Medicare Advantage Enrollment Update 2025

This policy brief is part of the RUPRI Center's ongoing annual series analyzing Medicare Advantage (MA) enrollment trends. It examines both total and rural/urban (nonmetropolitan/metropolitan) enrollment patterns, as well as shifts in the types of MA plans selected by beneficiaries. The brief also explores how past policy changes may have influenced these enrollment dynamics.

Key Findings:

• MA enrollment in 2025 grew 1.5 percent from 2024, marking the smallest annual increase in a decade. However, growth remained higher in nonmetropolitan counties (2.5 percent) than metropolitan counties (1.4 percent).
• Despite past projections, nonmetropolitan MA penetration did not exceed 50 percent in 2025. Instead, it reached 49.2 percent, compared to 56.8 percent in metropolitan counties.
• Much of the growth in nonmetropolitan MA enrollment remains in local preferred provider organization plans.