2025 Medicare Trends: Contraction, Growth, and Strategic Shifts
Medicare Advantage 2025 has undergone a substantial transformation, marked by an evident consolidation with respect to the number of plans available for beneficiaries, noticed a prolonged period of growth. As of September 2024, Individual Medicare Advantage (MA) enrollment has surpassed 28 million. This article offers insights into the national distribution of MA plans for 2025, along with a state-level overview that highlights important takeaways for MA Only and MAPD plans.
Drawing facts and insights based on CMS landscape and crosswalk data, we explore the evolving dynamics within the Medicare Advantage 2025 market. Our analysis delves into how changes in plan types over the past five years have contributed to market expansion or reduction.
Focus on the significant roles played by Non-Special Needs Plans (Non-SNP), Dual Eligible Special Needs Plans (D-SNP), Chronic or Disabling Condition Special Needs Plans (C-SNP), and Institutional Special Needs Plans (I-SNP), as well as HMO and PPO categories.
Medicare Advantage 2025 — First-Ever Plan Count Decline
The past trend from 2019 reveals a clear deceleration in the growth of plans, shifting from a period of rapid expansion to a slight contraction. Growth rate peaked at 17.1% in 2019, but progressively slowed — 15.0% in 2020, 12.8% in 2021, 9.1% in 2022, and 6.3% in 2023. By 2024, growth was minimal at 1.1% Year-over-Year (YoY), indicating market saturation.
In 2025, the Medicare Advantage market contracted by −2.1% YoY — the first decline in Medicare industry history. This signals a period of consolidation, where innovation has plateaued, or there has been a refocus on enhancing existing plans.
Down from 5,805
First-Ever Decline
Tripled from 214
+13% YoY Rebound
- The total number of plans is divided into several categories, which include Renewal Plans, Consolidated Renewal Plans, Renewal Plans with Service Area Expansion (SAE), Renewal Plans with SAR, Initial Contracts, and New Plans.
- Categories of plans will be represented in italics (e.g., Consolidated Renewal Plans, New Plans).
- New Plans (without italics or capitalization) indicate both New Plans and Initial Contracts. Renewal Plans is a combination of Renewal Plans, Consolidated Renewal Plans, Renewal Plans with SAR, and Renewal Plans with SAE.
"The surge in Renewal Plans with SAR catalyzed industry contraction, with the plan count tripling in 2025 compared to 2024."
In 2025, the Medicare Advantage landscape saw a significant shift, with Renewal Plans with SAR tripling their count to 651 from just 214 in 2024, impacting around 1.9 million lives. This sharp rise stands out as one of the primary reasons for industry-wide contraction, where the remaining renewal plan categories saw a reduction.
Notably, the total number of new plans increased from 714 to 810, marking a 13% YoY rise — a reversal after the previous year's 19% decline. At the same time, renewal plans fell from 5,091 to 4,872, underscoring the reshaping of the Medicare Advantage 2025 market. While new plans made a modest comeback, the SAR category's explosive growth stands out against an overall industry slowdown.
Breaking down the plan categories for 2025, Renewal Plans continue to dominate with around 60% of the total share, a slight decline from 2024's 65%. Historically, Renewal Plans with SAE held the second-largest share, but in 2025, New Plans have taken this spot, comprising approximately 13% of the total. Following closely behind are Renewal Plans with SAR, which surged to 11.5%, a significant rise from just 3.7% in 2024. Meanwhile, Renewal Plans with SAE have been steadily decreasing — from 20% in 2023 to 13% in 2024, and now accounting for only 9% in 2025.
State-by-State Medicare Advantage 2025 Trends — Growth in 38%, Shifts in 54%, Stability in 8%
In 2025, several states saw notable shifts in plan counts, with growth in some areas and sharp declines in others. Pennsylvania led the increase with a 12% YoY rise, adding 35 plans compared to 2024, while Mississippi (22% YoY) and Georgia (10% YoY) also saw strong growth.
