Amid Fall Open Enrollment, New Insights on the Medicare Advantage Landscape in 2025

Medicare’s annual Fall Open Enrollment (FOE) period runs from October 15 to December 7. It is the time of year when people with Medicare can make unrestricted changes to their Medicare coverage. 

The Complexity of Choosing Medicare Plans

For many, this annual process of comparing a seemingly endless number of plan options is overwhelming. Plans can differ on everything from costs to coverage, making detailed analysis both critical and difficult. Deceptive marketing tactics further complicate beneficiary decision-making. People may make poor or no coverage choices as a result, with serious consequences like higher costs and problems accessing care.

Key Insights from the 2025 Medicare Advantage Landscape

A new KFF analysis of the 2025 MA landscape suggests it remains stable, and that plan evaluations remain complex. For 2025, the average beneficiary has access to 42 MA plans, similar to 2023 and 2024 (43 options), and more than twice as many as in 2018 (20 options). There is variability from state to state, but overall, nearly one-third (32%) of Medicare beneficiaries will have access to more than 50 MA plans—up from 7% in 2020, and largely unchanged from 2024 (33%). MA enrollment has also surged in recent years, more than doubling over the last decade. Today over half (54%) of all Medicare beneficiaries—nearly 33 million people—are enrolled in an MA plan.

Increasing Market Concentration in Medicare Advantage

As MA enrollment and plan numbers grow, market share for the biggest players is becoming increasingly concentrated, heightening concerns about an inadequately competitive marketplace. On average, beneficiaries can select from plans offered by 8 different firms, the same as in 2024. Companies are saturating individual geographic areas; more than half (58%) of beneficiaries live in counties where at least one firm is offering 10 or more plans. Two companies—UnitedHealthcare and Humana—maintain control over a significant portion of the landscape; they currently account for nearly half (47%) of MA enrollment. In 2025, their plans will be available in 87% and 89% of counties, respectively.

Overpayment Concerns in the Medicare Advantage Market

The stability in the MA market comes amid “concerns that modifications to the payment formula and higher utilization” would cause significant contractions. This outcome, along with significant independent research, indicates overpayment corrections are appropriate and necessary. In 2024 alone, MA payments are estimated to be 22% higher than what Medicare would have spent to cover the same group of enrollees in Original Medicare. These extra dollars allow plans to funnel money into attractive supplemental benefits that draw beneficiaries to the plans. However, it is unclear how or if these benefits are truly working for enrollees because data about their delivery and utilization, as well as about the consumer experience, is severely lacking. They nevertheless remain a powerful plan marketing tool: The Commonwealth Fund estimates that 24% of people who choose MA do so because of these extra services.

Advocacy for Better Medicare Advantage Policies

The Medicare Rights Center understands the importance of ensuring access to optimal coverage options in ways that ensure Medicare is strong now and in the future. We will continue to advocate for greater MA payment accuracy and plan accountability, and for changes to improve the enrollee experience, such as tougher consumer protections, enhanced benefits, better access and affordability, and more streamlined processes.

Additional Resources

Read the KFF report, Medicare Advantage 2025 Spotlight: A First Look at Plan Offerings

Read more from Medicare Rights about MA history, payment, and policy