 premium and $0 drug deductible ($0/$0 plans).
Fewer $0/$0 MAPDs. About 22% of all 2025 Medicare Advantage plans that include prescription drug coverage (MAPDs) will have a $0 premium and $0 initial drug deductible – down from 39% in 2024.
Below is a chart showing the different types of $0/$0 Medicare Advantage plans (MAPDs).
(8) More 2025 Medicare Advantage plans will “give back” a portion of your Part B premium.
In 2025, our analysis shows a 93% increase in the total number of Medicare Advantage plans that rebate or “give back” a portion of a member’s Medicare Part B premium.
More $0/$0 MAPDs with a Part B giveback. Although there will be fewer $0/$0 2025 Medicare Advantage plans, 382 Medicare Advantage plans with a $0 premium and $0 deductible ($0/$0 plans) will return a portion of your Medicare Part B premium as compared to 275 $0/$0 giveback plans in 2024 (a 39% increase). In addition, there is a 234% increase in Medicare Advantage giveback plans that include either a premium and/or a Rx-deductible. Giveback plans will be available in slightly more counties in 2025. In more detail, over 3,109 counties offer at least one 2025 Medicare Advantage plan with a partial Part B premium refund.
Learn more in our article, Slightly more 2025 Medicare Advantage plans include a Medicare Part B premium giveback feature.
(9) Over 9.2 million Medicare Advantage plan members will see an increase in their in-network 2025 Maximum Out-of-Pocket (MOOP) limit.
One key benefit of a Medicare Advantage plan is that annual spending for in-network Medicare Part A (in-patient or hospitalization) and Medicare Part B (out-patient or doctor visit) eligible services is capped by the plan’s Maximum Out-of-Pocket spending limit (MOOP). Once you reach your plan’s MOOP you will no longer pay cost-sharing for eligible, in-network Part A or Part B services.
A Medicare Advantage plan’s MOOP limit can change every year and in 2025, MOOP limits will range from $198 to $9,350 (although Medicare Advantage plans designed for low-income beneficiaries have a $0 MOOP). And based on our analysis, about 9.26 million Medicare Advantage plan members will see an increase in their plan's in-network 2025 MOOP limit. The MOOP increase can range from $50 to $6,450.
Over 41% of Medicare Advantage plans increase their MOOP limit in 2025, with 30% of 2025 Medicare Advantage plans having a MOOP at, or below, $4,150, 39% with a MOOP between $4,151 and $6,350, and 31% with a MOOP between $6,351 and $9,350.
And this means: The lower the MOOP, the less you will spend per year for your total Medicare Part A and Medicare Part B covered services.
(10) All Medicare Advantage plans with drug coverage will have a $2,000 out-of-pocket spending limit for Part D formulary drugs.
2025 Medicare Advantage plans with drug coverage (MAPDs) will no longer have a Coverage Gap (Donut Hole). After spending $2,000 out-of-pocket for formulary Part D drugs, MAPD plan members will move directly from the Initial Coverage phase to the Catastrophic Coverage phase where they will have no cost-sharing through the end of the year for their Part D drugs.
What counts toward the $2,000?
What you actually spend out-of-pocket on Medicare Part D drugs found on your plan’s formulary will count toward the annual $2,000 maximum prescription drug out-of-pocket spending limit (RxMOOP).
Plus, what certain third-parties spend for your Part D drugs covered by your plan will also count toward TrOOP. As was true in the past, your out-of-pocket spending can also include what other people spend on your behalf for your formulary Part D drugs. For example, your total out-of-pocket spending can include the benefits you receive from a qualified State Pharmacy Assistance Programs (SPAPs).
Important: Plus, what your Medicare Part D plan pays for your Part D formulary drugs may also count toward TrOOP. There are four different types of Medicare Part D drug plans that vary depending on how close the plan coverage is to the annual Medicare Defined Standard benefit (having a $590 deductible and 25% cost-sharing for all formulary tiers in 2025). The four types of drug plans you can join are: Defined Standard (DS), Basic Alternative (BA), Actuarial Equivalent (AE), and Enhanced Alternative (EA).
In an earlier article about 2025 stand-alone Part D plans we presented the simplest example of how drug spending in a Defined Standard (DS) Medicare Part D plan accumulates toward your $2,000 RxMOOP.
However, if you are enrolled in an "Enhanced Alternative" (EA) Medicare Part D plan (or MAPD with EA drug coverage) – coverage exceeding the Defined Standard (DS) benefit with lower or no deductible and lower copays – you will get credit for what you spend on Part D formulary drugs plus what the EA Medicare plan spends toward your Part D drugs – up to the amount you would have spent if you were covered by a Defined Standard Part D plan.
You can click here to see an example of how Enhanced Alternative Medicare drug benefits may help you save on your out-of-pocket prescription costs.
(11) You can spread your 2025 Medicare drug spending over the entire year.
You will have the option in 2025 to shift the continued cost of formulary drug purchase over the entire year with your plan’s "Medicare prescription payment plan" (MPPP or M3P) and the optional-MPPP would then take your out-of-pocket spending and spread it across the whole year.
(12) All 2025 Medicare Advantage plans with drug coverage (MAPD) will continue to offer insulin at a $35 (or less) copay, cover ACIP Part D vaccines at a $0 copay, and have no additional formulary drug cost-sharing in the Catastrophic Coverage phase.
Based on the Inflation Reduction Act, all 2025 Medicare Advantage plans with drug coverage (MAPDs) will continue to offer all insulin found on the plan’s formulary for a copay of $35 (or less) for a 30-day supply through all phases of Part D coverage.
In addition, all Medicare Advantage plans with drug coverage (MAPDs) will offer $0 cost sharing for Part D vaccines that are recommended by the Advisory Committee on Immunization Practices (ACIP), such as Shingles and Pneumonia vaccines.
Need an overview of Medicare Advantage plan options in your area?
To get you started with your review of 2025 Medicare Advantage plans available in your area, just click on your state and then click on your county name: AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IS IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UT VA VI VT WA WI WV WY.
You can also use our 2025 Medicare Advantage plan finder (MA-Finder) to review plans in your area – found directly at: MA-Finder.com/2025. he MA-Finder currently displays the plan premium, prescription deductible, 30-day cost-sharing, health benefits, and Medicare Part A and Part B Maximum Out-of-Pocket limit (MOOP).
You can use our 2024/2025 MA-Compare tool to see how your 2024 Medicare Advantage plan is changing in 2025. Our Medicare Advantage comparison tool can be found directly at: MA-Compare.com/2025.