States such as Louisiana, Tennessee, North Carolina, Indiana, and Colorado demonstrated notable growth, each increasing by over 10 plans. This upward trend suggests active expansion in Medicare markets — essential areas of growth amidst overall industry consolidation.
| State | Plans in 2024 | Plans in 2025 | Added Plans in 2025 | Penetration Rate (%) |
|---|---|---|---|---|
| Pennsylvania | 281 | 316 | +35 | 44% |
| Georgia | 162 | 178 | +16 | 43% |
| Mississippi | 72 | 88 | +16 | 40% |
| Tennessee | 118 | 131 | +13 | 48% |
| Louisiana | 99 | 112 | +13 | 49% |
| North Carolina | 162 | 174 | +12 | 44% |
| Colorado | 120 | 132 | +12 | 42% |
| Indiana | 144 | 155 | +11 | 41% |
**Penetration rate (%) is based on September 2024.
However, significant consolidation was observed in major states like California, which dropped by 44 plans (−9% YoY), and New York, down by 36 plans (−13% YoY). Other regions, such as Washington (−18% YoY) and Wisconsin (−20% YoY), faced sharp contractions. Vermont experienced the most dramatic drop with a 67% YoY reduction in plan counts from 24 to 8 plans.
| State | Plans in 2024 | Plans in 2025 | Declined Plans in 2025 | Penetration Rate (%) |
|---|---|---|---|---|
| California | 465 | 421 | −44 | 40% |
| New York | 272 | 236 | −36 | 44% |
| Wisconsin | 144 | 115 | −29 | 50% |
| Washington | 152 | 125 | −27 | 42% |
| Oregon | 132 | 109 | −23 | 49% |
| Florida | 613 | 591 | −22 | 52% |
| Idaho | 83 | 66 | −17 | 47% |
| Vermont | 24 | 8 | −16 | 23% |
| Massachusetts | 113 | 99 | −14 | 31% |
| Rhode Island | 36 | 25 | −11 | 55% |
**Penetration rate (%) is based on September 2024.
At the national level in 2025, Florida is leading the way with 591 total plans and 64 new plans, followed by California (421, 52), Texas (385, 55), Pennsylvania (316, 54), and New York (236, 26). Along with these leading states, Georgia, Illinois, and Washington are witnessing a surge in new plans — Georgia showing 37 new additions, and both Illinois and Washington at 35.
The distribution of plan categories across states reveals that Renewal Plans continue to dominate, reflecting national trends. Even in Consolidated Renewal Plans, the leading states are California (45), Florida (22), and Pennsylvania (17), while six states have no such plans. Texas (54), Ohio (33), and Florida (28) top the list for Renewal Plans with SAE, although four states have none. Texas (48), Indiana (41), and North Carolina (38) also show strong numbers for Renewal Plans with SAR, while Hawaii does not have any SAR plans. Initial Contracts are concentrated in Indiana with 11 plans, and Georgia, North Carolina, and Missouri each having 8.
Smaller states, like Vermont and Wyoming, exhibit minimal growth. Wyoming holds steady with 20 total plans despite no new additions, and Vermont — with only eight plans, the fewest among all states — includes just a single New Plan. These variations reflect diverse strategic priorities across regions.
MA Only & MAPD Plans — Renewal Plans with SAR Rise from 8% to 18%
In 2025, the Medicare Advantage Prescription Drug (MAPD) segment shows a slight decline in the total number of plans, dropping from 5,321 in 2024 to 5,200 — a decrease of approximately 2.3%. This reflects a continuation of the slowing growth rate seen in previous years.
For MA Only plans, the downward trajectory is even more pronounced. The total number of plans decreased marginally from 484 in 2024 to 482 in 2025, indicating a YoY decline of less than 1%. Despite overall market consolidation, a notable increase was observed in new plans — MA Only plans rising by 32% YoY and MAPD new plans by 12% YoY in 2025.
Down from 5,321 (−2.3%)
Down from 484 (<1%)
Renewed Innovation
Continued Growth
The same trend holds across both MA Only and MAPD plans, with Renewal Plans continuing to have the largest share, though they dropped from 64% to 59% in MA Only and from 65% to 60% in MAPD. Renewal Plans with SAE experienced a sharp decline, particularly in MAPD (13% to 9%) and MA Only (17% to 11%). On the other hand, New Plans showed an uptick — signifying renewed innovation — with MA Only increasing from 7% to 10% and MAPD from 12% to 13%.
