How Medicare Advantage Cuts Have Hurt the 2025 Plan Market
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, according to the Better Medicare Alliance analysis.
“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),” the Alliance said.
Changes in premiums, out-of-pocket costs and benefits will also vary by state, the Alliance reported.
“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,” Tuffin wrote.
Out-of-Pocket Costs, Medicare Part D
Maximum out-of-pocket levels in Medicare Advantage plans are rising for 2025, according to AHIP.
The share of general enrollment Medicare Advantage plans with an out-of-pocket maximum of $3,500 or less decreased from 23% to 20%. The share of general enrollment Medicare Advantage plans with a maximum over $5,000 rose from 46% in 2024 to 52% in 2025.
The Better Medicare Alliance said that 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,” the Alliance said.
Medicare Part D deductibles are also rising.
“The share of Medicare Advantage Prescription Drug (MA-PD) plans with a $0 Part D deductible fell by more than 25 percentage points (66.8% to 39.8%) compared to 2024,” AHIP said.
Further, the share of MA-PD plans “with a deductible of more than $300 almost quadrupled, going from 11.6% of plans to 42.6% for 2025,” AHIP said.
