A new report released by the Better Medicare Alliance, a research and advocacy organization that supports Medicare Advantage, says millions of seniors will face significant disruptions to their Medicare Advantage plans next year and federal policy decisions are to blame.
While premiums for the average Medicare Advantage enrollee will remain stable next year, a new analysis said that seniors will see a reduction in plan choices, higher out-of-pocket costs, and fewer supplemental benefits. Better Medicare Alliance said in a study announcement that these changes are a direct result of recent federal policy decisions that impact the Medicare Advantage program, including insufficient funding, coding changes, and changes in the Inflation Reduction Act, as well as pressures from higher utilization rates and growing medical costs.
“As policymakers consider policy and payment changes for 2026, stability for the Medicare Advantage program is critical to minimizing further disruption and preventing unintended consequences for beneficiaries,” the Better Medicare Alliance said in the executive summary of the report.
The study, conducted by Avalere on behalf of Better Medicare Alliance, is based on 2025 Medicare Advantage and Part D Landscape and Plan Benefit Package files released recently by the Centers for Medicare & Medicaid Services (CMS).
The report found:
- Individual Medicare Advantage plan offerings will decline by 6.54 percent in 2025, while Special Needs Plans (SNPs) will increase 8.5 percent.
- The median out-of-pocket maximum will increase by eight percent, 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.
- While dental, vision, and hearing benefits remain stable, fewer plans will offer other important benefits that close coverage gaps. Specifically:
o Plans offering fitness benefits will decline from 98 percent to 96 percent
o In-home support services will decline from nine percent to six percent
o Meals will decline from 72 percent to 66 percent
o Nutrition services will decline from 40 percent to 29 percent
o The over-the-counter benefit, which helps defray costs of certain health and wellness products, will decline from 86 percent to 73 percent
o Transportation offerings will decline from 36 percent to 29 percent of plans
The number of available plans varies greatly depending on the state. For example, Mississippi will see an approximate 23 percent increase, while Vermont will face a 66.7 percent decrease. Overall, 31 states will see a decrease in the availability of individual Medicare Advantage plans, and seven states and the District of Columbia will see a decrease in the availability of SNPs. Changes in premiums, out-of-pocket costs, and benefits will also vary by state.