Medicare Advantage 2025 SNP Trends — 27% of C-SNPs Are New Plans
In 2025, the distribution of Special Needs Plan (SNP) types highlights a significant focus on targeted care. C-SNP comprises 7% of the total and D-SNP makes up 17%, indicating a strong commitment to integrated care for those eligible for both Medicare and Medicaid. I-SNP plans account for only 3%, while Non-SNP remains dominant at 74%.
C-SNP — 21% YoY Growth, 104 New Plans
The count of C-SNPs has steadily increased from 169 in 2020 to 391 in 2025. The total number of plans added in 2023 (+33) and 2024 (+6) was minimal, while 2025 saw a significant addition of 69 plans, resulting in a 21% YoY increase.
Notably, 104 new C-SNPs were introduced in 2025, compared to 84 in 2024, with no Initial Contracts. Aside from Consolidated Renewal Plans, other plan categories experienced growth — in both Renewal and New Plans, 38 plans were added for C-SNP type. Florida leads with the highest number of total C-SNPs at 84 plans, and California leads in new plans, while seven states do not have any C-SNPs. Tennessee notably increased its plans from 3 to 12.
D-SNP — 8% YoY Growth, 166 New Plans
This category has shown robust growth from 545 plans in 2020 to 945 in 2025, with an addition of 70 plans in 2025 compared to 2024 — an 8% YoY increase, slightly lower than in the previous year.
Notably, 166 new D-SNPs were introduced in 2025, surpassing the 134 added in 2024, contributing to a total increase of 32 plans. While the Renewal Plans with SAE category saw a decline of 48 plans, other categories experienced moderate growth. The Renewal Plans with SAR category made a significant leap from 28 to 92. Florida remains the leading state with a total of 114 D-SNP plans, while Washington leads in new plans with 16. New Hampshire, Vermont, and Illinois do not have any D-SNPs, while Puerto Rico increased its D-SNPs from 26 to 36.
I-SNP — Declining for the Second Consecutive Year
The I-SNP type has shown fluctuations over the years, with the total plans decreasing from 191 in 2023 to 162 in 2025. The growth rate was initially strong, with a peak of 19.7% YoY in 2021, but a negative growth rate has been observed in the last two years.
While 18 new plans were introduced in 2024, approximately 24 new I-SNPs will be available in 2025. The primary area of concern within this category is the Consolidated Renewal Plans, which saw a significant drop from 7 in 2024 to none in 2025. However, Initial Contracts and New Plans increased by 3 plans each. Renewal Plans declined from 89 to 72, while Renewal Plans with SAR rose from 13 to 24. New York and Florida are leading with the total number of I-SNPs, and Indiana added 3 new plans. There are 5 states without I-SNPs.
Non-SNP — 5.6% YoY Decline with Signs of New Plan Recovery
The Non-SNP category has exhibited a declining trend, with a total count of plans decreasing from 4,433 in 2024 to 4,184 in 2025 — a 5.6% YoY drop. Earlier in 2024, new Non-SNPs saw a sharp 27% YoY decline, but in 2025 the trend reversed, showing 8% YoY growth as new plans increased from 478 to 516.
Consolidated Renewal Plans decreased by 21, while Initial Contracts rose from 33 to 56. There was a sharp decline in Renewal Plans, dropping from 2,980 to 2,572, and Renewal Plans with SAE fell significantly by 210 plans to 348. On the other hand, Renewal Plans with SAR saw a remarkable increase, jumping from 168 to 520 plans.
Though Florida and California remain the leading states for both new and total Non-SNP plans, they experienced declines in total counts — Florida dropping from 406 to 381 and California from 352 to 307. In contrast, Pennsylvania saw growth, adding 20 plans for a total of 267, and Georgia added 15 plans, bringing its total to 123.
Medicare Advantage 2025 HMO & PPO — New Plans Surge Despite Total Decline
All plan types are expected to see a decline in total availability in 2025. HMO plans continue to dominate with 61.9% of the market, though their count dropped to 3,518, down from 3,586 in 2024. PPO plans, comprising 35.4% of all plans, decreased to 2,010 from 2,045 in 2024, reflecting a 1.7% YoY decline.
