Medicare Advantage enrollment slows, increasing 3.9%

Medicare Advantage enrollment slowed during the 2024 annual enrollment period but remained strong despite significant market headwinds, according to a new analysis from Chartis and HealthScape Advisors.

The analysis found 3.9% growth in MA enrollment from the annual enrollment period, reaching a record 34.5 million people enrolled in an MA plan. However, growth in enrollment decelerated from historic levels of 7% to 10% annual growth in the early 2020s.

Now, over half (51%) of the Medicare population is enrolled in an MA plan, as plans enrolled 1.3 million new beneficiaries during the annual enrollment period.

Meanwhile, enrollment in Traditional Medicare increased by about 200,000 beneficiaries, representing growth after years of contracting numbers.

Together, MA and Traditional Medicare enrollment added 1.5 new beneficiaries during the annual enrollment period, marking the highest on record for overall Medicare program growth. Researchers said this year is expected to be "the peak annual age-in for Medicare overall."

Special Needs Plan (SNP) enrollment also saw dramatic growth during the annual enrollment period, growing by 10.1% and adding 665,000 members. However, this rate is slightly cool compared to previous years, the analysis stated. Still, over 50% of MA enrollments enrolled in SNPs during the enrollment period, with Chronic Condition SNPs seeing the most growth.

"Even with slowed growth, Medicare Advantage enrollment continues to show signs of strength, and it should for the foreseeable future," Nick Herro, a Chartis senior partner in Strategic Transformation and co-author of the report, said in a statement. "Special Needs Plan popularity, anticipated regulatory support by the new administration, and consistent growth in the aging population present future growth opportunities and instill confidence in this market segment."

Health plan executives are confident in plan performance this year. About 91% of plan executives surveyed for the analysis anticipate the same or better performance in 2026 versus just 74% the previous year.

Additionally, 59% of executives said their outlook for growth is positive or extremely positive compared to 47% last year.

The analysis also found a declining number of plan options for consumers, with 5,581 plans available in 2025, down 1.6% compared to last year. The trend over the past five years has been 5.4% growth. In contrast, SNP plan availability grew in 2025.

Health maintenance organizations continued to dominate plan offerings, making up 56% of the non-SNP MA market. Although, preferred provider organization (PPO) plans still saw year-over-year growth, constituting 44% of all plans offered versus 33% in 2020. However, researchers noted that the "proliferation of PPO plans stalled this year, signaling potential plan reluctance to offer broader and often more costly plan types."

For-profit insurers also continue to control the MA market, comprising nearly three quarters, while Blues, nonprofit and provider-sponsored health plans saw marginal market share erosion, despite overall MA enrollment growth.

Jacqueline LaPointe is a graduate of Brandeis University and King's College London. She has been writing about healthcare finance and revenue cycle management since 2016.