Here is what you’ll find in this week’s newsletter!

1. Important links 🔗 - the best articles we found this week about the Medicare Market along with links to Jared’s recent LinkedIn posts.

2. Deep Dive 📚 - AEP 2025 → Medicare Advantage Enrollment Growth 🚀

3. Sponsor Snapshot 🚀 - brought to you by Modivcare

4. Compliance Chatter 📢 - Several new regulations to review!

It’s only a 5-minute read, but it will make you 10x smarter.

DEEP DIVE 📚

AEP 2025 → Medicare Advantage Enrollment Growth 🚀

The work of AEP has been over for a while, but we are just now able to see the results of the activity. After a bit of a delay from CMS, February 2025 enrollment data is now available.

This AEP was wild (we predicted it would be). We had:

• Carriers exiting markets

• Plan Terminations and Service Area Reductions (link)

• Benefit Reductions in 2025 plans

• Commissions being pulled from plans mid-AEP (link, link)

• and much more

What was the overall impact on MA/MAPD AEP enrollment?

That is what we are going to start looking at today. Enjoy!

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Medicare Advantage (“MA”) enrollment increased 1.3% during AEP 2025.

A sharp slowdown in growth—less than half the enrollment increase of last year. The 0.45M new enrollees pale in comparison to the ~1M+ growth seen in each of the past three AEPs.

• AEP '22 enrollment increase → ~1.33 million (4.8%)

• AEP '23 enrollment increase → ~1.10 million (3.7%)

• AEP '24 enrollment increase → ~0.99 million (3.1%)

• AEP '25 enrollment increase → ~0.45 million (1.3%)

[NOTE: this utilizes enrollment by Contract, Plan, State, County which excludes some enrollment counts.]

It looks to me like all of the changes going on in the MA market resulted in more consumers sticking with Original Medicare than had been during previous AEPs.

In today’s deep dive we will look at the makeup of the 0.45 million member growth.

First, we will explore Geography and Health Plan. Next week we will explore Plan Types.

The definition of “AEP enrollment increase” is the change in enrollment counts from December 2024 to February 2025.

Geography

To start off we will look at AEP results by state. I always like to say that in Medicare, each state is its own unique market.

The amount of growth in each state is influenced by how many (or little) Medicare eligibles there are in the state, how high or low the MA penetration is, where Health Plans expanded or removed their product offerings, how strong (or weak) networks are, and many other factors.

The map below shows the enrollment growth during AEP 2025 by state.

The top 10 states in terms of overall AEP growth are:

There were a few states where enrollment declined during AEP:

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One factor in a state market’s ability to grow MA membership is the level of penetration the state is already at.

(Note: “penetration”= count of MA members / count of Medicare eligibles)

There is a point in which MA growth tends to slow down once a certain penetration % is achieved.

The chart below is showing AEP growth % by state compared to that state’s penetration %.

You can see that (in general) the higher the penetration, the lower the % growth. This year’s “trend” is not as clear as last year. I think that’s due to many Carrier’s exited certain markets where they were less profitable, resulting in some major outliers (Vermont, New York).

[This excludes Alaska because it messed up the chart. AK grew 23% and started with a 1.3% penetration]

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Health Plans

There was one Health Plan that clearly “won” in terms of membership growth during AEP 2025.

While some others showed impressive % growth and several decreased membership as expected.

Here is a look at the top and bottom 10 Health Plans by growth (including both Individual and Employer Group combined).

As expected, UnitedHealth “won” AEP growing 380,000 members.

Elevance, Cigna, Lifetime Healthcare and BCBS of MI rounded out the top 5.

Lifetime Healthcare’s growth is primary driven by the acquisition of CDPHP’s MA block (also why CDPHP is shown in the bottom 10).

Humana and CVS had the largest drop in enrollment (as expected).

One interesting note is that if you exclude Employer Group plans and only look at Individual plans (SNP and non SNP combined) UnitedHealth dominated this AEP even more.

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In addition to looking at Health Plans that had the highest overall member growth, it’s also interesting to look at Health Plans with the highest growth percentage.

The table below shows the top 11 growth % companies (excluding any that have <10,000 membership growth).

We already discussed Lifetime Healthcare’s growth.

The other Health Plan that stands out is Medicare Mutual of Ohio. They were one of the companies that stopped paying commissions mid-AEP. It’s possible they were growing faster than they thought sustainable.

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That’s all for today! Next week will be Part 2 where we will take a closer look at AEP results by Plan Types.

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_{Source Data: Medicare Market Insights MA/MAPD/PDP Enrollment Web App. which uses Dec 2024 and Feb 2025 CMS Medicare Advantage/Part D Contract and Enrollment Data, CMS PBP Benefits Q42024, CMS CY2025 Landscape Files}

_{Note: Enrollment data excludes plans with less than 10 enrollees}

If you’re ready, here are some ways we can help you:

• Newsletter Sponsorship opportunities: Promote your product or services to leaders in the Medicare space. Let’s discuss. (link)

• Market Research: Reports that help you wrap your arms around the Senior focused insurance markets. (link)

• Consulting: We can help you develop new insurance products for the Medicare market, appraise your books of business, and keep you compliant. Let’s discuss. (link)