Despite this contraction, new plan additions surged in the Medicare Advantage 2025 market — HMO plans growing by 12% YoY (453 new plans) and PPO plans by 16% YoY (357 new plans). Florida continues to lead in HMO plans with 499 total plans and 54 new ones. Pennsylvania ranks first in PPO plans, with total PPO plans growing from 136 to 164 and new plans rising from 21 to 36.
Other plan types — Cost, MMP (Medicare-Medicaid Plans), MSA (Medical Savings Account), PFFS (Private Fee-for-Service), and Regional PPOs — collectively represent about 2.7% of total plans. Cost plans fell from 57 to 50, PFFS plans declined by 3 to 24, Regional PPO decreased from 60 to 51, and MMP plans saw a marginal decline by one plan.
3,518 Total Plans
2,010 Total Plans
453 New Additions
357 New Additions
Non-SNP Type
Of the total Non-SNP plans, HMO plans account for approximately 54%, slightly down from 2024, while PPO plans represent around 42%. Local HMO plans experienced the sharpest drop, falling by 173 plans — a 7.1% decrease compared to 2024. Local PPO plans also saw a reduction from 1,819 to 1,762, a 3.1% decrease YoY. Regional PPOs saw a 15.7% YoY decrease, losing 8 plans.
A positive development comes with the addition of 224 new Non-SNP HMO plans and 292 new Non-SNP PPO plans in 2025, indicating a slight recovery in new offerings despite the overall contraction.
D-SNP Type
D-SNP plans continue to exhibit growth, particularly in Local HMO and PPO categories. HMO plans account for approximately 83% of the total D-SNP offerings. Local HMO plans saw a 6.3% YoY increase, adding 46 plans to reach 780. Local PPO plans grew by 18.1% YoY, adding 25 plans to bring the total to 163. Notably, 124 new HMO plans and 42 new PPO plans were added within the D-SNP category.
C-SNP Type
C-SNP saw significant growth, particularly in Local HMO and Local PPO categories. 89% of C-SNPs are HMO plans and 9% are from PPOs. Local HMO plans saw a robust increase of 19.2% YoY, compared to a modest 0.3% in 2024, bringing the total to 348. Local PPO plans also demonstrated strong growth, adding 13 plans to reach a total of 37.
In contrast, Regional PPOs remained static at 6 plans for the fourth consecutive year. Overall, C-SNP plans continue to expand in Local HMO and PPO offerings, while Regional PPOs show no growth. Notably, 90 new C-SNP HMO plans were introduced, along with new C-SNP PPO plans, bringing their total to 14 from 6.
I-SNP Type
70% of I-SNPs are HMO plans; the remaining are PPOs. Local HMO plans slightly increased to 114, reflecting modest growth of 2.7% YoY after a prior-year decline. Local PPO plans decreased significantly by 25% YoY, falling to 48 plans. New HMO I-SNP plans accounted for 15 additions, while PPO plans saw an increase with a total of 9.
"Despite the first-ever contraction, the introduction of new plans in C-SNP and D-SNP categories signals a strategic shift toward targeted, specialized care in Medicare Advantage 2025."
Medicare Advantage 2025 — Navigating the First Contraction Era
After experiencing a peak growth rate of 17.1% YoY during 2019, the Medicare Advantage market steadily slowed, culminating in a 2.1% YoY decline in 2025 — the first drop in Medicare's history. This shift signals a consolidation phase as insurers navigate rising healthcare costs and regulatory pressures, leading to a pullback from unprofitable regions.
Notably, the rise of Renewal Plans with SAR contributed significantly to this industry contraction, impacting around 1.9 million lives, while new plans showed signs of resurgence. While some states experienced growth in plan counts, the national picture reflects a divergence in Medicare Advantage 2025 plan availability, highlighting ongoing challenges and opportunities across the sector.
Despite facing challenges, the introduction of new plans — particularly in C-SNP and D-SNP categories — indicates a strategic shift towards enhancing targeted care. The Medicare Advantage 2025 market's evolution underscores a complex interplay of growth and decline across various plan types. Health plan leaders who understand these dynamics will be best positioned to capture emerging opportunities heading into 2026.
For deeper analytics on Medicare Advantage 2025 market dynamics, explore HealthWorksAI's Medicare Advantage analytics platform. You can also read our latest MA market insights for additional analysis.
